With global temperatures, populations and ecological stressors expected to rise, hydrological droughts are projected to have progressively severe economic and environmental impacts. As a result, hydrological drought forecasting systems have become increasingly important water resource management tools for mitigating these impacts. However, high frequency behaviours in meteorological or atmospheric conditions often limit the lead times of hydrological drought forecasts to seasonal timescales, either through poorer performance of multi-year meteorological forecasts or the lack of multi-year lags in atmosphere-hydrology systems. By contrast, low frequency behaviours in regionally important teleconnection systems (such as the North Atlantic Oscillation, NAO) offer a novel way to forecast hydrological drought at longer lead times. This paper shows that, by using a data-driven modelling approach, long-term behaviours within the NAO can be skilful predictors of hydrological drought conditions at a four-year forecasting horizon. Multi-year semi-periodic patterns in the NAO were used to forecast regional groundwater drought coverage in the UK (proportion of groundwater boreholes in drought), with the greatest forecast performance achieved for longer duration droughts, and for hydrogeological regions with longer response times. Model errors vary from 14 % (proportion of boreholes, (MAE)) in flashy hydrological regions or short droughts (<3 months), to 2 % for longer duration droughts (>8 months). Model fits of r2 up to 0.8 were produced between simulated and recorded regional drought coverage. As such our results show that teleconnection indices can be a skilful predictor of hydrological drought dynamics at multi-year timescales, opening new opportunities for long-lead groundwater drought forecasts to be integrated within existing drought management strategies in Europe and beyond.