What will happen to health and care provision in a no-deal Brexit?
There are a huge number of unknowns around the timing and shape of the UK’s departure from the European Union.
In this article we outline the concerns reported by three leading healthcare organisations around health and care. And we look at government advice to care providers on preparing for Brexit.
Possible challenges around health and care
Three organisations – the King’s Fund, the Nuffield Trust and the Health Foundation – have written to Members of Parliament expressing their view of the implications of a no-deal Brexit for health and care services. The organisations say they have used objective evidence to determine where the impact is likely to be felt most sharply.
- A risk of intensifying staff shortages. There are already 100,000 vacancies in NHS trusts and a further 110,000 in social care. Uncertainly around settled status and exchange rates could mean that some of the 116,000 EU nationals working in healthcare and 104,000 in social care could leave the UK. Many social care workers earn less than a previously proposed threshold for a permanent work visa. The loss of workers could put further pressure on an already hard-pressed care sector.
- Shortage and price rises for vital supplies. The group is concerned that new paperwork and regulatory hurdles could create new shortages of medicines and medical devices. Costs are likely to rise as a result, which will be passed on to the NHS, meaning the health service will need more money or have to cut other services.
- Around 200,000 UK citizens using the special EU scheme that guarantees healthcare right to retirees abroad could lose that protection and want to return to the UK. There are a further 800,000 UK nationals living in Europe who might also choose to return if they cannot access or afford care.
- An extra £205.5 billion has been pledged to the NHS in England, but the group believes both the NHS and social care need more investment to make up for reduced spending in recent years. The group is concerned that in a no-deal Brexit, this funding will not be available.
What is the government view?
The UK government has published advice for health and social care providers in England around how to manage the run-up to a potential no-deal Brexit and what happens next.
For the healthcare providers, there’s an operations guide that outlines how an additional agency will offer advice to NHS organisations, alongside the usual organisational structure. This includes potential effects and what should be done to address shortages of medicines, which we’ve covered in a separate article here on When They Get Older.
The effects on the adult social care system are also addressed. The overall message appears to be that organisations should check that their business continuity planning is up to date. (Business continuity is often used alongside the term ‘disaster planning’, and is all about having back-up options if operational problems arise within the organisation. It’s more usually associated with physical disasters such as fire or floor, or cyber attack.)
The advice is that:
- Service providers shouldn’t stockpile medicines or encourage service users to do so, but should make sure they have 5 days’ worth of supplies, and be prepared to take delivery outside normal working hours
- Providers should review staffing plans, and ensure EU citizens know about the EU settlement scheme. Providers should contact the Care Quality Commission if they are worried about service levels
- Professional qualifications of staff from the EU and other countries will continue to be recognised
- Data sharing may be affected and service providers may need to find other ways to hold and transfer vital personal data
Scotland, Wales and Northern Ireland
While the advice above refers to England in many cases, the Scottish government offers much the same viewpoint and refers readers to the UK government pages for more information.
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