Going it alone: health and Brexit in the UK

After nearly a year out of the Single Market and Customs Union, Brexit is still fuelling uncertainty in many aspects of health and social care. This report looks at six key areas that are being impacted, what has already happened and what NHS, government and business figures expect for the future.

When the UK left the single market, it marked the end of the application of European law and institutions which underpinned many elements of health and health care in the UK. Regulations on medicines and devices, laws on the buying and selling of care, trade agreements, and rules on migration which had previously worked across most of a continent, were repatriated to the UK. 

This report, an interim output from the Health and International Relations Monitor project funded by the Health Foundation, considers the impact of leaving the EU and changing international relations for health. 

It considers changes in health across six key areas: medicines and devices, international trade agreements, devolution, procurement, workforce and Northern Ireland. 

In the full report to be published in the Spring, we intend to examine two of the building blocks of health most affected by Brexit - workforce and living standards. 

Key findings

  • Workforce-related issues such as staffing, sustainability and wellbeing were the most pressing concern to interviewees following the introduction of new immigration rules. The situation in social care is the most urgent, where new immigration rules effectively halt immigration from the EEA. 
  • The medicines, medical devices and life sciences industry in the UK faces great uncertainty. Border bureaucracy has increased dramatically, and clear plans are lacking to keep areas of health care attractive or competitive. 
  • Governments in Scotland, Wales and Northern Ireland are concerned that they have lost some of their control over health protection, improvement of health outcomes and health-related funding. 
  • Pledges to keep the NHS and medicines prices "off the table" in trade negotiations mean little without specific committments on key areas such as patent protections and investment rules. Transparency and engagement with the health sector have both been limited. 
  • There does not appear to be a clear agenda to bring any benefits to health in the UK through trade agreements. 
  • Northern Ireland faces serious risks to medicines and devices supply at the end of 2021 should arrangements with Europe simply end without agreements in place. Checks and customs will begin to apply at the border between Northern Ireland and Great Britain without mitigation.



Suggested citation

Dayan M, McCarey M, Hervey T, Fahy N, Greer S, Jarman H, Stewart E and Bristow D (2021) Going it alone: health and Brexit in the UK. Research report, Nuffield Trust