Tackling Brexit in the NHS

  • April 09, 2020

Since the UK voted to leave the EU in 2016, the countries exit (now commonly known as Brexit), has raised many questions in the healthcare sector centred on the implications for workforce management and planning. 

With some European doctors publicly stating that they either intend to leave the UK, or are uncertain as to the future plans to remain a staff member of the NHS, their decisions pose important questions – are European doctors welcome in the NHS and what is being done to encourage doctors to stay in post? 

Speaking with senior NHS figures, it is clear that the contribution of European doctors and healthcare professionals is greatly valued. To add, workforce managers and service leads have advised in no uncertain terms that they do not wish to lose any of their workforce, far from it – services up and down the country are trying to attract more doctors to their services. Brexit they say, is an unfortunate stumbling block at a time when demand is increasing for healthcare. It is therefore a major hurdle that the NHS needs to overcome in order to continue to bring experienced healthcare staff to the UK. 

What might not be clear amongst the bad press surrounding Brexit, is that in 2018, the Government actually relaxed its rules on the immigration of overseas doctors seeking relocation to the UK, considerably increasing the number of Visas made available. 

Further evidence of the demand for overseas doctors can be found in the recent White Paper advising the government to add all grades and specialities of medicine to the shortage occupation list. Whilst this is yet to become government policy, the report makes clear the ever-growing demand for European and Non-European doctors. 

With ministers agreeing to expand the number of doctors allowed into the UK and changes to the shortage occupation lists in the pipeline, Brexit very much goes against the grain.

So, with a conflicting backdrop of Brexit set against the welcoming approach to European doctors in the NHS, where does recruitment of the best doctors to the UK stand? 

Sources tell us that the government is set to continue to encourage doctors to the UK, taking on board proposals to increase the shortage occupation list to all medical doctors, as well as many other areas of healthcare professionals. Good news. 

The issue that the NHS faces, is the growing media storm and political posturing around the Brexit debate. This toxic masculinity and surge to the right of centre in British right-wing politics is putting a large number of Europeans off their previously planned immigration. It can also be said that this atmosphere has triggered a small but growing exodus from the NHS. 

The government now finds itself in a position where it is trying to explain its response to demand for staff in the NHS and its plans for Brexit, both very different approaches and rhetoric – can it have it both ways? 

Focusing on NHS services, Directors, lead consultants and HR managers cannot be clearer – all Europeans doctors will be welcomed with open arms, and all current members of the NHS are highly valued for their continuing contributions. The praise goes further, Royal Colleges from all specialties, the General Medical Council and the British Medical Association have all unequivocally stated that they wish to support their European colleagues. 

In addition, these organisations have increased their efforts to attract European candidates in an effort to combat the negative publicity brought about by Brexit. But, Brexit is having an immediate impact on retention, planning and hiring of new staff. 

The NHS in England alone was short of nearly 10,000 doctors, with latest figures across the whole of the UK showing further increases in demand. Such figures do not reveal the full picture, with locums filling many posts, the real number of vacancies is likely 25% higher. 

NHS operating departments continue to make it clear that staffing is their main problem when trying to combat the rising need for a varied healthcare system. What can be done to combat the negative stem caused by Brexit, and redress the balance in favour of the NHS? 

Some attempts have been made in recent years to increase numbers in University as well as attracting junior doctors to the MTI scheme, however such efforts have fallen short.  

In fact, the NHS will need to build its reliance on quality overseas doctors to take up fixed term and permanent service posts, an attractive option compared to either expensive temporary staff, or facing the prospect of competing for UK trainees, whose numbers remain very low. 

Our hope is that there will be continued drive to employ talented and committed international doctors to help deliver services. 

Starting with the local needs of each hospital or Trust in detail to create bespoke searches for the best talent, the best quality staff can be found. And rather than finishing at the point of placement, retention and after care services that ensure overseas doctors settle into their roles quickly, feel valued and integrate in their communities are crucial to successful relocation and retention. Such an approach will offset the negativity mindset and decrease in available candidates brought about by Brexit.

Supporting doctors with practical support & information surrounding their relocation ensures that they can focus on their work. Offering advice on engaging with their communities and new team can bring about a positive mindset. And connecting employers with a wider pool of candidates, most suited to the Trust values and fit, can ensure prolonged partnerships with European and non-European doctors. 

All in all, staffing demands caused by Brexit, coupled with the need to increase the skills base in the NHS, can be offset with agencies and HR departments being accountable for the challenges they face. Turning things around in the attraction of workforce supply to the NHS. 

What we know so far is that the status of already registered doctors is guaranteed. What is not clear is whether the current arrangements for registration will remain the same, with European Mutual Recognition continuing unaffected. 

In all Brexit outcomes, the NHS will need to engage in more international recruitment. Take rural and hard to reach areas, as a good example of where even without Brexit, NHS organisations face challenges to attract greater staffing numbers. 

With improved partnerships, focused on overseas recruitment, we can jointly attempt to maintain the number of EEA doctors remaining and joining the medical register. 

In summary, the NHS remains an attractive place for overseas doctors to work and train, and the NHS remains committed to supporting all European colleagues and future colleagues. However, the challenge to recruit the best and most committed candidates is growing. Demand is increasing for overseas recruitment; we all must pay our part to maintain the positive impact that employing and supporting Europeans doctors has on our patient care. 

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