With the Brexit landscape constantly changing, this section pulls together the latest updates on Brexit and its potential impact on health and care.
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.
UK and EU agree to Brexit extension
At a specially-convened EU Council meeting on 10 April, the UK and EU agreed to delay the UK's exit from the EU until 31 October, giving the UK Parliament more time to agree the Withdrawal Agreement (WA). The "flexible" extension still allows the UK to leave the EU if the UK Parliament agrees the WA before this date. Should Parliament fail to agree the WA by 22 May, then the UK must take part in elections to the EU Parliament. Read the Council text.
Responding to the extension, Niall Dickson, Brexit Health Alliance (BHA) co-chair and NHS Confederation chief executive said that no deal still remains a "potential outcome which means everyone involved in healthcare must continue to prepare for this possibility". Read the BHA response in full.
No deal preparations and primary care
NHS England has written to primary care contractors informing them of the actions they still need to take locally to prepare for the possibility of a ‘no deal’ EU exit. The letter from Prof. Keith Willett, EU Strategic Commander at NHS England, covers continuity of medicines' supply, reciprocal healthcare rights, workforce and data-sharing.
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 on 12 April.
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.
National Supply Disruption Response for Brexit
Keith Willett at NHS England has written to NHS trusts to provide details of the National Supply Disruption Response (NSDR) - measures at national level to support the continuity of supply of medicines and medical products in the event of a "no-deal" EU exit. Read the letter in full.
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 29 March and what manufacturers and healthcare organisations need to do to ensure their devices are certified for use post-Brexit.
No-deal medicines availability: NHSE publishes patient Q&A
NHS England has published further guidance for patients on how they can continue to access their medicines and medical products in the event of a "no-deal" EU Exit, with a quick Q&A for more information and guidance to prescribers of medicines on what action they should take when dispensing patients' medicines.
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.
Sharing of data post-Brexit
NHS Improvement has issued new guidance (21 February 2019) to NHS organisations on the actions they need to take to ensure continuity of access to, processing and sharing of personal data in the event of a "no-deal" Brexit.
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.
Updated guidance from NHS England on no-deal Brexit
Professor Keith Willett, EU Exit Strategic Commander and Medical Director for Acute Care and Emergency Preparedness at NHS England, has written to clinical commissioning group (CCG) and trust chief executives outlining the operational response that NHS England and NHS Improvement are undertaking at a national and regional level in preparation for a no-deal Brexit scenario.
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 29 March 2019, 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 on 29 March 2019 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 on 29 March 2019.
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.