End of the Brexit transition period

In a referendum on the United Kingdom’s membership of the European Union in June 2016, a majority (52%) of voters opted to leave the EU. The process of withdrawing from the EU (Brexit) was lengthy and the UK did not formally leave until 31 January 2020. There was then an 11-month transition period while the UK and EU negotiated further arrangements regarding their future relationship. During this period, the UK remained part of the single market and customs union.

On 24 December 2020, the UK and EU agreed a new trade and co-operation deal. The deal took effect from 11pm on 31 December 2020.

Implications for health and social care

Brexit represented a significant change to the UK’s economic relationship with the EU. The new agreement and end of the transition period also had wide-ranging implications for health and social care in England, including on:

• International recruitment of staff – Brexit ended freedom of movement between the UK and European Economic Area (EEA) countries. From 2021, all migrant workers from EEA and non-EEA countries became subject to the same ‘points-based’ immigration system. New salary and qualifications requirements were introduced for UK visas. The new system included a fast-track, less costly Health and Care visa route for certain health professionals but this did not cover most roles in social care.
• Supply and regulation of medicines and other resources – in leaving the customs union, the UK left the regulatory oversight of the European Medicines Agency (EMA) responsible for regulating medicines and medical devices. The Medicines and Healthcare products Regulatory Agency (MHRA) became the UK’s sovereign regulator. The trade deal between the EEA and UK included clauses mutually recognising good practice in medicine manufacturing. New customs checks and approvals for medical products were introduced.

Later developments

In May 2022, the Office for Budget Responsibility (OBR), the UK’s official independent economic and fiscal forecasting body, published analysis on the impact of the change in trading relationship between the UK and EU that came into effect at the end of the transition period. The OBR estimated that Brexit would result in a 4% long-run reduction in productivity, compared with staying in the EU.

By 2021, recruitment of health care staff from the EU had fallen but recruitment from outside the EU had risen, particularly for nurses. In December 2021, government announced that it would make key roles in social care eligible for the Health and Care visa for at least 12 months, following a recommendation from its Migration Advisory Committee.