Heartbeat: Brexit deal or no deal – and the challenges for imaging

April 14, 2021

With much of the Brexit-related talk in the media being focused on potential food shortages and whether the fish are happier as British fish, exit from the EU had the potential for other more far reaching implications, particularly in the absence of a deal.

These included how our healthcare and medical needs can continue to be best served in the complex new relationship in which we find ourselves. In the four years since the 2016 referendum up to the announcement that UK and EU leaders had managed to come to a compromise meaning we would not have to face a ‘no deal’ scenario, colleagues across our Trust had been hard at work developing contingency plans.

One area that was quick to begin work on scoping out impact was our imaging team who were acutely aware that the EU withdrawal would also mean an exit from the European Atomic Energy Community.

Jilly Croasdale, Head of Radiopharmacy Services gave Heartbeat an insight into how imaging has been preparing for Brexit and what the changes mean for our service. She told us: “The radiopharmacy community in the UK has been very involved in the negotiations throughout this process. When this started, I was Chair of the UK Radiopharmacy Group and sat on the British Nuclear Medicine Society (BNMS) Council. It meant I was involved as one of the NHS stakeholders in Department of Health and Social Care (DHSC) meetings to develop contingency plans. I co-wrote the BNMS Guidance on how to manage Radiopharmacy and nuclear medicine services in the event of a no-deal Brexit with the Royal College of Radiologists and also liaised with other radiopharmacies and nuclear medicine departments across the West Midlands to assist in the development of their risk assessments and contingency plans.

“A major impact of a no deal Brexit was the potential to disrupt how goods, including medicines, move in and out of the UK. During the years following the referendum, whilst a deal was being negotiated, the government worked closely with stakeholders in the UK to make contingency plans to limit the impact of any disruption at borders. These included the NHS and industry partners.

“For medicines, decisions were made to stockpile where possible. However, our area was highlighted as having a particular problem because of their time-critical nature. These were the radioisotopes used in radiopharmacy and nuclear medicine. Since these materials are radioactive, and as such, are decaying away all the time, any delays have the potential for making them unusable. It would result in disruption and subsequent delays to patient appointments and, subsequently, diagnosis. Although many nuclear medicine patients are outpatients, the majority of them are cancer patients, or those suffering from cardiovascular problems. Delays to diagnosis and treatment can be serious.

“Initially Brexit represented a significant clinical risk to the radiopharmacy and nuclear medicine service. A lot of planning and negotiation followed to mitigate these risks. It resulted in a move from road to air freight for all radioactive shipments into the UK. The reason for this is that, without a deal, the channel tunnel and the ‘short straights’ (for example, short channel crossings via Dover and Calais) could become congested and the risk of substantial delays was a real threat. In contrast, air freight is booked, planned and arranged in advance – it is a good solution. However, it has been challenging to arrange suitable flights. There have been some delays, it’s not ideal, but is manageable.”

Thankfully we secured a deal with the EU, so we asked Jilly how this will positively impact our service. “Now a deal is agreed, most deliveries are being made as expected, albeit with the 24- hour delay for some things, which does have a financial impact.

“However, although it has been an uncertain and worrying few years, it shows how the NHS, Government and industry can work together to overcome potential patient problems. Throughout this process, the seriousness with which the DHSC took the impact on our small specialty could not be faulted. So in the end, whatever your views on Brexit, this turned out to be a good news story.”