Analysis

What does Brexit mean for nursing and our EU staff?

The UK is entering ‘uncharted territory’ after voting to leave the European Union. But what are the implications for nurses? Here we look at the immediate issues facing the profession

Currently there is free movement of labour and mutual recognition of nurse training and qualifications between EU member states. This means UK hospitals can actively recruit nurses from across the EU to cover staff shortfalls. So what now?

‘Brexit breaks the automatic recognition of professional qualifications,’ says the Spanish Council of Nursing’s head of international affairs Rafael Lletget. ‘In theory this means that, in future, a Spanish nurse wanting to work in the UK might need to go through the same process of recognition as a nurse from a country such as Bolivia or the Congo.’

There is also concern about how Brexit would affect EU nurses working in the NHS now.

Unison head of nursing Gail Adams says they need to feel valued. ‘I have always placed great importance on the contribution that overseas nursing staff make to our NHS,’ she says. ‘They have been and remain a vital part of our workforce.’

Free access to care

The European Health Insurance Card entitles travellers from the EU to free emergency care when visiting another EU country, as well as Switzerland, Norway, Lichtenstein and Iceland.

RCN senior international adviser Susan Williams says it would be sensible to keep this agreement in place.

‘We are in uncharted territory here,’ Ms Williams says. ‘At present, we have no idea whether the reciprocal arrangement for emergency care will be retained or not, but it would make sense for people to still be able to access emergency care.’

Working rights

Much of the UK’s employment law originates from EU regulation, which provides important protections for nurses, including equal pay, access to training and annual leave.

In the NHS, the equal pay measures were a driving force behind Agenda for Change.

The EU working time directive, which was implemented in the UK in 1998, introduced a maximum 48-hour working week, a daily rest period of 11 consecutive hours, and rest breaks during the working day.

The Royal College of Midwives, which backed the remain campaign, says it is considering the implications of the result for members and for women’s rights.

‘The RCM will redouble its efforts to safeguard its members’ employment rights, the status of the profession and women’s maternity entitlements and protections,’ a spokesperson says.

‘We will also be seeking assurances about the position and future of the many valued EU citizens who work in the NHS.’

Health and safety

EU directive 90/269/EEC sets out minimum health and safety requirements for manual handling of loads where there is a risk of injury to workers.

It states that employers must take appropriate measures to avoid the need for manual handling. When it is unavoidable, employers should give staff appropriate training and equipment to reduce the risk of injury.

Another key EU directive offers greater protections to healthcare workers against injury and infection from needlestick injuries.

Under the directive, which aims to enhance measures present in UK health and safety law, employers should ensure safe sharps practice and have policies for if and when an incident occurs.

‘Health and safety legislation that has been implemented won’t suddenly disappear,’ says Ms Williams. ‘But it will be up to government and legislators to decide how they want to implement the rules.’

RCN public health forum chair Jason Warriner, who proposed a debate at RCN congress on the EU and nursing, says losing EU legislation would be a ‘massive step backwards’.

‘It took a long time to get those laws in place, and where needed, it is essential that UK-based ones are drawn up to replace them as quickly as possible,’ he says.

‘It is not just a matter of safety. If you stop staff getting back injuries, or infection from a needle, then you save money.’

The nursing regulator

EU legislation sets out the requirements for training nurses, including stipulations on programme length, content, ratio of theory to practice, the nature of practice learning and range of experience.

In addition, the EU warning system that came into force in January requires regulators to alert other member states when concerns are raised about individual nurses or doctors.

However, NMC chief executive Jackie Smith says Brexit will have ‘no immediate impact’ on the regulator. ‘We will be working closely with the government and other partners to understand the implications of the UK’s negotiated withdrawal from the EU on our work,’ Ms Smith says.

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