Health and social services

In this section

Will services be affected?
Medical supplies
Preparing for Brexit
Working in health and social care
Reciprocal healthcare

Maintaining high-quality and safe health and social care is our top priority as we prepare the leave the EU.

We are working with every health and social care organisation across Wales to ensure services are protected, as much as possible, from any disruption leaving the EU without a deal could cause.

These preparations have been taking place at a local, Wales and UK level. We are also working with senior leaders from the health and care sector and public health organisations to assess and address the public health and health security concerns.

The Welsh Government’s EU Transition Fund has given funding to projects to support health and care in Wales, including research into the social care workforce; extra resources to support the Food Standards Agency; a public health resilience programme; the Welsh NHS Confederation Brexit transition programme and the ADSS Cymru Brexit transition fund.

Will services be affected?

At this stage, we do not anticipate any immediate impact on day-to-day NHS or social care services. Local care and hospital services will continue to work as normal and we do not expect planned or emergency operations to be cancelled in the event of a no deal Brexit. This includes A&E care, social care, GP and dentist services.

How can you help?

You can help the NHS prepare for Brexit by continuing to Choose Well and choose the right NHS service for your illness or injury. Choose Well will help you decide if you need medical attention if you get sick. It explains what each NHS service does, and when it should be used. This allows NHS services to help the people who need it most. You can also check your symptoms using the NHS Direct Wales Symptom Checker.

Will there be a shortage of medicines and medical supplies?

There has been a lot of press attention about whether prescription medicines will be available in the event of a no deal Brexit.

We have been working with the UK government and the pharmaceutical industry over the last year to maintain the supply of medicines and drugs for people in the event of a no deal.

Watch the Chief Pharmaceutical Officer's video about the supply of medicines in the event of a no deal.

Posters and leaflets to help health and social care organisations prepare for Brexit

In Wales, we are taking extra steps to prepare for any disruption to medicines and to maintain supplies of other medical consumables and devices. Clinicians should not write longer NHS prescriptions and people should not stockpile medicines at home as this could cause disruptions to supply.

People should keep doing what they’ve always done. That means only ordering prescriptions when they are needed, get it dispensed in the usual way and continuing to take it in the way it was prescribed.

If you have any concerns about your medicines or your regular prescription, you should talk to your local pharmacist in the first instance.

Supply of radioisotopes

There have also been concerns about the availability of radioisotopes, which are used in the diagnosis and treatment of cancer if the UK is no longer part of Euratom. Due to the half-life of the isotope, it is not possible to stockpile supplies. Radioisotope is usually imported overnight from continental Europe via Dover and distributed by road. This relies on frictionless customs arrangements and unimpeded transit between continental Europe and the UK.

The UK government, as part of its medicines supply programme, is working to mitigate the risk of disruption to the supply of radioisotope and secure a reliable supply.

How local authorities, health boards and NHS trusts are preparing for Brexit

Health boards, NHS trusts and local authorities have reviewed their existing resilience plans in the context of a no-deal Brexit and are working with their partners in their local resilience forums. These plans will be tested as part of the wider public service preparations.

Local authorities and independent and third sector social care providers are responsible for social care in Wales. We are working closely with them to co-ordinate their preparations for a no deal Brexit.

The Welsh NHS Confederation has published an FAQ document about Brexit in health and social care, which is aimed at people working in the NHS and social care sectors.

They also produce a weekly bulletin with the latest news and updates, you can subscribe to receive this bulletin by visiting their website.

UK: EU nationals working in health and social care

EU citizens have always been, and will continue to be welcome in Wales. EU nationals play a valuable role in providing health and social care services in Wales and we value each person and the work they do in health and social care.

EU citizens and their families living in the UK can apply for the Home Office’s Settled Status scheme. This will mean they can continue to live and work in Wales following Brexit.

The Home Office has published the following advice if you are an EU citizen; an organisation employing EU staff or are recruiting from the EU:

  • EU citizens in the UK – Stay Informed, provides information about the citizens’ rights agreement and the Settlement Scheme for EU citizens in the UK.
  • If EU citizens want to stay in the UK beyond 31 December 2020, they and their close family members will need to apply to the EU Settlement Scheme
  • A toolkit has been launched to equip employers with tools and information to support EU citizens and their families about the EU Settlement Scheme.

The UK government has launched an Prepare for EU exit campaign to give individuals and businesses advice about how preparations and the steps they may need to take.

Wales: EU nationals working in health and social care

Earlier this year, the Welsh Government commissioned Ipsos Mori to undertake a piece of research looking at the make-up of the social care and childcare workforce in Wales to help identify how many of EU nationals are employed in the sector in order to support them and their employers. The report found that an estimated 6.4% of staff within registered social care settings and 4.5% of staff within registered childcare services in Wales are non-UK EU nationals, showing that EU nationals make up a relatively small but important part of the workforce. However, when viewed against the broader context of existing staffing challenges in the sectors, the report indicates that the impact of the UK leaving the EU is likely to exacerbate existing workforce pressures.

We recognise the importance of maintaining mutual recognition of professional qualifications (MRPQ) for the health and social care workforce. This will support the movement of health and social care professionals across Europe.

In the event of a no deal Brexit we anticipate existing EU and international qualifications will continue to be recognised for a fixed period. We are working with the UK government to develop the necessary legislation to support this.

Reciprocal healthcare arrangements

The UK government is currently looking at the future arrangements for reciprocal healthcare. The current reciprocal healthcare rights which we have as members of the EU include:

  • state pensioners have full access to healthcare in the country they retire to
  • the free EHIC (European Health Insurance Card) allows people temporarily visiting another member state to receive emergency healthcare
  • posted and frontier workers are able to benefit from local healthcare rights

UK patients are able to exercise the right to planned medical treatment in another EU/EEA country

UK patients are able to purchase healthcare services across the EEA and apply for reimbursement from the UK.

On 23 September 2019 the UK government committed to funding healthcare for over 180,000 UK nationals living in the EU for the first 6 months following the UK’s departure from the EU.

People living in the EU who have their healthcare funded by the UK, including pensioners and students, will have their healthcare costs covered by the UK government. Other commitments include:

  • covering the healthcare costs for students who begin their courses in the EU ahead of 31 January 2020 for the duration of their course.
  • covering the healthcare costs of UK visitors to the EU who commenced their trip before the UK left the EU until they return to the UK    
  • covering the costs of UK Nationals in the EU who may be in the middle of treatment when we leave the EU for up to a year. 
  • ensuring that people currently insured by the UK living in the EU can return to use the NHS temporarily in England, Wales & Scotland free of charge.

For more information people can contact Overseas Healthcare Services at the NHS Business Services Authority (NHS-BSA) by telephone Monday-Friday 8am-6pm and Saturday 9am-3pm (UK time) on +44 (0)191 218 1999.

We are working with the UK government to ensure the interests of Wales are properly recognised and represented.

Reciprocal Healthcare after EU Exit for citizens of the EU, Norway, Iceland, Liechtenstein and Switzerland living in Wales

Information on healthcare for citizens of EU countries, Norway, Iceland, Liechtenstein and Switzerland living in Wales after the UK leaves the EU.

What you need to do

If you are living in the UK before EU Exit, make sure you:

Getting healthcare in Wales

This section is about getting healthcare in Wales. You will be able to access free NHS treatment in Wales until the UK leaves the EU if you are ordinarily resident in Wales or are registered with a Welsh GP. To be considered ordinarily resident, you must be living in Wales on a lawful and properly settled basis for the time being. You may be asked for evidence of this.

If you are living lawfully in Wales on Exit day, you will be able to use the NHS in Wales, as you can now, after that date. If you are not ordinarily resident in Wales, you will be an overseas visitor and may be charged for NHS services.

The UK government is aiming to agree reciprocal healthcare arrangements either with the EU or with individual countries if there is a no-deal Brexit. Reciprocal healthcare provides urgent, immediate or planned medical treatment at a reduced cost or, in some cases, free.

If you are moving to the UK after exit day and there is no deal, you should check with your health insurance authority what has been agreed.

Agreement with Norway, Iceland, Liechtenstein and Switzerland

The UK has agreed citizens’ rights agreements with Norway, Iceland, Liechtenstein and Switzerland, which will apply if there is a no deal EU Exit. These agreements mean that citizens of these countries living lawfully in the UK on the day the UK leaves the EU will be able to use the NHS as they do now.

These agreements do not cover citizens of these countries who move to the UK after EU Exit.

Find out more about the Swiss Citizens’ Rights Agreement on GOV.UK.

Find out more about the EEA EFTA Citizens’ Rights Agreement (Norway, Iceland and Liechtenstein) on GOV.UK

Agreement with Ireland

Irish citizens who live in the UK, and British citizens who live in Ireland, will continue to have healthcare cover in the country they live in after Brexit. This is because of longstanding arrangements under the Common Travel Area.

Find out more information on the Common Travel Area between the UK and Ireland on GOV.UK

Studying in Wales

You can continue to use your EHIC or Provisional Replacement Certificate (PRC) to access free NHS healthcare if you have begun a course of education or training in Wales before the UK leaves the EU. This will apply until the end of your course, even if it finishes after exit day.

If you start your education or training in Wales after the UK leaves the EU, your EHIC may not be valid. You should buy insurance to cover your healthcare as you would if visiting another non-EU country.

This would not affect the rights of individuals covered by the citizens’ rights agreements with Switzerland, Norway, Iceland and Liechtenstein.

S1 certificate

Under current rules, an S1 certificate helps you and your dependants to be covered for healthcare when you are living in the UK.

If you are living in Wales on the day the UK leaves the EU, your S1 will still be valid in Wales after that date.

You can continue to apply for an S1 certificate until the UK leaves the EU. However, it may not be valid if you arrive in Wales after exit day, depending on what arrangements have been reached with the EU or individual countries.

You may be eligible for an S1 certificate, if you:

  • have worked and paid contributions in EU countries, Norway, Iceland, Liechtenstein or Switzerland
  • receive certain benefits, such as a pension, from EU countries, Norway, Iceland, Liechtenstein or Switzerland

You should apply to the health insurance authority in the relevant country, if you are eligible. You must register your S1 in Wales to access NHS care in the same way as someone who is ordinarily resident.

If you are a citizen of Norway, Iceland, Liechtenstein or Switzerland and living in the UK on exit day, your S1 will still be valid after that date because of the citizens’ rights agreements with those countries. If you do not have an S1, you can still apply to your health insurance authority for an S1 after exit day.

Data protection

Following Brexit, the rules about how personal data flows between the EU and the UK will change. Visit the Information Commissioner’s website to find out more about how these changes will affect you or your organisation.

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