Refreshed Delivering Care Policy Framework published

Date published: 24 March 2026

The Refreshed Delivering Care Policy Framework provides a clear and regionally consistent approach to determining safe and effective staffing and skill mix across midwifery and all fields of nursing.

It strengthens guidance for Health and Social Care Trusts and commissioners on workforce and workload planning, thereby supporting a culture of safety and improving staff wellbeing.

Minister Nesbitt said: 

“In the last 12 years since the Framework was first published our Health and Social Care system has faced a growing list of significant pressures, including an ageing population with more complex needs, longer waiting lists, rising demand for mental health and wellbeing support services, persistent health inequalities, and of course, highly constrained budgets. Against that backdrop, a re-examination of the Framework was necessary to ensure it remains fit for purpose. 

“These challenges highlight why workforce planning must be robust, evidence based, and future focused. Ensuring we have the right staff, with the right skills, in the right place at the right time, therefore remains fundamental to maintaining safety and quality and in meeting future demand.

“This Framework makes clear that safe and effective staffing is not only a professional standard, but a strategic priority embedded throughout our system’s governance.

“It will also support the much-needed transformation of our Health and Social Care system to better meet the needs of our population, and is therefore aligned to both the Reset Plan, and the Department’s five-year vision for nursing and midwifery.”

This is the first time that the Framework has been refreshed since its inception in 2014.

Population needs, service models, and the wider health and social care landscape have changed significantly over the last decade. Recognising this evolving context and the emergence of new evidence, a task and finish group was convened in autumn 2023 by Chief Nursing Officer Professor Maria McIlgorm to refresh the Framework.

The emphasis of the refresh is on clarifying the roles, responsibilities and accountability from ward to board and beyond, including tools and methods to assist robust workforce planning and improve consistency across the region.  The refreshed framework will support and aid in the preparation for any safe staffing legislation.

The revised accountability framework contained within this framework will:

•             Strengthen reporting mechanisms

•             Provide shared accountability

•             Provide and reinforce the importance of evidence to support and inform decision making.

Going forward, operational workforce planning is the responsibility of Health and Social Care Trusts and independent employers. The framework will support more responsive and context sensitive staffing decisions that align with the health needs of local populations. By supporting workforce planning responsibilities with those who are closest to service delivery, the system strengthens its ability to plan safely, effectively, and in a way that reflects real patient need.

Professor McIlgorm said: 

“Within the Health & Social Care system, Nursing and Midwifery represent the largest segment of the workforce. Ensuring the right staff, equipped with the appropriate skills, knowledge, and professional values, and deployed effectively, is critical to meeting evolving challenges and delivering improved outcomes and experiences for the population of Northern Ireland.

“We must prioritise workforce sustainability through effective recruitment and retention, valuing staff, and promoting wellbeing via robust workforce and workload planning and with clearly defined career pathways.

“This Framework outlines how we will achieve this for Nursing and Midwifery in Northern Ireland, while preparing for the potential introduction of safe staffing legislation.”

The Framework can be read in full here: https://www.health-ni.gov.uk/sites/default/files/2026-03/Delivering%20Care%20Policy%20Framework.pdf