Northern Ireland's five health and social care trusts have published savings plans as the Department of Health seeks to close an estimated £800m funding gap and restore financial balance over three years.
The trusts have been asked to deliver cash-releasing and efficiency savings of 4% in the current financial year. The target forms part of the Department's Reset and Recovery programme rather than a requirement to remove 12% of spending in a single year.
The Department said the health and social care system is spending more than £2m a day over budget. Its £800m estimate is based on current proposals for 2026-27 and includes about £280m for pay awards and the introduction of the real living wage, although the Executive has not yet agreed a budget.
Trust-level measures include controls on vacancies and reduced reliance on bank, agency and locum staff. The plans also envisage changes to the number of hospital beds as more care is moved into community settings closer to patients' homes.
Other proposals include standardising care pathways, shortening hospital stays and reorganising services considered vulnerable. The trusts are also expected to work together on workforce, finance, procurement and partnership decisions through a new Committees in Common structure.
The Department said resources released through the programme would be redirected towards primary care, voluntary-sector provision and support for older people in their own homes. Its wider policy is intended to move more treatment from hospitals into community services while using health data to target spending.
Reset and Recovery delivered savings of more than £300m in 2025-26, following more than £200m in the previous year, according to the Department. Officials have nevertheless acknowledged that the next stage will be a difficult and continuing process for the trusts.
The plans will now move into implementation while the Executive considers the 2026-27 budget. The Department has said the trusts will be supported as the measures are put into effect.