With the Brexit landscape constantly changing, this section pulls together the latest updates on Brexit and its potential impact on health and care.
Draft text of agreement for future relationship
The European Commission has published its draft legal text of the agreement for the future relationship between the UK and the EU.
Government publishes details of new immigration policy
The Government has published details of its long-awaited new points-based immigration system, which it hopes to operate from January 2021. The new system will end free movement from the EU and will introduce a new system of points for specific skills, qualifications, salary thresholds and shortage professions.
Responding to the publication, Danny Mortimer, Chief Executive of NHS Employers, said that while "today's announcement is positive for the NHS...it is of great concern that it provides no obvious solution for social care".
Prioritising health in the future relationship with the EU
A new briefing from the Brexit Health Alliance raises concerns over the safety and health of patients and citizens being overlooked during the negotiations on the future UK-EU relationship. The briefing highlights that the UK has until the end of 2020 to work out its future relationship with the EU and it is therefore important to define the key elements of the future relationship as early as possible, not only to end the current uncertainty, but also to make sure the UK remains an attractive place to work and live and that we are able to take advantage of global opportunities.
The UK's future immigration system
The Migration Advisory Committee has published its report on the UK's future immigration system. The Committee was asked to consider how a points-based immigration system could be introduced in the UK to strengthen the UK labour market, and to review the salary thresholds for the future system. Read the response to report from Niall Dickson, Chief Executive of the NHS Confederation.
Protecting the health of UK and EU citizens
The Brexit Health Alliance has published a new briefing setting out their priority areas for negotiations on the future relationship between the UK and the EU. The briefing calls for a close cooperative relationship with the EU across trade in medicines and medical devices, health security and research in order to protect the health and wellbeing of citizens and patients across the UK and Europe.
Reciprocal healthcare arrangements in a no-deal brexit scenario
The Welsh NHS Confederation has published a short overview on what will happen to UK-EU reciprocal healthcare arrangements if the UK exits the EU without a deal.
Brexit negotiating teams reach agreement
The President of the European Commission, Jean-Claude Juncker has written to the European Council to confirm that the EU and UK have reached a "fair and balanced agreement" in the Brexit negotiations. The "new" version of the Withdrawal Agreement includes a revised Protocol on Ireland / Northern Ireland, and a revised Political Declaration on the framework of the future EU-UK relationship. The agreement will now have to be ratified by both the UK and the EU parliaments. Read the response from the NHS Confederation.
Participation in Horizon 2020 funding post-Brexit
The Government has revised its advice to UK organisations currently participating in or seeking future participation in Horizon 2020 EU funding, should the UK leave the EU without a deal.
Continuity of medical supplies
On 8 October, Matt Hancock, the Secretary of State for Health and Social Care, provided a written statement to update the UK Parliament on the Department’s plans to support the continuity of supply of medicines and medical products into the UK if we leave the EU without a deal. The Department has also written to pharmaceutical companies and medical device manufacturers to update them on the Government's contingency planning for a no-deal exit.
NHS treatment for overseas visitors post-Bexit
The Government has issued revised guidance to healthcare providers on how changes to charging rules will affect how they recover the costs for treatment from visitors from the EU27 and EEA in the event of a no-deal Brexit.
National Audit Office
A report from the National Audit Office welcomes the preparations already in place by the Department of Health and Social Care to ensure continued medicines' supply in a no-deal Brexit scenario, but highlights that there remains significant work to be done. Reacting to the report, Layla McCay, the NHS Confederation's Director of International Relations said "the report identifies that uncertainties remain and, as we have warned, it is the unknowns and unknowables that present the biggest risk......Alarm bells should be ringing loudly about the fact the government knows very little about the readiness of the 24,000 social care providers in England alone".
Healthcare after Brexit
The Government has updated its healthcare guidance to UK residents visiting the EU and UK nationals living in the EU after the UK exits the European Union. The provisions include funding healthcare for UK nationals already living in the EU, including pensioners and students, for six months if the UK leaves without a deal. Reacting to the news, Layla McCay, the NHS Confederation's Director of International Relations said "today's announcement will provide some reassurance that most won't have to pay for healthcare costs immediately after no deal" but that "reassurance in other areas" was still needed and that "this will be best achieved by a negotiated deal" or at the very least "a mini-deal....to keep both UK and EU patients safe".
Providers and Commissioners of healthcare services
The Government has updated its guidance to providers and commissioners of healthcare services on what actions they should be taking to manage the risks of a "no-deal" Brexit.
European health community organisations voice "no-deal" Brexit concerns
Organisations from across the European health community came together on 12 September in the European Parliament to raise their concerns over the possibility that the UK might leave the EU without a deal and what needs to be done to mitigate any adverse effect this might have on patients and public health. Read more.
Brexit and EU research funding
Our office has prepared a brief guide to update NHS organisations on what Brexit means for EU research funding.
EU Commission updates advice on "no-deal" preparedness
The European Commission has issued updated advice to business and citizens to prepare for the UK's withdrawal and has published a Brexit preparedness checklist on what business needs to do to get ready in the event the UK exits the EU without a withdrawal agreement.
Data flows post-Brexit
NHS England has updated its FAQs on data protection and the implications for personal data in the event of a no-deal EU exit, setting out what NHS organisations can do to prepare and how appropriate safeguards can be put in place.
Additional help for UK research and innovation post-EU exit
The Government has pledged further support for UK researchers and businesses post-Brexit, including providing additional funding to support Horizon 2020 projects beyond 2020 and a shake-up of immigration rules to continue to attract international science and research talent after the UK leaves the EU. Read here.
Brexit preparedness toolkit for the Welsh NHS
The Welsh NHS Confederation has published a toolkit with accompanying guidance for NHS organisations in Wales to support them in understanding the implications of no-deal Brexit and how these might be mitigated.
UK trade in services
The NHS Confederation has responded to the House of Commons International Trade Committee inquiry on UK trade in services. In our response, we urge the government to ensure that any future trade deals should not result in lowering standards or increasing costs for patients; that commercial advantage should not be prioritised at the expense of human or economic health; and that the fundamental NHS principle of free care at the point of use should not be undermined or weakened. Read the full response.
Continuity of medicines' supply
The Government has announced that it will be continuing with its multi-layered approach to continuity of medicines' supply, involving a range of activities including (but not limited to) warehousing, buffer stocks and procurement for extra ferry capacity, including an express freight service for medicines and medical products. It has also written to the medicines and medical devices industries providing further information on its plans to minimise medicines' disruption.
Rights of UK nationals living in the EU27 post-Brexit
The European Commission has published updated guidance outlining the rights UK citizens living in the EU27 can continue to enjoy post-Brexit in the event of a no-deal scenario.
No-deal preparations to continue despite Article 50 extension
Keith Willett has written to NHS organisations to provide an update following the extension to Article 50 negotiations. His letter advises that NHS England and NHS Improvement are keen to ensure that EU Exit structures and preparations put in place nationally, regionally and locally are adapted for the extension. In particular, organisations should be aware that:
- NHS England have stood down the requirement for daily situation reporting
- NHS England will continue to work to understand any implications for the NHS of any further developments relating to an EU Exit deal
- Necessary preparations for a no-deal outcome must continue, though with "sensibly adjusted" timescales given the extension the Government has agreed
- Organisations should continue to have an EU Exit SRO overseeing plans and preparations and should be prepared to stand up their no-deal plans again if required
Brexit: key issues for Wales
The Welsh NHS Confederation has worked with key stakeholders to develop a quick information sheet of key issues for health and social care in Wales as the UK prepares to leave the EU. Download your copy.
Charging overseas visitors who use the NHS: changes to regulations
The Department for Health and Social Care has written to all NHS trusts and Clinical Commissioning Groups updating them on how they are to recover costs from overseas visitors, if the UK leaves the EU without a deal, or without agreements on healthcare in place.
Health and social care staff from other EU member states
Matt Hancock, Secretary of State for Health and Social Care, has written to all health and social care staff to inform them about the protection of the rights of EU staff working in health and social care and how their professional qualifications will continue to be recognised, whether or not the UK leaves the EU with a deal.
NHS Estates and facilities: preparing for "no-deal" Brexit
NHS Improvement has written to all NHS Estates and Facilities teams outlining the guidance available to help prepare for a "no-deal" Brexit.
Dispensing prescriptions post-Brexit
The Department of Health and Social Care has issued guidance to pharmacists about the actions they need to take concerning dispensing prescriptions issued by pharmacists in an EEA member state or Switzerland, if the Uk leaves the EU without a deal.
Brexit and UK Parliament indicative votes
Following from Parliament's 29 March vote not to pass the Withdrawal Agreement negotiated between the UK and EU, a second round of indicative votes was held on 1 April to seek a way forward and to determine the next steps in the Brexit process. Read more.
NHS Confederation guide to preparing your NHS organisation for a no-deal Brexit
We have prepared a brief summary of what you need to be doing and thinking about based on information issued by NHS England and the Department of Health and Social Care. We hope you find this useful in your no-deal preparations.
Reciprocal healthcare for UK and EU citizens after Brexit - written ministerial statement
The government issued a statement on 19 March clarifying the situation for UK citizens who require healthcare in EU / European Free Trade Association (EFTA) countries, and EU/EFTA citizens requiring healthcare in the UK, after the UK leaves the EU.
The UK government has proposed to EU and EFTA member states that, even in the event of a no-deal scenario, the existing healthcare arrangements should be maintained until 31 December 2020. Legislation has been brought forward in the UK to enable this to happen. This would minimise disruption and give peace of mind, during this period, to citizens requiring healthcare.
However, if this proposal is not acceptable to EU / EFTA member states, UK citizens travelling, working or living abroad will need to ensure they have comprehensive health insurance after EU exit. In addition the government has already committed for a limited period to fund certain UK nationals already undergoing treatment in the EU.
Citizens of EU and EFTA member states already living lawfully in the UK on exit day will continue to be entitled to NHS treatment as now. There are no guarantees for people arriving in the UK after this date.
Read the statement in full, which contains detailed guidance covering a range of scenarios.
New guidance on the regulation of medical devices
The Medicines and Health Products Regulatory Agency has published guidance that sets out how medical devices will be regulated in the UK in a Brexit "no-deal" scenario. The guidance provides further detail on how the UK regulatory framework will operate after exit day and what manufacturers and healthcare organisations need to do to ensure their devices are certified for use post-Brexit.
Health Minister updates MPs on no-deal medicines' supply
Stephen Hammond, Minister of State for Health, has made a Written Ministerial Statement updating MPs on the Department for Health and Social Care’s plans for the continuity of medicines and medical products in the event the UK exits the EU without a deal.
New guidance on the availability of medical devices post-Brexit
NHS Improvement has issued new guidance (11 February 2019) to NHS providers and heads of procurement on the actions they need to take to safeguard the availability and supply of medical devices and clinical consumables in the event of a "no-deal" Brexit.
Access to healthcare post-Brexit
The government has issued guidance to holders of S1 certificates informing them that in the event of no deal, these certificate may not be valid after exit day, depending on decisions taken by EU/EEA member states. An S1 certificate allows the holder to access healthcare in the EU/EEA country in which they live and is used by many UK pensioners living in Spain and France.
Government cancels EU Settlement Scheme fee
The government has decided to drop the £65 fee it had planned to charge EU27 nationals applying for settled status which would allow them to continue to live and work in the UK after Brexit. Anyone who applied as part of the various pilot schemes will also have their fee reimbursed. Read more on the EU Settlement Scheme.
Accessing medicines post-Brexit
The government has issued an amendment to the Human Medicines (Amendment) Regulations 2019, adding a Serious Shortage Protocol for potential shortages of medicines that could occur in scenarios such as a no-deal Brexit. The Protocol makes provisions for pharmacists to supply a different strength, quantity or pharmaceutical form of certain medicines in particular situations. Read the explanatory notes to accompany the amendment and the communication to patients (18 January 2019).
Welsh Government launches new Brexit website
The Welsh Government has launched a new public website to reassure and advise citizens and organisations about the potential impacts of a no deal Brexit in Wales and providing information about the steps that need to be taken to prepare in the event of a no-deal outcome.
MHRA issues updated guidance on medicines' regulation
The Medicines and Healthcare products Regulatory Agency (MHRA) has issued updated guidance setting out the UK’s proposed arrangements for medicines' regulation if we leave the EU with no deal.
Government updates its no-deal guidance for health sector
On 20 December, the Government published updated guidance for the NHS on what providers and commissioners of health and care services in England need to know and should do now to prepare for the possibility that the UK leaves the EU without agreement.
Government Immigration White Paper
NHS Employers has responded to the publication (19 December) of the Government's long-waited White Paper on proposals for immigration rules post-Brexit.
EU contingency action plan
The European Commission has published a series of notices to help EU27 citizens and businesses to prepare in the event of a no-deal Brexit and to ensure minimum disruption to Union life.
European health community
With formal ratification of the Withdrawal Agreement by the UK Parliament on hold, the European health community has reiterated the importance of putting the safety of patients and public health at the forefront of the Brexit debate.
Welsh NHS Confederation
The Welsh NHS Confederation has responded the the External Affairs and Additional Legislation Committee report on how prepared the NHS is for Brexit.
Brexit Health Alliance meets with MPs
The Brexit Health Alliance met with MPs, Lords, government officials and health sector leaders to share their perspectives on the far-reaching impacts of Brexit on health.
This new infographic from the Brexit Health Alliance highlights the key areas for health that will be affected if the UK finds itself in a no-deal scenario. Download your copy.
The Withdrawal Agreement
The Withdrawal Agreement and political declaration, while yet to be ratified by the UK Parliament, set out the terms of the UK's divorce deal and framework for future relationship with the EU. Read more.
Managing EU withdrawal: Welsh NHS Confederation
The Welsh NHS Confederation has produced a frequently asked questions document for health and social care, which aims to answer some of the main questions concerning the UK's exit from the EU.
The government has published a series of technical notices setting out information to enable businesses and organisations to make informed plans and preparations in the event of a no-deal Brexit. Read our analysis of the technical notices on health.