Brexit: What does it mean for doctors?

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Brexit: What does it mean for patients and doctors? is part of a series of briefings produced by the Royal College of Physicians (RCP) outlining key statistics on topics surrounding Brexit negotiations and beyond. 

 Workforce stats in brief

  • 9.3% of doctors working in the NHS are from EU member states.[1]
  • There are significant regional variances across the country: for example, 1.7% of EU doctors work in the north-east compared with 10.1% in south London.[2]
  • Certain specialties are more reliant on doctors from EU member states than others: for example, 11% of cardiology specialists, 13% of infectious disease specialists and 14% of neurology specialists are from EU member states.[3]
  • 21% of doctors who qualified overseas have told the RCP that they plan to leave the UK in the next 5 years or are unsure of their plans[4] and 45% of EU doctors currently working in the UK are considering leaving the UK following the referendum vote, with another 29% saying they are unsure.[5]
  • 37% of registered doctors gained their initial qualification / primary medical qualification outside of the UK.[6] This rises to 42.1% for consultants.
  • The top three reasons cited for considering leaving were the UK’s decision to leave the EU, a current negative attitude towards EU workers in the UK, and continuing uncertainty over future immigration rules.[7]

The impact

The lack of guarantees for doctors about whether they or their colleagues will be able to remain in the UK after Brexit compounds the challenges of an already demoralised workforce.[8][9] It is likely that Brexit will make it harder for the NHS to recruit new doctors from the EU and the uncertainties about the future immigration system may leave EU doctors from member states needing to obtain visas to work in the UK.

The uncertainty of the government’s planned approach to the UK’s adoption, or otherwise, of current EU rules on working practices and the status of mutual recognition of EU and overseas professional qualifications is likely to increase workforce shortages and cause significant delays and uncertainty for individuals and organisations across the NHS.

The RCP's recommendations

The needs of patients must be paramount and leaving the EU cannot be allowed to put patient safety or the quality of care at risk. The UK must continue to welcome EU doctors to work in the NHS and provide urgent guarantees that EU doctors working in the NHS will be able to permanently remain in the UK following the exit from the EU.  

The government must urgently clarify the future landscape for working practices and the approach for mutual recognition of EU and overseas professional qualifications. 

The government must take the opportunity to ensure that effective systems are in place to allow the NHS to increase recruitment of doctors from overseas to meet rising demand, including growing the Medical Training Initiative (MTI)  by increasing the number of visas available. The government should seek to establish a scheme similar to the MTI for DfID or low and low-middle income non-priority countries, particularly those – such as Australia – that have similar training programmes to the UK and more doctors than training places. The government should also seek to establish a scheme to attract students from particular countries to study medicine on a Tier 4 student visa in the UK.

References

[1] NHS Digital. NHS Hospital and Community Health Services (HCHS): All staff by nationality grouping, staff group secondary area of work and Health Education England region, in NHS Trusts and CCGs in England, 30 June 2016 to 30 September 2016, headcount, 2017. [Accessed 18 April 2017]
[2] NHS Digital. EU nationals by staff group speciality and region, 2016. Available online: http://content.digital.nhs.uk/media/23213/EU-nationals-by-staff-group-sp...
[3] NHS Digital. NHS Hospital and Community Health Services (HCHS): All staff by nationality grouping, staff group secondary area of work and Health Education England region, in NHS Trusts and CCGs in England, 30 June 2016 to 30 September 2016, headcount, 2017.
[4] Royal College of Physicians, RCP Census 2015–16, 2017.
[5] British Medical Association. 2017. EU survey. [Accessed 20 November 2017].
[6] General Medical Council. 2017. List of Registered Medical Practitioners - statistics. [Accessed 20 November 2017]
[7] British Medical Association. 2017. EU survey. [Accessed 20 November 2017].
[8] Royal College of Physicians. NHS reality check: Delivering care under pressure, 2017.
[9] Royal College of Physicians. Being a junior doctor: Experiences from the front line of the NHS, 2016.