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Introduction

The NHS is the largest employer in Wales and currently employs more than 103,000 people, in almost 89,000 full-time equivalent (FTE) posts. Data on staff employed by the NHS is available from 1979; however due to changes in the classifications of staff only the overall numbers are strictly comparable over time.

There have been a number of changes to the NHS occupation manual and several data quality issues identified in recent years. These affect the comparisons over time for some staff groups; further details can be found in the quality report.

The time period covered by this data includes the coronavirus (COVID-19) pandemic. Most of the staff groups at 30 September 2021 included staff on short term or fixed contracts. These included recently retired staff brought in to help during the COVID-19 pandemic.

The data exclude General Medical Practitioners and some Dental Practitioners as they are independent NHS Contractors.

The data is sourced from the NHS Electronic Staff Record, provided by Health Education and Improvement Wales.

Data included in this release is published on StatsWales.

Main points

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Chart showing the number of staff directly employed by the NHS in Wales, by staff group, at 30 September 2020 and 2021. All groups except for the HCAs and other support staff have increased since 30 September 2020.

Between 30 September 2020 and 30 September 2021 (in terms of full-time equivalent numbers):

  • the total number of staff increased by 3,493 (4.1%) to 88,638
  • medical and dental staff increased by 294 (4.1%) to 7,505
  • nursing, midwifery and health visiting staff increased by 926 (2.7%) to 35,688
  • other staff groups increased by 2,273 (5.3%) to 45,445

Summary of staff employed

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Chart showing the number of staff directly employed by the NHS in Wales each year between 1979 and 2021, broken down by staff group. The chart shows that since 1979 the number of full time equivalent staff has increased by 89.0% and by 4.1% in the most recent year.

The total number of staff directly employed by the NHS (FTE) has gone up from 46,909 in 1979 to 88,638 in 2021, an increase of 89.0%.

The increase of 4.1% in the number of staff between 30 September 2020 and 30 September 2021 is lower than the previous year, but is also likely to be partly due to the recruitment of temporary staff in response to the COVID-19 pandemic.

Table 1: Number of staff (FTE) directly employed by the NHS in Wales at 30 September 2020 and 30 September 2021, and the percentage change from 30 September 2020
Staff groups At 30 September 2020 At 30 September 2021 % change from 2020
Medical and dental      
Hospital medical 1 6,798 7,096 4.4%
Hospital dental 169 166 -2.3%
Community / public health medical 49 46 -4.8%
Community / public health dental 2 195 197 1.2%
All medical and dental staff 7,211 7,505 4.1%
Nursing, midwifery and health visiting      
Registered nurses and health visitors 21,898 22,591 3.2%
Registered midwives 1,377 1,379 0.2%
Support staff 3 4 11,487 11,718 2.0%
All nursing, midwifery and health visiting staff 34,762 35,688 2.7%
Scientific, therapeutic and technical      
Qualified staff 11,164 11,443 2.5%
Support staff 3,347 3,620 8.2%
All scientific, therapeutic and technical staff 14,512 15,063 3.8%
Administration and estates      
Senior Manager / Manager 2,538 2,662 4.9%
Clerical and Administrative 15,770 17,249 9.4%
Maintenance and Works 1,415 1,672 18.1%
All admin & estates staff 19,722 21,583 9.4%
Health Care Assistants and other Support Workers      
Health Care Assistant 3 94 107 13.6%
Support Worker 6,080 5,799 -4.6%
All HCAs and other support staff 6,174 5,906 -4.3%
Ambulance      
Registered staff 1,151 1,107 -3.8%
Support staff 4 1,518 1,677 10.4%
All ambulance staff 2,670 2,784 4.3%
 Other      
Other non-medical staff 5 94 109 15.8%
Total 85,145 88,638 4.1%

Source: Health Education and Improvement Wales (HEIW)

Note: further details on staff groups can be found in the quality report.

1 See GP trainees
2 See Dentists (non-hospital dental staff)
3 See Healthcare Assistants (H1s) and Nursing Assistants / Auxiliaries (N9s)
4 See Ambulance personnel
5 Staff on general payments, and other non-medical staff. Also see Other staff.

All staff groups except for the Health Care Assistants and other support staff showed an increase in staff numbers from 30 September 2020 to 30 September 2021. It is likely that some staff who were taken on temporarily during the COVID-19 pandemic are still recorded on the ESR system.

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Pie chart showing the proportion of staff by staff group at 30 September 2021. The biggest group is the nursing, midwifery and health visiting group, making up 40% of the total.

NHS staff summary on StatsWales 

At 30 September 2021, almost half of the staff directly employed by the NHS in Wales were either medical and dental staff, or belonged to the nursing, midwifery and health visiting group. The nursing, midwifery and health visiting group was the largest staff group, accounting for 40% of all staff.

Medical and dental staff

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Line chart showing the FTE numbers of hospital medical staff from 2009 to date, all grades and consultants. Total hospital medical staff have increased by 1,805 (34.1%) since 30 September 2009, and by 298 (4.4%) since 30 September 2020 to 7,096 at 30 September 2021. Hospital medical consultants have increased by 747 (38.3%) since 30 September 2009, and by 87 (3.3%) since 30 September 2020, to 2,699 at 30 September 2021.

Total hospital medical staff (FTE) have generally increased steadily from 2009, however there has been a more noticeable increase since 30 September 2019. This is also true for medical consultants.

Hospital medical staff (FTE) have increased by 1,805 (34.1%) since 2009, and by 298 (4.4%) since 30 September 2020, to 7,096 at 30 September 2021.

Hospital medical consultants (FTE) have increased by 747 (38.3%) since 2009, and by 87 (3.3%) since 30 September 2020, to 2,699 at 30 September 2021.

Total hospital dental staff (FTE) have remained at around 160 since 2009. Dental consultants (FTE) have also remained fairly consistent in number but have increased by 4 (9.3%) since 30 September 2020, to 49 at 30 September 2021. 

Nursing, midwifery and health visiting staff

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Line chart showing the FTE numbers of nursing, midwifery and health visiting staff, at 30 September 2009 and annually to date. Registered nursing staff have increased by 2,223 (10.2%) since 30 September 2009, and by 695 (3.0%) since 30 September 2020.

Both registered nursing, midwifery and health visiting staff, and nursing support staff, have generally increased since 2009. Whilst these staff decreased slightly in number in September 2018, there was a marked increase in September 2020 with numbers increasing further by September 2021.

Registered nursing staff (FTE) have increased by 2,223 (10.2%) since 2009 and by 695 (3.0%) since 30 September 2020, to 23,969 at 30 September 2021.

Nursing support staff (FTE) have increased by 2,305 (24.5%) since 2009 and by 231 (2.0%) since 30 September 2020, to 11,718 at 30 September 2021. 

Other staff groups

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Line chart showing the FTE numbers of other staff, at 30 September 2009 and annually to date. Apart from the Health Care Assistants and other support staff group, all staff groups show an increase of staff since 2009.

NHS staff on StatsWales

Scientific, therapeutic and technical staff (FTE) have increased by 3,799 (33.7%) since 2009, and by 552 (3.8%) since 30 September 2020, to 15,063 at 30 September 2021. There has been a consistent increase in numbers since 2014.

Administration and estates staff (FTE) have increased by 5,515 (34.3%) since 2009, and by 1,861 (9.4%) since 30 September 2020, to 21,583 at 30 September 2021. Following small decreases from 2009, numbers have increased each year since 2012. The latest annual increase is the highest percentage increase seen.

Ambulance staff (FTE) have increased by 929 (50.1%) since 2009, and by 114 (4.3%) since 30 September 2020, to 2,784 at 30 September 2021. There was a marked increase of 16.0% from 2018 to 2019 (mainly due to significant changes to the ambulance section of the NHS occupation codes manual, see the quality report for more information) and a further increase of 9.8% from 2019 to 2020.

Healthcare assistants (HCAs) and other support staff (FTE) have decreased by 594 (9.1%) since 30 September 2009, and by 268 (4.3%) since 30 September 2020 to 5,906 at 30 September 2021; this is partly affected by the re-coding of some HCAs to nursing assistants / auxiliaries, see the quality report for more information.

More detailed breakdowns within the staff groups, including staff numbers for individual NHS organisations, are available on StatsWales

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.

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 Well-being 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.

Contact details

Statistician: Bethan Sherwood
Telephone: 0300 025 6735
Email: stats.healthinfo@gov.wales 

Media: 0300 025 8099

SFR 49/2022