14 October 2019


Read our latest update on how Brexit will impact health care services. 


So when is Brexit happening?

The UK is currently scheduled to leave the European Union on or before 31 October 2019. Parliament has recently passed a law, however, that requires the Prime Minister to request an extension until January 2020 if a deal for leaving the EU has not been agreed by 19 October.


Will Brexit have an impact on the health service?

Yes. Forecasting what that impact will be, however, is far from easy. Much will depend on whether the Government are able to agree a deal with the EU before the UK exits.


Has a deal been agreed?

Not yet.


Ah. So what happens if the UK leaves without a deal?

Nobody knows for certain. Possibilities range from a minimal impact on day-to-day life, to pretty major disruption across a number of sectors. Under a no-deal Brexit, very few existing international agreements that the UK has been party to previously will still have effect. Only a handful of the most vital exceptions have been agreed (the EU has agreed, for example, to allow UK air traffic to continue to operate more-or-less as usual in the event of no-deal).


In most instances, however, immediate resilience against any potential disruption will rely chiefly on contingencies being put in place by individual organisations. Within healthcare, this could be very difficult. Newly released government documents warn that medicines and medical products could be particularly vulnerable to severe extended delays caused by customs issues. Although stockpiling can help in some cases, certain products have short shelf lives, and the government warns that even stockpiling would not be able to cover delays forecast to last up to six months.


Is there anything I can do?

The Department for Health and Social Care is acting to try to mitigate these possible problems. They have issued guidance on Operational Readiness that your Trust or Health Board should already be aware of, covering supply of medicines, goods and services, workforce, reciprocal healthcare and clinical trials. 


There is also more detailed guidance on the regulation of medicines and medical devices. Below is a summary of some of the most common areas of concern, for ease of reference. For most specific queries, your first port of call should be your Trust’s clinical director or other senior management. BSR’s policy team will also gladly assist members with any further questions.


How easy will it be to access medicines?

The government have asked all pharmaceutical companies to ensure they have a minimum of six weeks’ additional supply in the UK, in preparation for exit day. This request was originally made in readiness for a March 2019 departure from the EU, and it is unclear whether a change in exit day will have affected these preparations. Companies were also asked to make arrangements to air freight medicines with a short shelf life, such as medical radioisotopes.


To support this, the government has also made funding available for additional storage space, and will seek to prioritise available transport capacity for medical supplies if needed.


Understandably, some patients are nervous about being able to access medicines they rely on. Official advice urges against encouraging individuals to stockpile medicines themselves as a precaution.


This is, perhaps, the area of greatest concern among the medical community, and further clarity is being sought from the government about supply chains and contingency plans. For the time being, we recommend following government advice about stockpiling, however the society will keep members updated with any significant developments.


What about workforce issues? Will EU nationals be forced to leave the UK?

The government have put in place a Settlement Scheme, to allow all EU national UK residents to apply for settled status in advance of the UK leaving the EU. No EU nationals currently residing and working within the UK should have to leave because of Brexit. We understand, however, that individuals may be facing problems with the application process. Unfortunately, the society is not able to offer individual assistance with this, but members of the BMA may find their support useful.


The impact of Brexit on recruitment of new staff is less clear. The government have announced that they plan to end Freedom of Movement for EU citizens within the UK, and instead move to a points-based immigration system. How this will function in practice is still unclear, and it is likely that the new system will not be in place in time for exit day. No interim arrangements have been announced, although it may be anticipated that they will be closer to the time.


We believe that many services within the NHS will face severe workforce pressures following Brexit. This document will be updated as and when further information becomes available, but in the meantime please do keep the BSR team informed of any issues your department encounters.


Will patients still be able to access healthcare abroad? Can EU citizens access healthcare here?

In a no deal exit, UK nationals resident in the EU and Switzerland may face barriers to accessing healthcare, as international treaties will expire. The Government has announced that they are seeking to protect current reciprocal healthcare rights through temporary agreements with other countries, but details are yet to be announced.


The government has not commented on the impact of EU national UK residents. There is also no confirmation of whether UK nationals resident in European countries, but who access prescriptions on the NHS, will have their status changed.


I collaborate with colleagues abroad through a European Research Network. Will this be affected?

Unfortunately, yes. The government says that in a no-deal Brexit, UK clinicians would be required to leave European Reference Networks. 


I’m involved in a clinical trial. Will this be impacted?

Probably. Detailed information is available in the government’s operational readiness guide, but their first advice is to contact your trial sponsor for confirmation of plans.


Okay, so that’s what happens with no deal. But what if the UK and EU agree a Brexit deal?

Then this whole FAQ needs rewriting! At the current time, it seems unlikely that a deal will be agreed before 31 October, if the UK does end up leaving the EU on that date. If a deal is agreed, however, then healthcare issues are likely to be a central part – with existing arrangements carried over through a transitional period while replacement treaties are agreed.


Under any kind of deal, it is highly unlikely that there will be any disruption to medicines or medical supplies, and we can expect that access to healthcare for UK citizens abroad and EU citizens in the UK will be maintained as at present. Research agreements are more of a question, but these too would likely be maintained, at least temporarily.


The biggest question mark under an agreed deal exit is over workforce. The most likely outcome is that freedom of movement would be maintained to some extent during transition, but this may not necessarily be the case. Trusts, Health Boards and individual departments would be best advised to prepare accordingly.


What if I have another question not answered here?

Email us and we'll do our best to help!