Health Minister Mike Nesbitt has approved significant changes to childcare regulations in Northern Ireland, paving the way for childminders to care for more children while easing some of the recruitment pressures facing the sector.

The reforms, which follow a public consultation involving almost 500 responses, will alter adult-to-child ratios in both childminding and group day care settings and reduce the requirement for GP-signed health assessments for many childcare workers.

The changes are expected to have a direct impact on childcare availability, staffing pressures and costs for providers and families across Northern Ireland at a time when many parents continue to struggle with access to affordable childcare.

Minister says sector needs “stability and certainty”

Announcing the measures, Mr Nesbitt said maintaining safety and quality in childcare remained “of paramount importance” while recognising the pressures faced by providers.

“I am committed to improving the childcare experience for all stakeholders – providers, staff, parents and carers. The changes outlined below will, I hope, provide some stability and certainty to the sector,” he said.

The Department of Health said the changes followed a review of Minimum Standards and feedback gathered during a consultation which ran between March and June 2025.

A total of 495 responses were submitted by organisations, childcare providers, staff, parents and individuals.

GP checks to be reduced for many childcare workers

One of the most significant changes relates to the requirement for prospective childcare workers to obtain GP countersigned health assessments before starting work.

Under the revised approach, Health and Social Care Trusts will only require GP-signed declarations for the most senior childcare roles, including registered childminders, the person in charge of a day care setting, or assistants to the person in charge.

The Department said the consultation showed widespread support for the move.

Mr Nesbitt acknowledged the existing system had contributed to recruitment difficulties within the childcare sector.

“The consultation exercise confirmed that there have been occasions when the HSC Trusts’ policy of requiring GP countersigned health declarations to be provided by all prospective childcare workers had negatively affected recruitment within the childcare sector, due in part to the challenges posed by the numbers seeking GP assessments,” he said.

The Minister added that staff members who no longer require GP countersignatures would still work under supervision within childcare settings.

“Those individuals for whom a GP declaration is not required will be managed and supervised by at least one other person within the setting. This provides opportunities for any issues of concern in relation to an individual’s mental or physical health, which are not disclosed on their health assessment, to be identified and acted upon.”

Childminders to be allowed care for more children

From 1 June 2026, new adult-to-child ratios will apply to registered childminders.

A single childminder will be permitted to care for up to two children under 18 months old, replacing the current restriction of one child under 12 months.

They will also be allowed to care for up to three children below compulsory school age.

That figure can increase to four where at least two of the children are siblings and one is below school age.

Overall, a childminder will be able to care for up to eight children under the age of 12, including their own children, provided no more than six are under the age of eight.

The revised ratios are likely to be closely watched by parents and providers amid continuing concerns over childcare capacity and affordability across Northern Ireland.

Supporters argue the changes could help increase childcare availability and ease pressure on waiting lists, while critics of ratio expansions in other regions have previously raised concerns around workload and safeguarding pressures.

Covid-era group day care ratios made permanent

The Department has also confirmed that temporary adult-to-child ratios introduced during the Covid-19 pandemic for group day care settings will now become permanent.

The ratios, first introduced in 2021, include:

• one adult for every three children aged under two

• one adult for every five two-year-olds

• one adult for every eight children aged three

• one adult for every 10 children aged over four

The Department confirmed that at least two staff members must still be on duty in every room within a childcare setting at all times.

During the pandemic, ratios for two-year-olds were changed from 1:4 to 1:5, while ratios for children aged four to 12 moved from 1:8 to 1:10.

Those temporary changes had remained in place pending the wider review of Minimum Standards.

Further childcare standards review planned

Mr Nesbitt said officials will now continue discussions with childcare providers, HSC Trusts, parents and staff as part of a broader review of childcare standards.

“I would like to thank all those interested parties and individuals who took part in the consultation,” he said.

“My officials will be making contact with a range of stakeholders, including HSC Trusts, childcare providers, parents and staff, to seek their feedback on the wider Minimum Standards.

“Any further proposed changes to the Minimum Standards will be made in the context of my overall priority of ensuring childcare remains a safe and high quality experience for all children.”

The changes mark one of the most significant updates to childcare operational rules in Northern Ireland in recent years and are expected to influence staffing practices, childcare availability and provider operations across the sector from this summer onward.