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Why Brexit could be catastrophic for the NHS

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Brexit could have a disastrous impact on healthcare innovation and improving services UK.

A recent article in The Lancet argued that leaving the EU would have drastic consequences for the NHS, primarily due to staffing concerns. More than 60,000 workers in the NHS, and 90,000 in adult social care are from other EU countries, and a 92% drop in EU nationals registering as nurses in England since the referendum has been widely reported.

A potential staffing crisis is clearly a challenge to the future of a high performing healthcare system, but it is not the biggest threat to a post-Brexit NHS.

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The NHS needs to make productivity savings of £22 billion by 2020/21, which The Kings Fund argue can only be made through an ongoing commitment to quality improvement and innovation in healthcare. This relies on the effective translation of high quality research into frontline care and service design, closing the gap between ‘what we know and ‘what we do’.

In other words, in a quest for ongoing quality improvement in the NHS we need skilled researchers working with experienced clinicians, encouraging innovation at all levels of the health service.

But what impact will Brexit have on this? Despite assurances from some that leaving the EU will not undermine innovation, in reality the picture seems far more uncertain.

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The European Medical Agency (EMA) recently announced it would be relocating its headquarters from the UK as a result of Brexit. Notwithstanding the loss of the EMA as a safety regulator of the drugs and technologies marketed in the UK, perhaps more profound is the loss to the scientific community as highly skilled researchers leave.

The move of the EMA reflects the current landscape in healthcare research. The loss of funding streams, the free movement of research personnel and issues related to shared intellectual property undermine the potential for international research collaboration.

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There are currently 25,000 EU nationals working in academic or research roles in Russell Group Universities, many of whom are at risk of leaving. They take with them years of experience, insight and knowledge, which will not be easy to replace.

These challenges all take place against a backdrop of uncertainty, where the threat of future economic downturn is ever present. How the NHS responds to this relies on its ability to work with international academic and research institutions, searching for innovative solutions that improve quality without increasing costs.

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Until the terms of Brexit can be agreed, there can be little reassurance about the future of a high performing NHS.

While the practicality of a staffing shortage could be resolved, the exodus of talented and experienced researchers and clinicians threatens our ability to produce world-class research and innovation, and to translate that research and innovation into world-class healthcare.

Charlotte Croft, of Warwick Business School, is Assistant Professor of Healthcare Improvement and is researching the impact of Brexit on the NHS.