Brexit has major implications for health and social care in England. Here we look at some of the latest developments that could impact the health and care system in England.
The deadline of 29 March 2019, set when Article 50 was triggered, is rapidly approaching but many important issues are still to be resolved. Brexit has already had an impact, especially on the recruitment and retention of EU nationals in some parts of the workforce which is contributing to shortages of key staff. In addition, the ongoing debate in parliament and uncertainty about whether a deal can be agreed mean considerable work has gone into preparations for a no-deal Brexit. The Department of Health and Social Care has published guidance for organisations to prepare contingency plans and has established a national operational response centre to lead on responding to any disruption to the delivery of health and care services.
Across NHS trusts there is currently a shortage of more than 100,000 staff (representing 1 in 11 posts), severely affecting some key groups of essential staff, including nurses, many types of doctors, allied health professionals, and care staff. Vacancies in adult social care are rising, currently totally 110,000, with around 1 in 10 social worker and 1 in 11 care worker roles unfilled. International recruitment is a key factor in addressing these vacancies. Brexit and immigration policy will have an impact on the ability of the NHS to successfully fill these vacancies.
The policy of freedom of movement and mutual recognition of professional qualifications within the EU means that many health and social care professionals currently working in the UK have come from other EU countries. This includes nearly 62,000 (5.2 per cent)1 of the English NHS’s 1.2 million workforce and an estimated 104,000 (around 8 per cent)2 of the 1.3 million workers in England’s adult social care sector (NHS Digital 2018; Skills for Care 2018). The proportion of EU workers in both the NHS and the social care sector has grown over time, suggesting that both sectors have become increasingly reliant on EU migrants.
The UK has a greater proportion of doctors who qualified abroad working than in any other European country, except Ireland and Norway. Latest General Medical Council (GMC) data shows that the number of doctors from the European Economic Area (EEA) joining the medical register is holding steady (but still down 40 per cent on 2014 after new language requirements were introduced). A combination of relaxed visa restrictions and active recruitment by trusts means that the number of non-EEA doctors joining the register doubled between 2014 and 2017 (GMC 2018). However, some specialties not currently on the Home Office’s shortage occupation list are still facing difficulties, for example child and adolescent psychiatry.