What are the biggest issues facing health and social care in the wake of Brexit?
For public and private providers alike working in health and social care, there are significant issues to deal with in the post-Brexit world.
Staying informed of changing trends and priorities is crucial for business leaders. They need to plan with the right staffing and training to meet future patient needs. Strategic positioning and service provision are also important.
It’s important to know that on an EU wide basis, healthcare provision is not a marked and significant competence.
The UK relies on incoming talent from across the world. They are crucial in training specialists and implementing cutting-edge healthcare practices. This helps to deliver advanced services across the NHS and private provision space.
The Brexit vote has significant implications for health and social care. This is especially true as the NHS is currently facing tremendous operational and financial pressures.
The degree of anticipated impacts from Brexit on health and social care industries cannot be quantified yet. Policymakers will have to carefully address and consider a number of issues that may arise.
Staffing issues after Brexit
Currently, many UK healthcare workers are from the EU and beyond.
55,000 NHS workers from the EU and 80,000 adult social care workers, according to figures from Skills for Care.
The NHS is struggling to attract and retain quality permanent staff. In 2014, a 5.9% shortfall in permanent resource equated to a gap of around 50,000 full-time roles.
Areas which are particularly struggling include health visitors, midwives and nurses according to the National Audit Office 2016 figures.
The social care sector has a high turnover of over 25%, which represents around 300,000 staff leaving their roles annually.
Until the details of the UK’s employment and migration policy with the EU is clarified. The existing freedom of movement regulations remains in place.
The government has publicly reassured EU staff working in the NHS. “We will support their right to remain and work in the UK.” Many healthcare providers would like to see the retained right to recruit EU staff. This would be particularly important when resident equivalents are not available.
This could be done by adding key health and social care roles to the shortage occupation list maintained by the Migration Advisory Committee, which currently allows employers to recruit midwives and nurses from beyond the EEA.
As the UK clarifies its employment and migration policies, ensuring the right to recruit EU staff for essential healthcare roles, especially during night shifts, becomes crucial. Including these roles on the shortage occupation list allows healthcare providers to address staffing gaps and maintain quality care throughout the night.
Treatment access in health sector after Brexit
The impact of immigration and treatment access on the NHS is another hot issue. Where immigration to the UK grows, the pressure on public health and social care services tends to grow with it.
The current European Health Insurance Card is an important measure for guaranteeing reciprocal care within EU countries for EU nationals. The government will need to define arrangements for the future.
Around three million EU migrants currently live in the UK, and around 1.2 million British migrants live in EU countries. They will need reassurance that they can continue to access healthcare on a similar basis to the existing EHIC scheme.
The parties will need to agree on this as part of the ‘divorce’ settlement.
Certain non-EU countries already have reciprocal healthcare arrangements that could serve as a model.
Regulation in health and social care
The government will need to decide whether it continues to abide by existing EU regulations on areas such as working hours, competition and procurement law, the regulation of medical devices and medicines, and professional standards regulations and medical education.
The healthcare industry considers these areas absolutely crucial, and they could potentially affect the way they deliver and accredit training.
Clinical trials could also be heavily impacted and the UK may seek to rework the way that new drugs are developed and brought to the market.
It’s important to note too that the EU has a heavy governance role when it comes to public health.
It has systems that detect and warn about communicable diseases, which are overseen by the European Centre for Disease Prevention and Control.
This currently allows for cross-border cooperation on health threats and possible pandemics.
Recent examples include collaboration on efforts to overcome resistant to antimicrobials (AMR) and the response to the H1N1 pandemic.
This EU wide cooperation also has allowed the UK to enjoy a strongly successful record of scientific research thanks to its ability to access key funding sources and EU-wide research talent.
In 2015, the ONS found that the UK accessed over 8.8 billion EUR for R&D and contributed 5.4 billion EUR to R&D.
The medical and academic communities have already flagged up their concerns about leaving the EU within the context of medical research and science.
Hopes are that the Brexit discussions will prioritize the issues of access to research talent and funding for specialist scientific investigations.
Finance and funding in health and social care
The Vote Leave campaign claimed before the referendum that the UK could directly pump the money it puts into the EU’s membership pot into the NHS.
This was one of the most contentious aspects of the campaign and then rapidly refuted by many Leave politicians.
The campaign said that EU membership cost £350 million a week to the UK. It also suggested that a Brexit decision could lead to £100 million extra a week. This would be in excess of the amounts agreed by the Spending Review and would be directed towards the NHS.
The NHS is certainly facing huge pressure in the wake of limited finance and dwindling performance against more challenging targets.
Ultimately, the UK’s economic performance will help to influence the NHS and its funding.
A strong economy means healthy tax receipts and the ability to fund public spending campaigns, so ongoing stability will be key to public health services.
Many NHS leaders have called on the government to provide extra funding for social care. Social care has already experienced heavy cuts resulting in around 400,000 fewer Britons receiving public social care sources.
The health and social care industries will continue to work hard to ensure that they are heard, and that the government gives necessary priority and focus to these key strategic areas to ensure a healthy, happy and adequately funded post-Brexit world of health and social care provision. They will also work towards finding the right staff. Brexit negotiations are still in full swing and negotiators are working through the details in lengthy and complex negotiations.
where training can be properly accredited and where specialist research activities and funding access can continue unabated, for the good of patients across the UK and beyond.
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