Nuffield Trust response to Brexit technical notices on healthcare

Mark Dayan comments on newly published Government guidance on how the NHS and its suppliers should prepare for a no deal Brexit.

Press release

Published: 23/08/2018

"It makes absolute sense for the Government to issue guidance to the NHS and its suppliers on how they should prepare for a no deal Brexit, even though avoiding such a scenario should remain the number one priority.

"It is hard to argue with the measures announced today on stockpiling drugs and devices, letting companies keep inspecting medicines in the EU, and discouraging individual NHS hospitals or GP surgeries from storing their own emergency supplies. But a no deal ultimately means a leap into the unknown - so even the best laid plans will not avoid uncertainty for the NHS.

"Manufacturers will still have to adapt to new delays and requirements, which could affect the ingredients even for medicines made in the UK, while NHS leaders will face a huge task planning special flights and storage facilities. It will be difficult to guess the scale and duration of any resulting problems. There will be an upfront cost of hundreds of millions which the NHS cannot be left to shoulder alone [1].

"What’s more, leaving without a deal could rob the NHS of vital workers at a time when staff shortages are rife. No deal on the rights of UK citizens abroad could cost the NHS millions and require almost a thousand more hospital beds if expat pensioners were forced to return to the UK [2].

"It has been said that no deal is better than a bad deal. But in the case of the NHS, any deal we are likely to get is better than no deal at all."

Notes to editors

  1. Total UK pharmaceutical imports from the rest of the EU amount to around £20 billion each year. Building up an extra stockpile of six weeks’ supply represents more than a tenth of a year’s worth of extra spending, so while it is unclear exactly what proportion of these imports is made up of the prescription and pharmacy-only drugs which will be stockpiled, the immediate cost is likely to be counted in hundreds of millions of pounds. There would then be savings in the longer term as we run down the stockpile instead of buying new medicines.
  2. Analysis by the Nuffield Trust found that caring for the 190,000 expat pensioners who use EU reciprocal healthcare to live abroad could cost the NHS an additional £500m (at last year’s rates) and would require around 900 new hospital beds.
  3. Mark Dayan at the Nuffield Trust has produced a series of reports and articles exploring the implications of a No Deal Brexit on the NHS. Find out more here: