Agenda item

Preparing for Brexit - health

To receive a briefing on preparing for Brexit – health.

(30 mins)


Rhosyn Harris, Public Health and Rebecca Clegg, Chief Finance Officer, NHS Berkshire West Clinical Commissioning Group (CCG), provided an update on preparing for Brexit – health.


During the discussion of this item the following points were made:


·         Rhosyn Harris reminded Members that with regards to local authorities it was government policy that specific plans for a possible no deal situation were not shared publicly.

·         Under the Civil Contingency Act 2004 local authorities were Category 1 responders and as such they were required to assess the risk of emergencies occurring and use this to inform contingency planning, put in place emergency plans and to put in place business continuity management arrangements.

·         Nationally there was approximately 1.6million jobs in the social care sector, the majority of which were with independent providers.  Approximately 7% were with local authorities.  Nationally, approximately 104,000 social care posts were held by EU nationals and 71% of these either held British citizenship or were eligible for settled status.  Members were informed that the estimated proportion of the adult social care workforce with an EU nationality had not seen a big decrease.

·         In the South East there were 3,450 organisations providing care at over 6,900 locations and 181,000 full time equivalent (FTE) jobs of which 12% of post holders were EU Nationals.  In the Borough there was 3,700 full time equivalent social care jobs; 3% of these were within the local authority, 89% were in the independent sector and 8% were direct payment recipients.  444 posts (12%) were held by EU Nationals.

·         Members were advised that overall it was considered that there was a low risk of disruption to local social care delivery in the short term.

·         Mitigations included the EU Settlement Scheme and wider work to address recruitment and retention of the Adult Social Care workforce.

·         Rebecca Clegg indicated that she was the nominated lead for Brexit for the CCG.  The NHS had been asked to prepare in the context of the possibility of a no deal situation.  Preparations could be adapted should other outcomes occur.

·         The Committee was informed that the NHS was used to managing risk and system pressures and that Emergency Preparedness, Resilience and Response (EPRR) processes and procedures were in place.  Existing command and control protocols and systems that were familiar for information-gathering, assurance, direction and advice, would be used.  Additional capacity would be added at both regional and national levels.

·         It was noted that NHS Berkshire West CCG was a Category 2 responder (a supporting agency).

·         The Department of Health and Social Care had issued EU Exit Operational Guidance in December 2018, which outlined what actions providers and commissioners of health and social care services should take to prepare for, and manage, the risks of a no deal exit scenario.  Rebecca Clegg highlighted what action the CCG was required to take including preparing business continuity plans for a no deal EU exit, by the end of January 2019; and carrying out a no deal EU exit exercise to test business continuity plans by the end of February 2019.  Members were informed that the business continuity plans of 14 practices had been tested and that a report of findings would be shared with all practices in the area.

·         The NHS had been asked to prepare specifically in seven key areas:

o   Supply of medicines and vaccines;

o   Supply of medical devices and clinical consumables;

o   Supply of non-clinical consumables, goods and services;

o   Workforce;

o   Reciprocal healthcare;

o   Research and clinical trials; and

o   Data sharing, processing and access

·         Ensuring continuity of medical devices and clinical consumables was discussed.  Measures that would be taken included a centralised stock build; preparing suppliers; prioritisation of medical products; dedicated supply channels for products that had a supply centre located within the EU; additional warehouse capacity and the provision of advice to NHS providers.

·         With regards to medicines, Rebecca Clegg highlighted issues under consideration including the undertaking of a medicine supply assessment, considering alternative transport routes; vaccine stocks; clinical research including trials; unlicensed medicines and a serious shortage protocol.  In addition the Government had advised to have six weeks additional supplies of medicines to avoid disruption potentially caused by a possible no deal EU exit. 

·         With regards to data, guidance had been issued on the actions that organisations needed to take in order to ensure continuity of access to, processing and sharing of personal data.  An early review of data flows and contracts to understand what data was sent and received from overseas, had been undertaken.

·         With regards to workforce, the overall assessment was that there was a low risk of disruption to local service delivery in the short term.

·         Councillor Miall commented that many paramedics, volunteer drivers and delivery drivers may currently be driving in the UK using EU drivers licences and that should there be a no deal EU exit these may no longer be accepted.  He questioned whether consideration had been given to this and whether these drivers would be required to gain UK drivers licences.  Rebecca Clegg indicated that she would follow this up with South Central Ambulance Service.

·         Councillor Miall went on to ask about the preparedness of private companies.  Rebecca Clegg indicated that all providers were required to have business continuity plans in place. 

·         Councillor Loyes questioned whether 6 weeks additional supply of medicines would be sufficient and was informed that this was what had been recommended by central Government.

·         Councillor Shepherd-DuBey commented that if there was a £30,000 salary threshold for skilled workers moving to the UK there would be a detrimental effect on the social care sector.  She commented that the number of staff coming from the EU was reducing and questioned how they would be replaced.  Rhosyn Harris commented recruitment was an issue locally due to the high cost of living in the area.

·         Councillor Richards asked about the supply and transportation of medicine.

·         Councillor Croy stated that he believed that workforce should be considered a greater risk than ‘low’ and asked that this be fed back.  Recruitment and retention was already an issue locally. 

·         Councillor Croy went on to ask about a potential shortage of radioisotopes in the event of a no deal EU exit.

·         In response to questions from Councillor Mike Haines, Rebecca Clegg indicated that the CCG’s data was based in the UK.  Greater awareness was sought in relation to cloud based storage.

·         Councillor Mike Haines also asked whether staff qualifications would still be recognised in the EU and vice versa.




1)         the update on preparing for Brexit – health be noted.


2)         Rhosyn Harris and Rebecca Clegg be thanked for their presentation.