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SWB Brexit Bulletin

March 8, 2019

Welcome to the first weekly Brexit bulletin for SWB colleagues to keep you up to date with the latest news and guidance about NHS national and local preparations.

As you are no doubt aware, at this point there is still no final deal agreed with the EU on arrangements and, as we draw closer to 29th March, contingency planning for a ‘no deal’ scenario has been stepped up.

At our Trust, a group of key individuals are meeting regularly to ensure we have sufficient plans in place.

This bulletin focuses on workforce and overseas visitors. Future bulletins will describe our preparedness for medicines, supplies and equipment.

EU citizens who work with us

  • The Home Office has outlined the arrangements for EU citizens in the event of a no deal Brexit, which set out the rights for EU citizens to live and work in the UK depending on whether they have come to the UK before or after 29th
  • EU staff currently working in NHS trusts are eligible to apply for the EU Settled Status Scheme at no cost. Applicants can gain settled status if you have been living in the UK for five years, or pre-settled status if you have been resident for a shorter period. The application deadline has been brought forward to December 2020 in the case of no deal. If EU citizens come to the UK after 29thMarch they will be automatically eligible to work in the NHS for up to three months, but need to apply for European Temporary Leave to Remain status if they wish to stay for a maximum of three years.
  • The future “skills based immigration system” will be implemented from 2021 and will clarify the status of EU healthcare staff in the long term. The government is consulting with stakeholders on proposals set out in the Immigration White Paper last December, which aim to standardise rights of EU and non-EU citizens.

Professional regulation (recognition of professional qualifications)

  • Health and care professionals (including UK citizens), whose qualification has been recognised and who are registered in the UK before 23:00 on 29 March 2019, will continue to be registered after this point.
  • Health and care professionals (including UK citizens), who apply to have their qualification recognised in the UK before 23:00 on 29 March 2019, will have their application concluded under current arrangements.
  • Health and care professionals (including UK citizens) with an EU/EEA or Swiss qualification, who apply to have their qualification recognised in the UK from 23:00 on 29 March 2019 will be subject to future arrangements.

Reciprocal arrangements and overseas visitors

  • In a ‘no deal’ scenario, UK nationals resident in the EU, EEA and Switzerland may experience limitations to their access to healthcare services. The Government is therefore seeking to protect current reciprocal healthcare rights through transitional bilateral agreements with other member states.
  • Advice will be issued by the Government to UK nationals living in the EU, to UK residents travelling to the EU and to EU nationals living in the UK. It will explain how the UK is working to maintain reciprocal healthcare arrangements, but this will depend on decisions by member states. It will set out what options people might have to access healthcare under local laws in the member state they live in if we do not have bilateral agreements in place, and what people can do to prepare. We will update you as more information becomes available.
  • As is currently the case, if UK nationals living in the EU face changes in how they can access healthcare, and if they return permanently to the UK and take up ordinary residence here, they will be entitled to NHS-funded healthcare on the same basis as UK nationals already living here.

The important message for all colleagues is that, until we are given any different instructions, our existing arrangements apply, in that we must continue to ask the three questions as patients present to our Trust:

  1. Are you a UK citizen? (if ‘yes’ go to Q4)
  2. Are you a EU, EEA or Swiss citizen? (only if answered ‘no’ to Q1)
  3. Do you have a valid visa or permission to remain in the UK? (only if answered ‘no’ to Q1 and Q2)
  4. Are you living in the UK permanently?
  5. Do you have a valid EHIC (European Health Insurance Card)? (only if answered ‘yes’ to Q2).

If an EU citizen you must take a copy of their EHIC and send to the overseas visitors team. If the patient answers ‘no’ to any other question they should be referred to the team at swb-tr.SWBHOverseasVisitors@nhs.net or on 3420. For more details see https://connect2.swbh.nhs.uk/governance/overseas-visitors-team/

If you have any concerns or comments please send them to tobylewis@nhs.net who is our Senior Responsible Officer for Brexit preparedness.