The National Health Service (NHS) is facing a transformative period in the wake of Brexit, with various workforce challenges and opportunities on the horizon. In this article, we examine some of the key issuessuch as GP staff shortages, international ‘brain drain’ and strikes, that are currently affecting the NHS workforce. We will also explore potential solutions and positive developments that are shaping the future of healthcare in the United Kingdom. For the private healthcare industry, although NHS wages and work conditions are not policy focus areas, the lack of services being carried out and the disruption to normal practice happening across the country may have a long term impact on the uptake and usage of new medical products. Increasingly, an assessment lens for any product entering the UK market will be its capability as a support tool to an NHS under pressure.

Unpacking the Challenges: shortages, drains and strikes

One of the immediate impacts of Brexit has been the migration-related workforce issues in the NHS. The healthcare sector has long relied on talent from across the European Union (EU) to fill critical roles. However, since the UK’s departure, the ease of hiring professionals from EU countries has diminished, creating staffing shortages and putting pressure on NHS services. A recent article by GP Online highlights the growing reliance on locum doctors (doctors who temporarily fill in roles due to illness or staff being on leave) in GP practices as they struggle to hire full-time staff. This is both a response to workforce shortages and a reflection of the broader challenges in recruitment and retention, an issue compounded by the fact that foreign GPs currently work under ‘Skilled Worker’ Visas, which require five years of working experience before an individual can request Indefinite Leave to Remain. Currently, the training timeline for a GP is three years, meaning workers must look for external sponsorship to remain in the country for the full required period. This has led to concerns over a ‘brain-drain’, as unsatisfied workers either shift industries or move countries entirely for better opportunities.

This so-called ‘brain drain’ of skilled professionals to other European countries seems to be an issue across the UK. Data from 2020 shows that the annual number of Brits migrating to Europe had increased by 30% compared to before Brexit. Australian programmes are also specifically advertising to British junior doctors, with one advert even reading, “Are you a UK-based junior doctor who wants job stability, great remuneration and the clinical support you need to develop your career?”. These programmes are certainly offering a tempting package: with a base pay rate ranging from £42,805 to £74,509 compared to £29,384 to £58,398 in the UK. The long term ramifications of this are yet to be seen: from 2021 to 2022 there was an increase of 5,576 applications for licenses to practice abroad, a quarter of which were from doctors aiming to move to Australia. National strikes within the NHS are perhaps the largest symptom of the issues faced by public services. Healthcare workers, including nurses and other staff, have taken to the streets in unprecedented numbers to protest working conditions, pay disparities, and workforce shortages.

The Way Forward: NHS response and future opportunities

While these challenges are substantial, there are potential solutions and positive developments that offer hope for the NHS workforce. The two keys to growth are recruitment and retention, factors which tat stakeholders in the UK health industry must factor into long-term planning.

The government is certainly aware of these issues, publishing the NHS Long-Term Workforce Plan earlier this year as a comprehensive strategy aimed at ensuring that the NHS has the staff it needs to meet future healthcare demands. This plan outlines initiatives to recruit, train, and retain healthcare professionals while addressing workforce inequalities and ensuring the highest quality patient care. Most importantly, it aims training an extra 60,000 doctors, 170,000 more nurses and 71,000 more allied health professionals by 2036/37. An opportunity for medicine manufacturers is presented in a pledge that states that, in the future, “all newly qualified pharmacists will be independent prescribers”. Private companies can plan for a future increase in collaboration, perhaps in the form of increased engagement with pharmacists via events and representatives, or even sponsorships and grants towards the National Pharmacy Association (NPA).

In terms of recruitment, the continuation into 2023/24 of the NHS bursary fund for students pursuing healthcare-related degrees is a significant step towards addressing workforce shortages. By providing financial support to aspiring healthcare professionals, the NHS aims to attract and retain talent within the system. The Medicines and Healthcare products Regulatory Agency (MHRA) has also published a ‘People Strategy’ for 2023-26, in which it addresses training concerns by committing to “secondments and loans across the health family”.

However, a major issue is still retention. Scotland has notably not experienced the same level of national strikes as other parts of the UK, and so examining the strategies that contribute to this relative stability and adapting them to other regions could offer valuable insights. Of course, the main difference remains salary, as the Scottish government agreed this summer to a historic 12.4% pay raise for junior doctors in training in 2023/24, therefore suspending industrial action.

The lesson the government needs to take from this is clear: investment is necessary. Investment in wages, accommodating foreign workers, and creating a competitive employment market that attracts rather than drives away its domestic workforce. The question, however, is where this investment will come from in the midst of a cost-of-living crisis, in which the inflation-adjusted budget for the NHS in 2022/2023 has fallen 2.65 and 6.22% from the 2021/2022 period. A possible suggestion is that the private sector intervenes, planning for the avoidance of a long-term potential collapse of services, and therefore of almost its entire costumer-base; an outcome with increasing plausibility as major workforce issues remain insufficiently addressed. Innovation in medical technologies will need to play a key part in filling the operational gap left while training schemes address the long-term issues, and that is where private companies must take up the mantle.

Interested in learning about the NHS and opportunities to influence future UK health policy? Get in touch with our UK team, at b.smith@rpp-group.com