Staff directly employed by the NHS: at 30 September 2023
Data on medical, dental, nursing and midwifery staff, at 30 September 2023.
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Introduction
This statistical release provides summary statistics on staff directly employed by NHS Wales. The release includes analyses by staff group and staff characteristics at Wales level. Data categorised by occupational code and NHS organisations are published on StatsWales.
The statistics are sourced from the NHS Electronic Staff Record, provided by Health Education and Improvement Wales. Staffing numbers are best measured by using full-time equivalent (FTE) data as FTE accounts for part-time working. One FTE is the equivalent of a person working the standard hours for their grade (usually 37.5 hours a week) and more detail is provided in the quality report. Overall headcount numbers are also provided and are used for analysis of characteristics.
This release focusses on staff employed on the last day of the latest available quarter and provides a ten-year time series for certain analyses. Data on staff employed by the NHS is available from 1979 on StatsWales; however due to changes to the NHS occupation manual only the total number of staff are strictly comparable over the whole time series. Further details can be found in the quality report.
Workforce data for primary care services such as general medical practitioners (GPs) and NHS dental practitioners are not included in this release and are published separately as they are independent NHS contractors.
Main points
Between 30 September 2022 and 30 September 2023, in terms of full-time equivalents (FTE):
- the total number of staff increased by 3,838 (4.2%) to 95,446
- medical and dental staff increased by 267 (3.4%) to 8,103
- nursing, midwifery and health visiting staff increased by 1,832 (5.1%) to 37,962
- scientific, therapeutic and technical staff increased by 642 (4.0%) to 16,627
- administration and estates staff increased by 985 (4.3%) to 23,715
- ambulance staff increased by 96 (3.3%) to 3,018
- healthcare assistants and other support staff increased by 22 (0.4%) to 5,900
- other staff (including general payments and other non-medical staff) decreased by 7 (5.2%) to 119
The total staff headcount also increased by 4,242 (4.0%) to 110,421.
Where characteristic data was recorded, on 30 September 2023:
- 77% of the workforce was female; 23% was male
- 79% were 55 years old or younger; 19% were 56 to 65 years old; and 2% were 66 years or older
- 94% had no recorded disability; 6% had a disability recorded
- 91% had UK nationality; 6% had non-EU nationalities and 2% had EU or EEA nationalities
- 91% were from any white ethnic group; 5% were from any Asian ethnic group; 1% were from any black ethnic group; 1% were from mixed ethnic groups; and 2% were from other ethnic groups
Summary of staff directly employed
Figure 1: Number of full-time equivalent (FTE) staff directly employed by NHS Wales on 30 September, 2014 to 2023
Description of Figure 1: Line chart showing that the number of FTE staff has increased over the last 10 years, with a sharper increase since 2019.
Source: Electronic Staff Record, Health Education and Improvement Wales (HEIW)
NHS staff summary by staff group and year on StatsWales
The total number of FTE staff directly employed by the NHS has increased over the long-term with almost a third (31.7%) more staff in September 2023 than there were in September 2014.
The annual increase in staff between September 2022 and September 2023 was 4.2%. This is higher than in the previous year and in years prior to the COVID-19 pandemic, but slightly lower than the increase between 2019 and 2020 where there was a high number of temporary staff recruited in response to the pandemic.
Historic NHS workforce data from 1979 to 2008 is also published on StatsWales.
The number of full-time equivalent staff (FTE) recorded in each staff group is shown in Figure 2.
Figure 2: Number of full-time equivalent (FTE) staff directly employed by NHS Wales on 30 September, by staff group, 2014 to 2023
Description of Figure 2: Line charts showing a long-term upward trend in the number of FTE staff for medical and dental; nursing; scientific, technical and therapeutic; administration and estates; and ambulance staff groups. The FTE of healthcare assistants has remained at broadly similar level.
Source: Electronic Staff Record, Health Education and Improvement Wales (HEIW)
NHS staff summary by staff group and year on StatsWales
[Note 1] Includes midwifery and health visiting staff
[Note 2] Healthcare assistants (HCAs) and other support staff
8.5% of FTE of all staff on 30 September 2023 were medical and dental staff. The number of staff in this group has increased each year over the last ten years and has increased by a little more than a third (34.4%) since 30 September 2014.
The upward trend has been more prominent in recent years and there were a little more than a fifth additional (21.1%) medical and dental staff on 30 September 2023, than there were on 30 September 2019. The annual percentage increases in FTE have been greater in each year since the pandemic than in the years prior to the pandemic.
39.8% of FTE of all staff on 30 September 2023 were nursing, midwifery and health visiting staff, which was the largest staff group. There has been a steady long-term upward trend with staff increasing by just over a fifth (21.0%) since 30 September 2014. The latest annual increase was 5.1%, the highest since comparable data collected from 2009.
17.4% of FTE of all staff on 30 September 2023 were scientific, therapeutic and technical staff. The number of staff in this group has increased every year for the last ten years and was 42.5% higher on 30 September 2023 than on 30 September 2014.
24.8% of FTE of all staff on 30 September 2023 were in the administration and estates group. The number of staff in this group has increased every year for the last ten years and was 56.3% higher on 30 September 2023 than on 30 September 2014.
3.2% of FTE of all staff on 30 September 2023 were ambulance staff. Significant changes to the ambulance section of the NHS Occupation Codes Manual between 2018 and 2019 limit long term comparisons, but there was nearly a quarter (24.1%) more ambulance staff on 30 September 2023 than on 30 September 2019.
6.2% of FTE of all staff on 30 September 2023 were healthcare assistants (HCAs) and other support staff. HCAs and other support staff have remained broadly stable over the last ten years, with some small year-to-year fluctuations. The number of staff in this group decreased by 4.2% compared to 2014, but increased by 0.4% compared to 30 September 2022. The number of staff in this group has fluctuated since 2014 and is partly affected by the re-coding of some HCAs to nursing assistants/auxiliaries, see the quality report for more information.
There were 119 FTE other non-medical staff on 30 September 2023. Numbers of staff in this group have remained broadly stable since 2014.
Health professional students and recently retired staff recruited to help during the COVID-19 pandemic are included in staff numbers from 2020. On 30 September 2023, around 70 FTE staff were coded to these types of staff role.
Medical and dental staff
Figure 3: Number of full-time equivalent (FTE) hospital medical staff on 30 September, 2014 to 2023
Description of Figure 3: Line chart showing that the number of FTE hospital medical staff of all grades has increased over the last 10 years, with marked increases since 2019. The FTE number of consultants has also increased since 2014.
Source: Electronic Staff Record, Health Education and Improvement Wales (HEIW)
NHS medical and dental staff by grade and year on StatsWales
The large majority of staff in the medical and dental staff group are categorised as hospital medical staff. On 30 September 2023, there were 7,683 FTE hospital medical staff, 3.1% higher than on the same date in the previous year and 35.9% higher than on the same date ten years ago.
Consultants are the most senior grade of hospital doctors and are specialists in a particular field of medicine. On 30 September 2023, there were 2,826 FTE hospital medical consultants, 2.4% higher than on the same date in the previous year and 27.2% higher than on the same date ten years ago.
The total number of FTE hospital dental staff has remained close to 160 since 2014. There were 54 FTE hospital dental consultants on 30 September 2023 which has also remained broadly consistent over the decade.
Nursing, midwifery and health visiting staff
Figure 4: Number of full-time equivalent (FTE) nursing, midwifery and health visiting staff on 30 September, 2014 to 2023 (Revised)
Description of Figure 4: Line chart showing an increase in the number of all FTE nursing staff, over the last 10 years, with marked increases from 2019. The number of registered nurses has remained broadly double the number of support staff, with both groups increasing on a similar long-term trend.
Source: Electronic Staff Record, Health Education and Improvement Wales (HEIW)
Nursing, midwifery and health visiting staff, by grade and area of work on StatsWales
Registered nurses and midwifes are qualified staff who are registered to the Nursing and Midwifery Council (NMC) and are governed by the NMC Code. On 30 September 2023 there were 25,501 (r) FTE registered nursing and midwifery staff, 5.0% higher than on the same date in the previous year and 15.6% (r) higher than on the same date ten years ago.
Nursing support staff are those who work with registered nurses to deliver patient care but are not registered to the NMC. On 30 September 2023 there were 12,462 (r) FTE nursing support staff, 5.3% (r) higher than on the same date in the previous year and 33.5% (r) higher than on the same date ten years ago.
[r] revised on 17 May 2024. 17 FTE nursing support staff were incorrectly recorded as registered nurses.
Staff characteristics
This release includes analyses on NHS Wales staff characteristics. Headcount numbers are used for this analysis. Statistics for all staff, and by selected staff groups, are presented on gender, age band, disability, nationality and ethnicity. Additional data for individual organisations is available on StatsWales.
Staff characteristics statistics are based on records where a known status was recorded, and therefore provide an indication of the characteristic breakdown of NHS staff in Wales. The percentage of not stated and missing records is included with each section indicating the level of uncertainty with these statistics. If the staff with missing data have a systemically different characteristic profile than those with a known status, these statistics would change.
Statistics shown in Figures 5 to 12 are rounded to the nearest per cent.
Figure 5: Percentage of staff directly employed by NHS Wales by staff group and gender, 30 September 2023 [Note 1]
Description of Figure 5: Stacked bar chart showing that the majority of staff were female in most staff groups, including: nursing, midwifery and health visiting; scientific, therapeutic and technical; administration and estates; and other staff. Ambulance staff and medical and dental staff had a larger percentage of male staff.
Source: Electronic Staff Record, Health Education and Improvement Wales (HEIW)
Per cent of NHS staff by organisation, staff group and gender on StatsWales
[Note 1] There were no records with missing gender data.
[Note 2] Includes some healthcare assistants, other support staff and other non-medical staff.
On 30 September 2023, 77% of all NHS staff in Wales were female, and 23% were male. This is unchanged from the previous year and is in large-part due to nine out of ten of the largest staff group (nursing, midwifery and health visiting) being female.
Close to three quarters of the staff in both the scientific, therapeutic and technical (77% female), and administration and estates (74% female) staff groups were female.
There were two staff groups where there were more males than females, these were ambulance staff (59% male) and medical and dental staff (54% male).
Figure 6: Percentage of staff directly employed by NHS Wales by age band, 30 September 2023 [Note 1]
Description of Figure 6: Bar chart showing that the percentage of staff directly employed by NHS Wales is fairly evenly spread between the ages of 26 and 60. There were fewer staff in the youngest and oldest age bands.
Source: Electronic Staff Record, Health Education and Improvement Wales (HEIW)
Per cent of NHS staff by organisation, staff group and age band on StatsWales
[Note 1] There were no records with missing age band data.
On 30 September 2023, 7% of staff were aged 25 or younger and 9% were aged 61 or older, both unchanged from the previous year.
The large majority of staff (84%) were aged between 26 and 60, spread broadly similarly over all five-year age bands within this age range. 47% of all staff were aged between 26 and 45, one percentage point higher than in the previous year; while 37% of all staff were aged between 46 and 60, one percentage point lower than in the previous year.
Figure 7: Percentage of medical and dental staff by age band, 30 September 2023 [Note 1]
Description of Figure 7: Bar chart showing that there was a high proportion of medical and dental staff in younger age groups, peaking in the 31 to 35 age band. There was a broad decrease in the percentage of staff in each age band after this point.
Source: Electronic Staff Record, Health Education and Improvement Wales (HEIW)
Per cent of NHS staff by organisation, staff group and age band on StatsWales
[Note 1] There were no records with missing age band data.
There was a higher proportion of medical and dental staff in the younger age bands when compared to all NHS staff on 30 September 2023. Half (50%) of medical and dental staff were aged between 26 and 40; while one in twenty (5%) were aged 61 or older, both unchanged from the previous year.
Figure 8: Number of nursing, midwifery and health visiting staff by age band, 30 September 2023 [Note 1]
Description of Figure 8: Bar chart showing a broadly similar spread of the percentage of nursing, midwifery and health visiting staff across each five-year age band between the ages of 26 and 60. There were fewer staff in the youngest and oldest age bands.
Source: Electronic Staff Record, Health Education and Improvement Wales (HEIW)
Per cent of NHS staff by organisation, staff group and age band on StatsWales
[Note 1] There were no records with missing age band data.
The age distribution of nursing, midwifery and health visiting staff was broadly similar to the distribution of all NHS staff on 30 September 2023. 7% of staff were aged 25 or younger and 8% were aged 61 or older, both unchanged from the previous year.
The large majority of staff in this group (85%) were aged between 26 and 60, spread broadly similarly over all five-year age bands within this age range. 48% of all staff in this group were aged between 26 and 45, one percentage point higher than in the previous year; while 37% of all staff were aged between 46 and 60, two percentage points lower than in the previous year.
Age distributions for other staff groups are available on StatsWales.
Figure 9: Percentage of staff directly employed by NHS Wales by disability status, 30 September 2023 [Note 1]
Description of Figure 9: Stacked bar chart showing that the percentage of staff with a disability recorded is similar for each staff group.
Source: Electronic Staff Record, Health Education and Improvement Wales (HEIW)
Per cent of NHS staff by organisation, staff group and disability on StatsWales
[Note 1] 21% of records on 30 September 2023 had missing or undisclosed disability status; this compares to 25% in the previous year.
[Note 2] Includes some healthcare assistants, other support staff and other non-medical staff.
Of all staff with a known disability status on 30 September 2023, 94% had no disability recorded, one percentage point lower than in the previous year; while 6% had a disability recorded, one percentage point higher than in the previous year. There was little variation across most staff groups with the percentage of staff with a disability recorded ranging from 3% in the medical and dental group to 8% for the ambulance staff group.
Figure 10: Percentage of staff directly employed by NHS Wales by nationality, 30 September 2023 [Note 1]
Description of Figure 10: Pie chart showing the large majority of staff have UK recorded as their nationality. Of the staff who were not recorded as UK nationals, there were more non-EU staff than EU and EEA (European Union and European Economic Area) staff.
Source: Electronic Staff Record, Health Education and Improvement Wales (HEIW)
Per cent of NHS staff by organisation, staff group and nationality on StatsWales
[Note 1] 13% of records on 30 September 2023 had missing or undisclosed nationality data; this compares to 15% in the previous year.
Of all staff with known nationality on 30 September 2023, 91% had UK nationality, one percentage point lower than on the same date last year; 6% had non-EU nationalities, one percentage point higher than on the same date last year; and 2% had EU or EEA nationalities, unchanged from the same date last year.
Data by staff group is available on StatsWales and shows that the medical and dental staff group had more variation than the other staff groups. Two thirds (66%) of medical and dental staff with known nationality had UK nationality, just over a quarter (28%) had non-EU nationalities, while 6% had EU or EEA nationalities.
Of the other staff groups, 99% of ambulance staff were recorded as UK nationals (the highest of any group), while 91% of nursing staff were UK nationals (the lowest of the non-medical and dental staff groups).
Figure 11: Percentage of staff directly employed by NHS Wales by ethnicity, 30 September 2023 [Note 1]
Description for Figure 11: Bar chart showing that the large majority of staff were recorded in white ethnic groups. The next highest ethnic group was Asian/Asian British, while there were fewer staff in the remaining ethnic groups.
Source: Electronic Staff Record, Health Education and Improvement Wales (HEIW)
Per cent of NHS staff by organisation, staff group and ethnicity on StatsWales
[Note 1] 12% of records on 30 September 2023 had missing or undisclosed ethnicity data, the same proportion as in the previous year.
Of all staff with a known ethnic group on 30 September 2023, a little more than nine out of ten (91%) were in white ethnic groups. One in twenty (5%) were in any Asian ethnic group, while 1% were in any black ethnic group, 1% were in mixed ethnic groups, and 2% were in other ethnic groups. The spread of staff between ethnic groups was broadly similar to the same date in the previous year.
Figure 12: Percentage of medical and dental staff by ethnicity, 30 September 2023 [Note 1]
Description for Figure 12: Bar chart showing that the spread of ethnic groups for medical and dental staff in Wales is different than the spread for all NHS staff. While the large majority of staff are recorded in white ethnic groups, there is a higher percentage of staff in all other ethnic groups.
Source: Electronic Staff Record, Health Education and Improvement Wales (HEIW)
Per cent of NHS staff by organisation, staff group and ethnicity on StatsWales
[Note 1] 38% of medical and dental staff had missing ethnicity data on 30 September 2023, compared to 35% in the previous year.
There was more variation in the distribution of ethnic groups in medical and dental staff than in all other staff groups on 30 September 2023. Nearly six out of ten (57%) staff were any white ethnic group, while close to three out of ten (28%) staff were of any Asian ethnic group.
The proportion of any black ethnic group, mixed ethnic group and other ethnic groups were all higher than in any other staff group.
Quality and methodology information
The data is sourced from the NHS Electronic Staff Record provided by Health Education and Improvement Wales. Further information is available in the quality report.
The number of staff directly employed by the NHS has some seasonal patterns, linked to set times in the year when newly qualified staff can be recruited into permanent roles. As such, comparisons are made with the same quarter from the previous year.
When based on full-time equivalent (FTE) figures, the percentages in this release are rounded to the nearest 0.1. When based on headcount figures, the percentages in this release are rounded to the nearest per cent. Percentage point changes are calculated based on the unrounded numbers.
Data on Sickness absence in the NHS and vacancies in NHS Wales are published on a quarterly basis. Note that there are minor differences in how staff groups are defined between the releases. These are detailed in the quality report.
Full details of quality issues identified with the data in recent years are provided in the quality report.
Workforce data on general medical practitioners (GPs) and NHS dental practitioners are not included in this release and are published separately as they are independent NHS contractors.
Well-being of Future Generations Act (WFG)
The Well-being of Future Generations Act 2015 is about improving the social, economic, environmental and cultural wellbeing of Wales. The Act puts in place seven wellbeing goals for Wales. These are for a more equal, prosperous, resilient, healthier and globally responsible Wales, with cohesive communities and a vibrant culture and thriving Welsh language. Under section (10)(1) of the Act, the Welsh Ministers must (a) publish indicators (“national indicators”) that must be applied for the purpose of measuring progress towards the achievement of the wellbeing goals, and (b) lay a copy of the national indicators before Senedd Cymru. Under section 10(8) of the Well-being of Future Generations Act, where the Welsh Ministers revise the national indicators, they must as soon as reasonably practicable (a) publish the indicators as revised and (b) lay a copy of them before the Senedd. These national indicators were laid before the Senedd in 2021. The indicators laid on 14 December 2021 replace the set laid on 16 March 2016.
Information on the indicators, along with narratives for each of the wellbeing goals and associated technical information is available in the Wellbeing of Wales report.
Further information on the Well-being of Future Generations (Wales) Act 2015.
The statistics included in this release could also provide supporting narrative to the national indicators and be used by public services boards in relation to their local wellbeing assessments and local wellbeing plans.