This week, concerns have been raised by the RCN’s London regional director that the Sustainability and Transformation Partnerships (STPs) planned for London do not have sufficient resources or appropriate workforce plans to produce change. Statistics have shown that nearly 10,000 NHS staff from the EU left the health service in the year after the Brexit vote, while the Health Select Committee has launched an inquiry into medicines and medical devices after Brexit. The Prime Minister is also set to announce her proposals for a two-year transitional Brexit deal at a speech in Florence.

Concerns raised about London STP resources and joint working

The RCN’s London regional director, Bernell Bussue, has warned in a blog post that Sustainability and Transformation Partnerships (STPs) planned for the city have not been allocated appropriate funding or staff to facilitate the changes they outline. While Mr Bussue endorsed the plans’ ambitions to move care into the community and close the NHS funding gap, he said, “there are huge questions still to be asked of the plans themselves, particularly when it comes to protecting patient care and the nursing workforce.” The proposals in some of the plans to reduce the number of nurses were highlighted as an area of concern, with Mr Bussue stating that “We need more nurses, not less.”

Meanwhile, a separate survey by the Chartered Institute of Public Finance and Accountancy and iMPOWER has found that very few STPs are or will be able to deliver full joint working between health services and local authorities, despite this being a key ambition of the plans. Fifty-five of the 56 organisations that answered the survey held this opinion; while only 15% of respondents anticipated being able to access funding to facilitate prevention even though this was considered essential or important by 95% of organisations.

Nearly 10,000 EU staff quit NHS since Brexit vote

Statistics from NHS Digital have shown that nearly 10,000 EU nationals working in the NHS have quit since the vote to leave the EU, prompting a renewed call for EU citizens to have their right to live in the UK guaranteed. Between June 2016 and June 2017 9,832 doctors, nurses and other health professionals from the EU had left the NHS, rising by 22% on the previous year and 42% on the year before that. Nearly 40% of those who left were nurses and 18% were doctors – a lower figure than predicted in a survey by the British Medical Association, which said that its research indicated that 40% of EU doctors were considering leaving since the referendum.

The data produced a call from the BMA to “end the uncertainty and grant EEA [European Economic Area] doctors working in the NHS permanent residence, rather than using them as political pawns in negotiations.” The leader of the Liberal Democrats, Sir Vince Cable, also called for the Prime Minister to “make a bold offer to the EU to ringfence negotiations on citizens’ rights and come to a rapid agreement.”

Health Committee launches inquiry into medicines and medical devices after Brexit

The Health Select Committee has announced it will be examining the regulatory arrangements required around medicines, medical devices and substances of human origin to “guarantee safe and effective supply” of these products after Brexit. The Committee wants to explore what the implications of Brexit for the life science industry, and medical research and development, will be. The terms of reference poses questions including:

  • What are the key considerations that arise for companies, healthcare services and regulatory bodies in the UK as a result of the UK’s withdrawal from the EU? Focussing on patients and the public, what needs to be done to ensure that any adverse impact is minimised or eliminated, and that opportunities to enhance services are maximised?
  • Following the UK’s withdrawal from the EU, what alternative arrangements for the regulation of medicines, medical devices, medical products and substances of human origin could be introduced? What are the respective opportunities, risks and trade-offs involved?
  • What are the implications for medical research and development, including for the timely patient access to new medicines, technologies and other relevant medical innovations developed within or outside the UK? How can any adverse consequences be avoided or mitigated and any potential opportunities be enhanced?

May to announce two-year transitional Brexit deal

The Prime Minister is set to announce her intention to seek a transitional deal to leave the EU, with the possibility of different sectors of the economy leaving the EU at different times to mitigate fears of a “cliff-edge Brexit.” The proposed two-year deal would be in place from March 2019. It is thought that this will be accompanied by continuing with the UK’s budget contributions to the EU for a defined period of time, and while these have not yet been set out there is speculation it will meet the UK’s existing contributions of around £20 billion.

The proposed deal was subject to extensive consultation with the Cabinet this week, and is being pushed in an attempt to make further progress on exit negotiations – with the EU having stated that future trade talks will not begin until the UK has settled issues including the Brexit bill. Mrs May had faced difficulties earlier this week with the Foreign Secretary Boris Johnson, following the publication of an article by him raising his concerns about the possibility of a “soft Brexit” and subsequent speculation that he would resign from the Cabinet over the issue. The pursuit of a flexible exit with a transition deal marks a victory for the Chancellor Phillip Hammond, while the EU’s chief Brexit negotiator Michel Barnier called for the UK to “settle the accounts – no more, no less”.