Scheduling public holidays in healthcare: continuity without overtime spikes

Published on 2 October 2026

A shop can close on 1 November. A residential care centre cannot. In healthcare, a public holiday isn't a pause in the schedule — it's an extra puzzle: the same staffing levels, fewer people available, and afterwards a pile of compensatory rest that also needs a slot in the work schedule.

Practice shows what happens when you tackle that puzzle too late: last-minute phone calls, double shifts, and an overtime counter that is already creeping towards the ceiling in early January. This article sets out exactly what the Belgian rules require, and how to plan public holidays in healthcare without an overtime spike.

The basics: ten public holidays, even when you have to keep working

Every employee in Belgium is entitled to ten statutory public holidays a year. That entitlement doesn't disappear because you work in a sector where the doors stay open. Hospitals, residential care centres, home nursing and other care providers fall under the exceptions to the ban on working on public holidays — so you may have people work, but you must compensate them.

Three principles your schedule rests on:

Does the public holiday fall on a Sunday or a normal day of inactivity? Then it has to be replaced by another day. In principle, those replacement days are set and communicated before 15 December of the preceding year. More on that in Planning public holidays 2026: replacement days before 15 December.
Does someone actually work on the public holiday? Then that person is entitled to paid compensatory rest, in principle within six weeks of the public holiday. Worked more than four hours? That means a full day of compensatory rest. Four hours or less gives a half day.
Premiums follow your sectoral collective agreement. The law governs the compensatory rest; pay for Sunday and public holiday work in the care sectors is largely set through collective agreements. So check your own joint committee for the exact percentages and how they combine with night premiums.

First work out how big the puzzle really is

Many department heads underestimate the volume. Make the calculation explicit for a single ward:

Say you have a ward with 24-hour staffing, three shifts a day, four staff per shift. That's 12 public holiday shifts per public holiday. Across ten public holidays: 120 public holiday shifts a year. With a team of 24 people, that works out at an average of five public holiday shifts per person — plus 120 days of compensatory rest that you have to fit in somewhere during the year.

Those 120 days are the part that's often forgotten. Compensatory rest isn't a bonus that "sorts itself out": it is staffing time you lose in the six weeks after the public holiday. If you don't plan it in advance, you fill the gaps with colleagues' overtime — and that's how the spiral starts.

Why the overtime spike happens in January

The classic chain of events: Christmas and New Year fall close together, there's a peak in leave requests, and you plug the gaps with extra shifts. In January, December's compensatory rest days come on top of that, so staffing drops again. Whoever already worked extra in December ends up working a bit more extra in January.

Legally, you then run into two limits:

The internal ceiling on the overtime counter (143 hours in most cases). Anyone who hits that limit has to take compensatory rest before you may have them work more overtime.
Rest periods: at least 11 consecutive hours of rest between two shifts, plus a weekly rest period. A late shift followed by an early one is quickly scheduled — and just as quickly unlawful.

Good public holiday planning is therefore not only a matter of fairness, but also of compliance. See also Maximum working hours in Belgium.

Five scheduling rules that make the difference

1. Schedule the compensatory rest together with the public holiday shift

As soon as you roster someone for 21 July, you schedule the compensatory rest day within six weeks in the same move. Not as a separate request afterwards, but as a fixed pair in the work schedule. That way you immediately see where a staffing gap appears and can absorb it with the rest of the monthly schedule in view.

In Forganiser you can enter that compensatory rest as a separate code in the schedule, so it counts towards your staffing calculation instead of popping up as a surprise.

2. Divide public holidays using a multi-year rotation

Don't spread the load per public holiday, but per cycle. A simple scheme that works in many care teams:

Group A works Christmas, group B works New Year — the other way round the following year.
The "smaller" public holidays (1 May, 21 July, 15 August, 1 and 11 November) rotate through the team in a fixed order.
Whoever worked Easter last year goes to the bottom of the list this year.

Keep the rotation visible to everyone. Arguments about public holidays are rarely about the work itself; they are almost always about the feeling that the split isn't fair. A transparent history per employee takes the heat out of that.

3. Collect public holiday preferences in two rounds

First a round in which staff indicate their one absolute priority for the year (their child's communion, the family trip). Then a second round for the rest. That way you avoid the fastest applicant snapping up all the popular days. Our practical approach to requests in shift work is set out in Managing leave requests in shift work.

4. Build a flexible outer layer around your fixed core

Public holidays are exactly the moments when a small flexible reserve makes the difference between a minor gap and a double shift:

Student workers for support tasks that don't require a care qualification (meal distribution, logistics, reception).
Part-time staff who want to work more hours temporarily, with a correct annex to the employment contract.
Flexi-jobbers, provided your joint committee falls under the extension — always check this for your sector and job role. Our practical guide is at /flexibele-arbeid.

Important: those extra hands are not a solution for structural understaffing. They cover the peak, not the average.

5. Put one person in charge of watching the counters

Give one person per ward the responsibility of looking at three figures every month: overtime balance per employee, outstanding compensatory rest older than four weeks, and the number of public holiday shifts worked per person. Three figures, once a month. That's enough to step in before the counter hits the ceiling.

Don't forget the admin behind the public holiday

Public holidays have a knock-on effect in your payroll and HR administration:

Correct codes for public holiday hours worked, public holidays not worked, replacement days and compensatory rest. A wrong code means a wrong pay calculation — and a correction two months later.
Registration of the hours actually worked, so that premiums and overtime are demonstrable. That is also exactly what an inspector will ask for; see Social inspection: which documents do you need ready?.
Dimona declarations and contracts for temporary staff you bring in around the public holidays — preferably automatically from your schedule, so that a last-minute change on Christmas Eve doesn't mean someone has to log in manually. More on that at /administratie.
Publication of work schedules, especially for variable part-time contracts. In healthcare these often coincide; we worked it out in Publishing variable part-time work schedules in healthcare.

Checklist: public holiday planning in healthcare

Replacement days for public holidays falling on a Sunday or day of inactivity set and communicated before 15 December.
Public holiday calendar with the required staffing per shift per public holiday, at least a quarter ahead.
Rotation scheme with a history per employee, visible to the team.
Compensatory rest scheduled together with the public holiday shift, within six weeks.
Overtime balance and internal ceiling monitored monthly.
Flexible reserve (students, part-timers, possibly flexi-jobbers) contacted in advance, not on the day itself.
Payroll and registration codes checked before payroll processing.
Dimona declarations and contracts for temporary staff followed up automatically.

From firefighting to planning ahead

Public holidays in healthcare are predictable: you know the dates a year ahead, you know your staffing standard, and you know your team. The spike isn't caused by the public holiday itself, but by the fact that the compensation only comes into view when it already has to be taken.

So treat the public holiday, the premium and the compensatory rest as one package in your schedule from the start. That way you keep continuity on the ward and an overtime counter that is still healthy in February. See what that looks like in practice on our page for healthcare and welfare or in the overview of personnel management.