NHS European Office

Brexit: FAQs


The European Union has never experienced the withdrawal of one of its member states and the EU Treaty does not provide much detail on the process to be followed in this type of event. Here we take a look at what we know about the process and clarify what it means for the NHS.

What is Article 50 of the EU Treaty?

Article 50 of the EU Treaty says that if a member decides to leave the EU, there will be a period of two years for the leave agreement to be conducted, starting from the moment a formal notification is submitted from the government of the member state to the EU. If required, this period of time can be extended.  

Michel Barnier, in his first statement on the negotiations, suggested a deadline of October 2018 for a deal to be agreed, giving the European Parliament, European Council and UK Parliament five months to ratify the agreement before the end of the two year period.

Negotiations will be long and complex and the EU has made clear that the UK cannot ‘cherry-pick’ the terms of its new relationship with the EU after Brexit, stressing that the EU's four principles – free movement of goods, services, people and capital – cannot be split up.

Now Article 50 has been triggered, what is the process and timescale for the UK withdrawing from the European Union?

On 29 March 2017, Theresa May, the Prime Minister of the UK, sent a letter to President of the Council of the European Union to inform him of the UK’s intention to leave the EU, and to invoke Article 50.

Until the moment the UK formally leaves the EU, it remains a full member and all EU policy and law will continue to apply. On the morning of the 24 June 2016, the President of the Council of the EU issued a statement saying “I would also like to reassure you that there will be no legal vacuum. Until the United Kingdom formally leaves the European Union, EU law will continue to apply to and within the UK. And by this I mean rights and obligations”.

The rights of EU citizens working in the NHS will be unaffected during this period and NHS employers can continue as before to recruit staff from EU countries. The UK will continue to receive EU funding and be able to participate as partners in the different EU funding programmes.

The UK government has set out plans for a (Great) Repeal Bill to ensure legal continuity on the day the UK leaves the European Union (EU), by incorporating pre-Brexit EU law into UK domestic law. See our briefing for more on the (Great) Repeal Bill. The Government has proposed a Common's vote on the Bill on 12 June.

This European Commission fact sheet on the Article 50 process gives an indication of timescales and key milestones in the process.  We have also produced an infographic on key decisions for the NHS during the exit negotiations.

Listen to episode two of our Brexit podcasts which includes an interview with Fabian Zuleeg from the European Policy Centre on the exit negotiation process.

Conduct of negotiations

On 19 June 2017, both the European Commission and the UK Government agreed the terms of reference, which set out the guiding principles for the conduct of the Brexit negotiations. 

Negotiations have been following the sequence set out by the EU 27, with terms of the divorce being addressed first - namely citizens rights, agreement on the financial settlement and the border separating Northern Ireland and the Irish Republic - followed by negotiations on the UK's future relationship with the EU. 

The negotiations have currently reached the phase of the future relationship between the EU and the UK. See the list of topics that have been agreed for discussion in this phase.

In June 2018, the Council of the European Union will make an important decision on whether sufficient progress has been made on important outstanding issues, such as the Northern Ireland border, in order to progress negotiations further. The UK government has committed to producing a substantive white paper on the negotiations before this critical meeting.

You can keep up to date with the negotiations via the European Commission's dedicated Article 50 Task Force webpage.

What sort of future relationship is the UK government seeking with the EU post-Brexit and what are the main priorities for the EU?

The Prime Minister set out the 12 principles which will guide the UK Government during its negotiations with the EU on leaving the union. This announcement was followed up by a Government White Paper. Later, in response to the proposal by the European Commission, the UK government has also put forward its proposal on safeguarding the rights of EU citizens. Read our article on potential implications to the NHS.

The EU's main priorities EU are revealed in the negotiating directives.  For the previous phase of the negotiations, the EU's priorities were; reciprocal rights for EU citizens living in the UK, and UK citizens living in the EU; finding an appropriate financial settlement; prevention of a legal vacuum for businesses; and maintaining the Northern Ireland peace process and resolving the issues of the land border with the EU.  

As of mid-August 2017, both the EU and the UK Government have published a series of position papers which provide more detail on their respective priorities for the Brexit negotiations and how they envisage their future relationship with each other post Brexit.

In terms of the future relationship, the EU has decided its priorities for the next phase of the negotiations. The Article 50 taskforce has also produced a number of presentations and papers on the basis of the UK’s ‘red lines’ to indicate the type of future relationship that can be proposed.

The UK also set out some ambitions for negotiations in the Prime Minister’s speech at Mansion House on 2 March 2018 and more recently, the Government has published a series of presentations on the negotiation process, including on the future economic partnership and the partnership on science, research and innovation.

What will be the impact of the UK’s plans to leave the EU on the NHS?

The NHS played a central part in the Remain and Leave campaigns before the EU Referendum. In this blog article, the director of the NHS European Office has considered what lies ahead for the NHS as the UK plans to exit the EU; there is also an article by Elisabetta Zanon published in the Health Service Journal.

We have produced an infographic on the top issues for the NHS related to Brexit and one on the key decisions for the NHS in the Brexit negotiations.

In October 2016, the NHS Confederation issued a response to the Health Select Committee (Commons) inquiry on Brexit and health and social care, where we discuss the key potential impacts and make some recommendations on how to mitigate risks and take advantage of opportunities.

Take a look at some of our other blogs and articles on the potential impact for the NHS:

In July 2017, the Brexit Health Alliance was formed to ensure that patients and the healthcare sector that supports them are in the strongest possible position once the UK leaves the EU.  More information on the work and members of the Alliance.

What will be the impact on the NHS EU workforce and on recruiting and retaining staff from outside the UK?

Kate Ling from the European Office has produced a blog article on immediate implications for the workforce and what may happen next. There is a highlight on issues such as education, training and on employment regulation, and the Working Time Directive. 

The NHS European Office is a member of a coalition of 29 health and social care organisations created to ensure that standards of care are maintained as Britain prepares to withdraw from the EU.

What will be the impact on EU grants for NHS organisations currently involved in EU funding bids?

Latest UK Government update on UK participation in Horizon 2020 (March 2018)

The update also includes an overview with a Q&A and is published by the Department for Business, Energy and Industrial Strategy.

The main messages are that:

  • Until our departure from the EU, we remain a Member State, with all the rights and obligations that entails. This means that UK entities are eligible to participate in all aspects of the Horizon 2020 programme while we remain a member of the EU.
  • The UK and the EU fully intend UK entities’ eligibility in Horizon 2020 to remain unchanged for the duration of the programme, as set out in the Joint Report. This includes eligibility to participate in all Horizon 2020 projects and to receive Horizon 2020 funding for the lifetime of projects.
  • The Government’s underwriting guarantee remains in place in the event that commitments made in the Joint Report are not met.

UK participants are therefore encouraged to continue applying for Horizon 2020 funding and participating in Horizon 2020 projects and to reassure their international partners about their capacity to fulfil the roles and assume the involvement which best fit proposed projects.

Will I still be able to use my European Health Insurance Card (EHIC) to access healthcare in the EU?

Until the UK formally leaves the EU, EU law will continue to apply to and within the UK – both in terms of rights and obligations. So there is no immediate impact on UK citizens travelling and living abroad and using the EHIC or for European citizens living in the UK.

What will happen to the European Medicines Agency (EMA) which is based in London?

For two decades, the EMA has overseen medicines regulation across the EU and has granted pharmaceutical companies a single marketing authorisation that provides access across the whole of the EU market. 

With the UK's withdrawal from the European Union, the EU began preparations to relocate the EMA from its London home to Amsterdam.   

The EMA has developed a business continuity plan prioritising the Agency’s activities in order ensure that the assessment of medicines is not disrupted and that patients in Europe continue to have access to high quality, safe and effective medicines in the coming months and after the UK’s withdrawal from the EU.  It has also produced a ‘Questions and Answers’ document related to the United Kingdom's withdrawal from the European Union with regard to the medicinal products for human and veterinary use. Both documents can be found on the EMA’s dedicated Article 50 page.

In April 2018, the EMA and the remaining 27 EU member states completed the reallocation of the UK's current portfolio of medicines, assigning over 370 centrally authorised products (currently held by the MHRA) to regulatory bodies within the remaining EU 27.

The Prime Minister in her Mansion House speech on 3 March 2018 indicated that despite leaving the centralised licensing system for medicines, the UK will seek associate membership of the EMA.


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