The Effects of Brexit on the NHS in the UK
Brexit, the United Kingdom's decision to leave the European Union (EU) following a referendum in 2016, has had wide-ranging effects across various sectors of British life. The National Health Service (NHS) is one of the most scrutinised areas. The NHS, a cornerstone of British society and a source of national pride, faces numerous challenges post-Brexit, many of which arise from the disentangling of the UK from EU policies, agreements, and markets
The Brexit campaign is often linked to Boris Johnson and his iconic battle bus, which displayed the eye-catching slogan: "We send £350 million a week to the EU. Let’s fund our NHS instead." However, this claim, like many promises made during the referendum, was misleading, and the anticipated £350 million boost to the NHS never materialised.
This blog will examine the significant impacts of Brexit on the NHS, addressing staffing challenges, supply chain disruptions, funding issues, and the wider implications for public health policy.
This is a hot topic in medical school interviews. You should be aware of the key aspects of the Brexit debate and its impact on the NHS, patients, staff, and healthcare provision in the UK.
Staffing Shortages and Recruitment Challenges
One of the most immediate and visible impacts of Brexit on the NHS has been its effect on staffing. The NHS has long depended on healthcare workers from the EU to fill critical positions, especially in nursing, medical roles, and support services.
Key Issues:
Decrease in EU Workers: Since Brexit, the number of healthcare professionals from the EU joining the NHS has significantly decreased. Reports indicate that applications from EU nurses to the NHS dropped by approximately 87% in the year following the 2016 referendum. This has worsened existing staff shortages.
Loss of Freedom of Movement: The end of freedom of movement means that EU nationals no longer have automatic rights to live and work in the UK. This change has introduced more complex visa and immigration processes, making recruitment from the EU more challenging.
Retention Challenges: Beyond recruitment, there are concerns about staff retention. Some EU staff, feeling uncertain about their future in the UK or facing bureaucratic hurdles like applying for settled status, have opted to return to their home countries or relocate to other EU nations.
Consequences: The NHS faces a staffing gap threatening patient care. The Royal College of Nursing has warned that staffing shortages could lead to longer waiting times and higher workloads for existing staff, ultimately impacting the quality of patient care.
A report by the Nuffield Trust in 2022 confirmed concerns about staffing, revealing a loss of over 10,000 healthcare workers from the EU. While recruitment from other regions has increased to fill some gaps, it hasn't been sufficient to replenish the workforce. Certain specialities, such as cardiothoracic surgery and anaesthetics, have been particularly affected.
The shortages pressure the remaining staff, resulting in higher workloads and diminished morale. Ethically, recruiting healthcare professionals from countries that face workforce challenges raises significant concerns. The new points-based immigration system is unlikely to benefit many healthcare workers, although care workers may face even more substantial difficulties.
The end of mutual recognition of professional qualifications has significant implications for staffing. While the UK has agreed to recognise EEA qualifications for up to two years, there is no reciprocal arrangement, exacerbating existing staffing shortages within the NHS.
EU and EEA students are now classified as international students for fee purposes, meaning they no longer benefit from home fee rates or financial support. This change may deter talented medical, nursing, and healthcare students from studying and working in the UK.
Supply Chain Disruptions and Medicine Shortages
The NHS relies significantly on importing medical supplies, equipment, and medicines from EU countries. The establishment of customs checks, tariffs, and other trade barriers after Brexit has posed logistical challenges in maintaining the uninterrupted flow of these crucial goods.
Key Issues:
Medicines Supply: Before Brexit, the NHS benefited from the EU’s single market, facilitating the fast and efficient import of medicines. The disruption of these supply chains has raised concerns about potential delays in obtaining critical medications, including those for cancer treatment, insulin, and vaccines.
Medical Equipment: Similarly, medical devices and equipment imported from Europe have faced port delays and increased costs due to new customs regulations. New customs checks and paperwork have introduced complications, particularly in the months following Brexit. This was especially concerning during the COVID-19 pandemic when the NHS faced unprecedented strain. A shortage of lorry drivers in September 2021 disrupted the import of essential medicines into the UK.
Stockpiling Measures: In preparation for potential Brexit disruptions, the NHS was compelled to stockpile medicines and medical equipment. While this approach mitigated some immediate risks, it incurred significant financial costs and was not a sustainable long-term solution.
Consequences: Supply chain issues could result in shortages, higher prices, and treatment delays. The government has pledged to ensure continuity of supply; however, the added complexity of customs and regulatory divergence continues to pose a challenge.
Funding and Economic Impact
Brexit has produced mixed effects on NHS funding, influenced by political viewpoints and shifting economic realities.
Key Issues:
The £350 Million Claim: One of the most prominent claims of the Leave campaign was that Brexit would allow the UK to redirect £350 million per week (the amount purportedly sent to the EU) to the NHS. However, this figure was widely contested, and in reality, the economic effects of Brexit have led to slower growth and decreased tax revenues, which may limit public spending capacity in the long run. In 2019, the government pledged an increase of £33.9 billion to the NHS budget by 2024. Additionally, in response to the challenges posed by the COVID-19 pandemic, further funding was allocated to address the surge in hospital admissions.
Impact on Research Funding: The NHS is closely linked to medical research, much of which has relied on EU grants and research programs like Horizon Europe. While the UK has secured some access to these programs, there is concern that research funding may decline or become more competitive, affecting innovation in healthcare.
Consequences: Any economic slowdown resulting from Brexit could indirectly affect the NHS through reduced public funding. Moreover, diminished research funding could hinder the development of new treatments and innovations in the UK healthcare sector.
Regulation and Standards
One less tangible but equally essential impact of Brexit on the NHS is the alteration of healthcare regulations and standards.
Key Issues:
Medicines and Healthcare Products Regulatory Agency (MHRA): Before Brexit, the UK was part of the European Medicines Agency (EMA), which streamlined the approval and regulation of medicines across Europe. Post-Brexit, the UK's MHRA must manage its regulatory processes independently, which may delay the approval of new drugs and medical devices.
Diverging Standards: While the UK government has expressed a desire to maintain high standards for healthcare and medical products, regulatory divergence could complicate trade and cooperation with the EU. If UK standards diverge from EU norms, it may create additional barriers to importing medical products or collaborating on healthcare projects.
Consequences: The potential for regulatory divergence could slow the availability of new treatments and innovations in the UK, as the NHS would need to navigate separate regulatory systems for domestic and EU-approved medicines and technologies.
Additionally, drug shortages have forced pharmacists to obtain waivers in order to purchase more expensive medications, placing further financial pressure on the NHS.
Impact on Public Health Policy
Brexit has had broader implications for public health policy, particularly in areas where the UK once benefited from EU-wide cooperation.
Key Issues:
Cross-Border Healthcare: Before Brexit, UK citizens could access healthcare throughout the EU using the European Health Insurance Card (EHIC) system. While the UK has negotiated a replacement, the Global Health Insurance Card (GHIC) does not encompass all the same countries or services, potentially limiting healthcare access for UK citizens travelling in Europe.
Pandemic Preparedness: During the COVID-19 pandemic, EU countries benefited from coordinated procurement of vaccines and PPE. Post-Brexit, the UK was excluded from these arrangements, although it independently secured its vaccine supply. In future pandemics or public health emergencies, the absence of EU cooperation could hinder the NHS's ability to respond effectively.
Consequences: The erosion of international cooperation in healthcare could diminish the UK’s capacity to address cross-border health threats and restrict citizens' access to healthcare while traveling abroad.
On a brighter note, in September 2023, the Prime Minister secured a deal that enables UK scientists to participate in the EU's Horizon Europe scientific research and innovation program until 2027, offering crucial access to funding opportunities.
Public Health Implications
The ramifications of Brexit extend beyond the operational aspects of the NHS, carrying significant implications for public health. A potential decline in the availability of healthcare professionals, funding constraints, and regulatory challenges could adversely affect health outcomes across the population. The interconnectedness of these factors underscores the importance of a holistic approach to health policy in the post-Brexit era.
Health Inequalities
One of the most concerning implications of Brexit for public health is exacerbating existing health inequalities. Vulnerable populations, particularly those in low-income areas, may face reduced access to healthcare services as the NHS struggles with workforce shortages and funding cuts. The widening gap in health outcomes could have long-term repercussions for societal well-being and economic productivity.
Addressing these disparities will necessitate targeted interventions and policies prioritising equitable access to healthcare resources, especially for marginalised communities that the fallout from Brexit may disproportionately impact.
Mental Health Considerations
Moreover, Brexit's psychological impact on healthcare professionals and the general population cannot be ignored. The uncertainty and anxiety surrounding the future of the NHS, combined with the stress of navigating a changing healthcare landscape, may lead to increased rates of mental health issues. Confronting these challenges will require a concerted effort from policymakers and healthcare providers to ensure that mental health services are sufficiently resourced and accessible. Initiatives aimed at promoting mental well-being among healthcare workers, as well as the wider population, will be essential in mitigating the adverse effects of Brexit on mental health outcomes.
The Impact of Brexit on UK University Education: A Focus on Medical School Applicants
Since the UK formally left the European Union (EU), Brexit has significantly changed university education, impacting student admissions, tuition fees, funding opportunities, and workforce planning—particularly in competitive fields such as medicine. The landscape has altered in various ways for medical school applicants, affecting both domestic and international students.
Changes in EU Student Applications and Enrolment
One of Brexit's most immediate and visible effects on UK universities is the decline in EU student applications. Before Brexit, EU nationals enjoyed the same tuition fees as UK students and had access to government-backed student loans. However, as of 2021, EU students are now classified as international applicants, which means they face significantly higher tuition fees and lose eligibility for financial support from the UK government.
This shift has led to a steep drop in EU applications to UK universities. According to UCAS data, applications from EU students fell by around 50% in the first post-Brexit admissions cycle. This decline has contributed to a changing applicant demographic for medical schools, which already have limited spaces and high competition, with fewer EU students competing for places.
Implications for UK Medical School Applicants
1. Reduced Competition from EU Applicants
With fewer EU students applying to UK medical schools, UK applicants may experience slightly less competition. However, this effect is relatively minor given the high domestic demand for medical places.
2. Increased Demand from Non-EU International Students
UK universities, including medical schools, have addressed the loss of EU applicants by targeting non-EU international students. Since these students pay significantly higher fees, universities view them as an essential source of revenue. Consequently, UK medical school applicants may still compete with a strong pool of highly qualified international candidates.
3. Tuition Fee Stability for UK Students
For domestic students, Brexit has had little impact on tuition fees. The standard £9,250 per year cap for undergraduate degrees, including medicine, remains in place. However, with increasing pressure on NHS workforce funding, there are concerns that future changes could affect financial support for medical training.
Impact on Medical Workforce Planning
Brexit has also impacted the medical profession, influencing workforce supply and planning. The NHS has traditionally depended on EU-trained doctors, and Brexit has complicated the ability of European graduates to work in the UK because of alterations in visa and licensing requirements.
This could mean increased job opportunities after graduation for UK medical students, as the NHS grapples with staff shortages. However, it may also heighten the pressure on current medical professionals, including students and junior doctors, due to understaffing and heavier workloads.
Research and Funding Challenges
After Brexit, another key concern for UK universities is losing access to EU research funding. The UK was a significant beneficiary of programs like Horizon 2020, which supported scientific and medical research. Although alternative agreements have been negotiated, uncertainty remains about long-term funding prospects. This could affect medical schools’ ability to provide research opportunities for students, a vital aspect of medical training.
Brexit has significantly changed the UK higher education system, particularly impacting medical school applicants. While UK students may encounter reduced competition from EU applicants, they are also experiencing shifts in international student recruitment, potential changes in workforce supply, and funding uncertainties. As the UK adjusts to its post-Brexit reality, prospective medical students must remain informed about evolving university policies, NHS workforce needs, and financial considerations.
Conclusion
As of April 2025, the National Health Service (NHS) has faced several significant impacts as a result of Brexit, particularly regarding workforce composition, medicine supply chains, and funding.
Workforce Challenges
The departure from the European Union has led to notable shifts in the NHS workforce. The cessation of free movement resulted in a decline in EU healthcare professionals working in the UK. To address staffing shortages, the NHS increased recruitment from non-EU countries. By November 2024, approximately 9% of NHS doctors in England came from countries the World Health Organisation identified as having critical shortages of healthcare staff, commonly referred to as "red list" countries. This reliance has raised ethical concerns about the impact on global health systems.
Efforts to improve staff retention have shown some success. In the 12 months up to September 2024, the proportion of hospital and community healthcare workers leaving the NHS fell to 10.1%, marking one of the lowest rates in over a decade. This reduction equated to nearly 21,300 fewer staff departures compared to the same period up to September 2022.
Medicine Supply and Shortages
Brexit has also affected the UK's medicine supply chains. In 2024, the UK experienced its most severe drug shortages in four years, with Brexit identified as a key contributing factor. Supply chains have shifted, leading to scarcities in medications for conditions such as epilepsy and cystic fibrosis. The UK has had the lowest import growth in medicines among G7 countries, driven by reduced EU imports.
Funding and Financial Considerations
In terms of funding, the Department of Health and Social Care's expenditure for 2023/24 was £188.5 billion, with 94.4% allocated to day-to-day expenses such as staff salaries and medicines. Spending is projected to rise in 2025/26 at roughly average historical levels. However, the NHS continues to face financial pressures, and the anticipated economic benefits of Brexit have not fully materialised. A January 2025 survey indicated that the public perceives Brexit to have had a primarily negative impact on various areas of life, including healthcare.
In summary, as of 2025, Brexit has led to significant workforce challenges, particularly an increased reliance on staff from countries experiencing critical shortages, and has exacerbated medicine supply issues within the NHS. While funding has seen planned increases, the overall economic impact of Brexit continues to present challenges for the healthcare system.
Medical School Interview Questions
Here are some questions for medical school interviews concerning Brexit and its impacts on the NHS and healthcare in the UK:
How do you think Brexit has affected the recruitment and retention of healthcare professionals in the NHS? What strategies would you suggest to address any staffing shortages resulting from Brexit?
What are the potential implications of Brexit on the supply chain for medicines and medical equipment in the UK? How do you believe these supply chain issues could affect patient care?
How has the end of free movement for EU citizens impacted the diversity of the NHS workforce? Why is diversity important in healthcare settings?
Can you discuss how Brexit has altered the funding landscape for the NHS? What implications will these changes have on future healthcare services?
What ethical dilemmas arise from recruiting healthcare professionals from countries facing their own workforce shortages post-Brexit? How should the NHS navigate these ethical considerations?
How do you think changes in tuition fees for EU students studying healthcare in the UK might affect the future of healthcare professionals? What are the potential long-term effects on the NHS?
Brexit has led to changes in public health policy and international collaboration. What do you believe are the risks and benefits of this shift? How can the NHS maintain effective public health strategies despite these changes?
Discuss the impact of Brexit on research funding for healthcare initiatives in the UK. What role does research play in improving healthcare delivery?
What do you think the future holds for the NHS in light of ongoing Brexit negotiations and developments? How can future healthcare professionals contribute to ensuring the NHS remains robust and effective?
How should medical professionals advocate for the needs of the NHS in the context of Brexit? What role do you think advocacy plays in healthcare delivery?
How has your understanding of the NHS and its challenges evolved in light of Brexit? What personal experiences have shaped your views on healthcare in the UK?
What actions do you believe future healthcare leaders should take to mitigate the negative impacts of Brexit on the NHS? How do you envision your role in contributing to these efforts as a medical professional?
These questions can help assess your understanding of the complexities surrounding Brexit, its implications for the NHS, and your ability to think critically about the future of healthcare in the UK.
