With the Brexit landscape constantly changing, this section pulls together the latest updates on Brexit and its potential impact on health and care.
The UK-EU negotiations
The future relationship: latest round of UK-EU talks
UK and EU negotiators met again w/c 7 September for a further round of discussions on the future relationship. As previously, the major sticking points continue to be level playing field arrangements for open and fair competition and EU access to UK fishing waters, with the EU's chief negotiator, Michel Barnier, suggesting that a deal is unlikely if satisfactory agreement cannot be reached on these two issues. Negotiations were overshadowed by the publication of the UK's Internal Market bill, which the Government admits may contravene certain clauses of the Ireland/Northern Ireland Protocol.
Future rounds of negotiations are set to continue. This UK government addendum to the terms of reference for negotiations sets out the dates and terms for the September negotiating rounds.
Read the draft texts from the UK and the EU to find out more on how each envisages their future relationship.
The Withdrawal Agreement: latest round of UK-EU talks
The Ireland/Northern Ireland Protocol
The second meeting of the Specialised Committee on the implementation and application of the Protocol on Ireland/Northern Ireland took place on 17 July 2020, with discussions being described as constructive by both the UK and EU parties.
The EU Commission welcomed the United Kingdom's engagement in technical discussions covering the full array of issues under the Protocol and the efforts made to set out the UK's plans concerning the Protocol's implementation. However, the Commission voiced concern over progress on practical preparations which will be needed for the full application of the Protocol on 1 January 2021.
A third meeting of the Specialised Committee is scheduled for early Autumn.
The EU-UK Joint Committee
The Joint Committee has the responsibility to oversee and monitor the application of the UK-EU Withdrawal Agreement.
Of interest to the health sector is that agreement was reached on the urgent need for the UK to set out its plans on a detailed implementation plan for the Northern Ireland protocol. Interpretation of this protocol in relation to medicines and medical devices will have implications across regulation, approval, packaging, commercialisation, supply and monitoring of medicines and devices. Life sciences companies have advised that any adjustments to regulatory systems and supply chains can take more than a year to implement. Further, the EU welcomed the UK’s commitment to protecting the residency rights of EU citizens in the UK, committing to supporting Member States in mutually implementing these rights across the continent.
Read the European Commission's read-out of the meeting.
Member briefing - what NHS organisations need to consider to get ready for the end of transition
The NHS Confederation's European Office has published a new member briefing this week on implications for the NHS and what organisations need to start to consider in terms of preparations for the end of the year. It reviews the most recent guidance and provides a checklist that covers the areas that may require additional preparations. This includes advice to patients, changes to processes or systems, international recruitment and retention planning, and ensuring continuity in areas such as research, funding and medicines and medical device supply.
Brexit Health Alliance - what's at stake for the healthcare rights of patients
As urgent negotiations continue between the UK and the EU to decide a new relationship to take effect from 1 January 2021, the Brexit Health Alliance has produced a briefing to highlight what’s at stake for the healthcare rights of patients. The two sides remain far apart on a number of issues and the Brexit Health Alliance is concerned that if no agreement is reached, vulnerable people needing treatment will lose out. The briefing calls for agreement on UK and EU citizens continuing to benefit from rights to healthcare at local, affordable cost in the EU member states and the UK, ensuring simple and safe access to treatment when working, living or travelling.
The Brexit Health Alliance has also produced an infographic to illustrate how individuals in different circumstances may have to pay privately for healthcare after 31 December 2020 if the UK and the EU cannot agree a deal.
Preparing for the end of the transition period - guidance for providers and commissioners
The UK government updated its guidance on 3 August around what providers and commissioners of healthcare services can do to prepare for the end of Brexit transition on 1 January 2021, including links to the new UK Border Operating Model released on 13 July that could impact the supply of medical products.
The guidance is aimed at commissioners and healthcare providers, including hospitals, care homes, GP practices and community pharmacies. It covers advice, contacts and actions to help to plan for and manage potential service disruption around the supply of medical products, business continuity, workforce issues such as recognition of professional qualifications and EU settlement scheme applications, and EU funding through the Third Health Programme.
The guidance sits alongside a new letter from DHSC to medicine suppliers, sent on 3 August, setting out the government’s plan to help ensure the continuity of supply of medical goods into and out of the UK, and guidance on getting EU funding under the current spending framework into 2021, including for Horizon 2020, Euratom and Health for Growth programmes.
How post-Brexit negotiations could affect our ability to manage another coronavirus
The Brexit Health Alliance has published a new briefing and infographic highlighting how the outcome of the UK-EU negotiations could affect the UK’s ability to manage another pandemic.
To protect public health and wellbeing across the UK and the EU, the Brexit Health Alliance is campaigning to ensure that the UK can continue to:
- Participate in key EU data-sharing platforms and alert systems to exchange information and early warnings about health threats.
- Import and export the medicines and medical devices that we need, so that they reach patients as quickly as possible. This relies on the minimum of delay caused by tariffs and regulatory barriers.
- Participate fully in research and testing of new treatments, including clinical trials, so that patients can benefit as soon as these become available.
- Recruit and retain the researchers and clinicians we need to staff our services.
Download your copy of the briefing and infographic.
Safeguarding patient access to medicines and medical technologies - new briefing from BHA
The Brexit Health Alliance (BHA) published a briefing on negotiating a new relationship with the EU that safeguards patient access to medicines and medical technologies. In the briefing, the BHA calls for the negotiations between the UK and the EU to provide patients and industry with as much clarity as possible and to prioritise:
- guaranteeing patients uninterrupted supply of their current treatments and fast access to new medicines and medical devices
- safeguarding high regulatory standards and public health protections for medicines and medical devices used to treat patients
- and promoting the UK’s position as a global leader in life sciences innovation and international influence.
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.
UK-EU negotiating mandates
Both the UK and the EU have published their mandates for the negotiations on their future relationship. We've published our take on what the mandates mean for the health of EU and UK citizens.
Throughout 2020, the negotiations will be divided into two major strands: the implementation of the Withdrawal Agreement and the future relationship.
- Implementation of the Withdrawal Agreement, which entered into force on 1 February, dictates the UK’s Brexit financial settlement; the rights of citizens in the UK and EU that must be protected; and the arrangements the UK needs to put in place to prevent a hard border on the island of Ireland.
- Negotiations to define our future relationship will cover areas such as trade and supplies of medicines and medical devices, international collaboration on health security, how UK citizens access healthcare, and international research collaboration.
EU exit: what will change on 1 February
From 1 February the UK will enter an implementation period that will last throughout 2020, while the next stage of negotiations on the future UK-EU relationship takes place. Until the end of the year, the UK will continue to follow most EU law in the same way as it did before. Dr Layla McCay, Director of International Relations at the NHS Confederation, outlines the impact on health, if any, over the coming year.
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.
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.