This page gives an overview of key pressures faced by Health and Social Care (HSC) in Northern Ireland. We also have analysis for pressures on the national health systems in England, Wales, and Scotland. Note that available data is not always comparable across all nations.

Last updated: 15 October 2026

NHS backlog

Northern Ireland is facing a substantial backlog of care exacerbated by the pandemic.

Waiting lists remain high

In June 2026 (latest data), over 81,000 patients waited for inpatient or day case treatment, with approximately 28,000 waiting over 52 weeks for an appointment. At the same time, almost 505,000 patients were recorded as waiting for an outpatient appointment, resulting in a total waiting list of approximately 586,000 patients.

Changes to how data is collected, and insufficient data recorded on the new system (‘Encompass’) mean that we cannot directly compare trends over time from the present day; however, historical data shows waiting list rising rapidly prior to 2023 (prior to the roll out of Encompass), with a continuous increase for outpatient cases since March 2020.

In September 2023, (the last pre-Encompass data point), there were almost 116,000 patients waiting for an inpatient or day case admission and about 429,000 patients waiting for a first consultant led outpatient appointment at hospitals. This amounts to a total of approximately 545,000 people waiting for elective care in Northern Ireland, the highest recorded since the dataset began in June 2008. This is around 1.4 times higher than in March 2020, at the start of the pandemic and 4.8 times higher than in June 2008.

Consequently, people are now waiting longer for treatment. The number of patients waiting between one to two years for a first consultant-led outpatient appointment rose drastically from about 117,000 in March 2020 to over 212,000 in September 2023 – a 81% increase.

Though there is currently insufficient data to analyse trends, waiting list data in the period after the encompass patient record system was introduced in 2023 show that figures remain high. In June 2026, over 81,000 patients waited for inpatient or day case treatment, with approximately 28,000 waiting over 52 weeks for an appointment. At the same time, almost 505,000 patients were recorded as waiting for an outpatient appointment, resulting in a total waiting list of approximately 586,000 patients in June 2026.

Performance against waiting times targets

Performance of the Health and Social Care (HSC) Trusts in Northern Ireland against the waiting times targets introduced in 2016/17 has declined dramatically since their introduction.

The target that 55% of patients should wait no longer than 13 weeks for inpatients/day case treatment has never been met, with the percentage waiting less than 13 weeks reaching an all-time low of 11% in June 2020.

In June 2026 (latest data), using non-comparable data recorded on the new Encompass system, 36.2% of patients were waiting less than 13 week – still well below the 55% target.

The target to have no patients waiting longer than 52 weeks has never been achieved. From June 2016, the numbers of patients waiting longer than 52 weeks rose to a peak of 70,871 (56.4%) in March 2022.

In June 2026, using non-comparable data recorded on the new Encompass system, 27,675 patients, were waiting longer than 52 weeks for an inpatient or day case admission to hospitals, or 34.1% of all such patients.

The target to have 50% of patients waiting less than 9 weeks for a first consultant-led outpatient appointment has never been achieved. By June 2023 (final pre-encompass data point), just 17.9% of patients were waiting under 9 weeks for a first consultant-led outpatient appointment.

In June 2026, using non-comparable data recorded on the new Encompass system, only around 15% of patients were waiting less than 9 weeks.

Cancer targets are not attained

Health and Social Care Trusts are failing to meet the waiting time targets for cancer care services at hospitals in Northern Ireland.

While the proportion of patients starting treatment within 31 days of a decision to treat previously remained consistently at or near the 98% target, rates gradually decreased in the decade up to December 2024 (last encompass data point).

In June 2026, using non-comparable data recorded on the new Encompass system, the proportion starting treatment within 31 days sits at 89%.

The proportion of patients starting treatment within 62 days of an urgent GP referral for suspected cancer rapidly declined in the decade up to December 2024 (latest pre-encompass data point). The 95% target has never been met.

In June 2026, using non-comparable data recorded on the new Encompass system, only 28% of patients started treatment within 62 days.

The percentage of breast cancer patients seen within 14 days of an urgent referral has repeatedly fluctuated over time and targets have not been met since 2012.

In June 2026, using non-comparable data recorded on the new Encompass system, only 6.2% of breast cancer patients were seen within 14 days of an urgent referral.

Patients are waiting longer for emergency admissions

Pressures on emergency care in Northern Ireland are rising. Since the pandemic, waiting times at A&E have progressively increased, leading to a higher proportion of people now waiting over 12 hours.

In March 2026 – the latest A&E data available - about 72,086 people attended A&E departments in Northern Ireland. 41% of those patients were seen in under 4 hours, a major decline against the 91% seen within 4 hours in April 2008, when this data collection began.

Over 17% of patients waited over 12 hours for an emergency admission in March 2026. While this a slight improvement to the first few months of 2023, it is a significant increase when comparing to the 4% in March 2019, before the pandemic began.

Medical staffing (secondary care)

The overall growth of the Health and Social Care (HSC) workforce in Northern Ireland slowed down in 2022 and 2023, but has been increasing since 2024. In March 2026, the HSC workforce stood at approximately 68,000 whole-time equivalent (WTE), a 14% increase since the start of the COVID-19 pandemic in March 2020, but only grew by 2.2% since March 2025.

The Medical & Dental staff group made up 8.1% of the total HSC workforce.  

Expansion in the medical workforce is increasing. As of March 2026, there were 5,555 WTE Medical staff employed. The workforce has grown by 6.5% from March 2025 to March 2026.

Vacancies are fluctuating

The total number of vacancies [1] under active recruitment in secondary care in HSC Northern Ireland has oscillated over the years. The definition of a vacancy used by the Department of Health only includes those being actively recruited, which excludes a number of posts not filled by a permanent doctor, for example, those awaiting approval for recruitment or where recruitment has previously failed and there is no live advertisement for the role.

BMA Northern Ireland research has shown that the number of posts not filled by a permanent consultant are more than double the reported vacancy total across Northern Ireland. 

The vacancy rate for consultants in December 2024 was 7.8%, and 7.6% in December 2023. Data previously obtained via BMA Northern Ireland information requests showed a consultant vacancy rate of 15.5% in September 2021 and 20.3% in September 2023. However, the Department of Health reported significantly lower figures for the same periods — 5.5% in 2021 and 7.6% in 2023. This suggests that the Department of Health had significantly under-reported and is likely replicated in other branches of practice, due to the narrow scope of its definition of a vacancy.

The total number of vacancies under active recruitment in the Medical & Dental staff group has fluctuated over time, with a record high of 431 vacancies in June 2026 - this is equivalent to a vacancy rate of 6.6%.

As of June 2026, there were 158 vacant consultant posts – a 25% increase since June 2019. There were 59 SAS (Associate Specialist/Staff Grade/ Specialty Doctors) vacancies actively being recruited in the same month, which is a decrease from the 80 vacant SAS posts the previous year (June 2025).

Pressures in general practice

The overall GP workforce across Northern Ireland has grown slowly since 2014. As of March 2026, there were 2,076 GPs (headcount), including locums. The total GP headcount excluding locums in March 2026 was 1,505. While this is a 28% rise in the number of GPs since March 2014, it is a mere a 2.5% increase since March 2025. Note: headcount figures do not distinguish between those working full time and those working less than full time. As a result, headcount figures do not account for WTE (Whole Time Equivalent), and therefore will not reflect GPs’ full capacity.  

The changing demographics of the GP workforce are reflected in the charts below. In terms of gender profile of GPs, there has been a gradual descending trend in the number of male GPs with a steeper increase in the number of female GPs. In March 2026, 60.8% of the GP workforce was female compared to 39.2% male. This is a pronounced shift in gender profile since 2014 when 45.5% of GPs were female and 54.5% were male.  

The older age bands are comprised of a higher percentage of male GPs than female GPs. In March 2026, over half of GPs in the 55-59 and 60+ age groups were male, while there were more female GPs in the younger age groups. Almost 67% of GPs in the 25-39 age band were female compared to about 33% male GPs. 

While there is an increasing number of Salaried GPs, the number of GP Partners has been declining since 2022.

At the same time, the number of patients is rising yearly. In March 2026, there were 2.08 million patients registered with a GP practice in Northern Ireland.

It remains to be seen whether the rising number of registered patients will be sustained by the slow growth of the GP workforce.