The provision of health and social care is a subject that is relevant to us all – we have heard that staff shortages result in operations being cancelled or that there are inadequate cover levels in nursing homes.
Most NHS staff in England are British – but around 139,000 of 1.2 million staff report themselves to be non-British. Of these, around 62,000 are nationals of other EU countries. Since Brexit, the health and social care sector has been significantly affected by the uncertainty for EU employees.
The EU’s free movement policy led to large increases in European staff in the NHS, the number of Portuguese nurses rose from 210 to 3,388 and Spanish nurses from 406 to 4,107. Both these nationalities saw a reduction in numbers after Brexit. Our infographic illustrates some of the pre and post Brexit figures.
The solution to staff shortages seems relatively simple: immigration restrictions on low paid workers in the health sector could be relaxed after Brexit. The Government is responding to the recruitment and retention challenge so that by increasing the number of nurses in training the UK will be able to meet any potential shortfall in staffing levels.
The impact of tightening immigration rules is not limited to the NHS; around a fifth of care-workers currently employed in UK care homes were born outside the UK.
What can employers do?
EU nationals will need to understand the impact of Brexit on their immigration status, and employers who rely on EU nationals will need to review and protect the stability of their business.
To do this employers would be well advised to consider supporting and encouraging early applications for permanent residence from those employees who qualify, because Home Office queues are getting longer by the day. If employers are unable to retain their foreign employees, their only other option is to find creative ways to attract UK workers into the health and social care sector by offering training, career progression, or re-skilling existing staff. These measures may also help retain workers in a sector already struggling with funding cuts and tight margins.
Is there anything else to consider?
Recruitment and retention appear to be the immediate issues for the health and social care sector, but the impact of Brexit will be much broader. For example, how will we continue to access treatment in EU countries when we go on holiday after Brexit is one area that will affect many of us – currently we just need to have an up-to-date European Health Insurance Card.
Regulation is another area where the impact of Brexit will feel very real. At the moment the EU countries have a harmonized regulatory regime for medicines; this could well change once we leave the EU and we may end up with a separate vetting procedure for EU-sourced drugs.
In many important areas, the Government will need to clarify whether its intention is to repeal EU regulations and replace them with UK-drafted alternatives or to continue to abide by them.