What impact will Brexit have on nursing?

The NHS faces a severe nursing shortage. An ageing population has pushed up demand, while an ageing nursing workforce – with one in three nurses set to retire in the next 10 years – is reducing supply. The shortage is particularly acute in mental health, with specialist nurse numbers falling more than 10% in the past five years.

And the Brexit vote may make it even worse. A July 2016 Institute for Employment Studies (IES) report reveals about 4.5% of NHS nurses in 2015 were from EU countries excluding Ireland, a steep rise from the 1% of 2009. In some trusts in London and the east of England, the proportion is as high as 20%.

Nurses who have been here more than five years will be eligible to remain. But what will happen to the others? Helen McKenna, senior policy adviser at the King’s Fund thinktank, believes that the government “urgently needs to clarify its position on the status of nationals who are already here in the UK working in health and social care roles”. While the prime minister has said she would like to guarantee the rights of EU citizens already living here, that is by no means certain. McKenna says: “Her position is likely to be dependent on reciprocal agreements for UK citizens living elsewhere in Europe.”

Rachel Marangozov, IES senior research fellow and report co-author, notes that the uncertainty and perceived hostility towards migrants may put some EU nurses off: “What are you going to say? ‘Come and work in London or the east of England – we can’t guarantee your future status, but come and work for us.’ It’s a very difficult sell.”

Janet Davies, Royal College of Nursing chief executive and general secretary, says that nurses from the “wider” EU are already losing interest in coming here and warns: “It’s to be expected as an immediate reaction, but what we don’t know is whether it’s a trend that will be sustained and become a serious problem.”

Both Marangozov and McKenna think the problem could be partially addressed by naming nurses as a priority occupation. But it may be difficult, says Marangozov, to devise a set of criteria that would allow in nurses but not other occupations in shortage areas.

An alternative is to ramp up recruitment from outside the EU. This will also need a change in policy, but, according to Marangozov, the very reason recruitment from EU countries has increased so dramatically is because of tighter immigration controls on countries outside the EU. The only realistic solution, she argues, is better workforce planning at a national level. Given the global shortage of nurses, dependence on immigrant nurses can only be a temporary measure: “We just rely on them as a stopgap because nobody has bothered to plan these issues in the workforce properly.”

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What impact will Brexit have on nursing?