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Make patient safety part of the Brexit legacy, say surgeons

20 Dec 2016

Leading surgeons have urged government and the NHS to use Brexit to improve patient safety in the UK.  The Royal College of Surgeons (RCS) says giving job security to NHS staff from the European Union (EU), testing the language skills and competence of non-UK healthcare staff, enforcing more rigorous standards for medical devices and drugs, and relaxing training time restrictions for surgeons should now be a priority.

According to the RCS, the UK, like other EU countries, has often been required to accept the lowest common denominator of standards across Europe, sometimes putting patients at risk. A new position paper from the RCS, Making the Best of Brexit for the NHS, outlines areas of opportunity that could strengthen patient safety, as well as risks to the NHS, now that the UK has voted to leave the EU.

Surgeons are disproportionately likely, compared with other medical specialties, to have trained in the EU. 22% of registered surgeons trained in the EU with a further 20% from the rest of the world. This compares to 11% of all doctors on the GMC register having trained in the EU and a further 26% from the rest of the world. The RCS warns that maintaining and enticing staff to work in the UK should therefore remain a priority. It says tougher migration rules could affect the many technicians, porters, cleaners and other staff who also serve patients and that the NHS must be able to continue to attract such staff. It calls on Government to confirm that it will protect the citizenship of all NHS professionals already residing in the UK and continue to attract foreign staff, while also training sufficient numbers of home-grown staff.

Miss Clare Marx, President of the Royal College of Surgeons, said:

“The UK has voted to leave the EU and regardless of which side of the debate doctors found themselves on prior to the referendum, it’s now clear the public expect us to use Brexit to help, not hinder, the health service.  

“First and foremost, we must make certain that the many staff from the EU already working in the NHS and on which it depends, are protected. We need good staff to maintain a safe NHS. Jeremy Hunt’s plans to increase the number of UK doctors being trained from September 2018 are very welcome but it can take around 15 years for a surgeon to be trained and in meantime the UK will still need to attract staff from overseas to address workforce shortages.
“As part of the EU, we’ve had to accept laws and regulation on issues such as language testing of non-UK staff, professional qualifications, working time and the safety of medical devices and drugs which perhaps fell short of our own standards or hindered our ability to do our jobs to the highest safety standards. Brexit allows us to correct this. The RCS strongly believes that if the opportunity is seized alongside protecting the right of staff from the EU to work here, improved patient safety in the NHS could be a positive legacy of Brexit.”

The position statement reiterates calls made by the RCS and the Faculty of Dental Surgery earlier this year to change the law so that the same language tests apply to staff from the EU as the rest of the world on the basis of English language capability in a medical setting. It also says that post-Brexit, regulators should have the power to test the competence of European health professionals in the same way as they do for international health professionals.

The RCS says that new legislation is required to give more flexibility to surgeons’ training and working patterns and that the Government should consult widely to assess the need for flexibility in other medical specialties. In 2014 a taskforce of medical bodies including the BMA concluded that the European Working Time Directive (EWTD) has had an adverse impact in the NHS on training in certain medical specialties, including surgeons and doctors working in acute medicine, introducing inflexibility into working patterns on wards.

The UK should also toughen laws relating to medical device and drug safety. Under current European legislation it is possible for some devices to find their way into the UK having been approved in European countries with lower safety standards. At the same time, the RCS says the Government should set out how it will attract and facilitate innovative medical devices and drugs.

The RCS also says that the pledges by both sides of the Brexit debate to strengthen the NHS should now be delivered.

Notes to editors

1. Data on percentage of surgeons and doctors from overseas countries is provided by the General Medical Council. Data was accurate at 31 December 2015.

2. The Royal College of Surgeons of England is a professional membership organisation and registered charity, which exists to advance surgical standards and improve patient care.

3. For more information, please contact the Press Office:

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