NRAS: How Brexit may impact on you

Published: 28 Feb 2019

Over the last few months, NRAS has asked its members and supporters to contact their MPs to raise various issues about the UK’s departure from the European Union and any impact this may have on people with RA and JIA.

Over 750 emails were sent to MPs from across the political spectrum, raising issues including:

  • Sufficient rheumatology workforce
  • Future innovation for research into treatments
  • Access to treatment and care in EU countries
  • Access to medicines

Regarding workforce issues, some MPs have raised concerns about recruiting staff from EU Member States once ‘freedom of movement’ ends. Currently, over 5% of staff working in the NHS are EU nationals. However, other MPs have stated that this may not be an issue, as healthcare professionals, such as doctors and nurses, have been taken out of the ‘Tier 2 visa cap’, meaning that there is not a limit on the number of skilled healthcare professionals coming into the UK.

Many MPs have raised concerns about the future of innovation and research into treatments for diseases such as RA, particularly in light of the UK’s close scientific relationships with neighbours in the EU. The UK Government launched its Industrial Strategy in 2018, and Ministers have pledged to build on existing relationships and open up new opportunities.

Millions of people in the UK have a European Health Insurance Card (EHIC), which entitles people to medical treatment when in a EU member state (also referred to as ‘reciprocal healthcare’). NRAS understands that if the UK leaves the EU without a deal, the EHIC will no longer apply in EU member states. However, if a deal is negotiated and the UK enters a ‘transition period’, the EHIC will apply during this period.

Access to medicines has been one of the most important and contentious issues, and NRAS has seen a wide variety of responses from MPs on this issue. The Government has stated that it is committed to ensuring that patients have safe and timely access to medicines and that it is prepared for all exit scenarios. The Government has asked pharmaceutical companies to stockpile 6 weeks’ supply of prescription-only and pharmacy medicines, over and above their business-as-usual buffer stocks. However, the Government has not released the lists of medical supplies for which it is seeking to develop stockpiling arrangements, and therefore it is unknown as to whether RA drugs are included within this scope.

NRAS asked its Members to raise concerns with their Members of Parliament about the Government’s ‘serious shortage protocols’, which indicated that medicines could be automatically switched by a pharmacist without discussing with the prescriber. This was a serious concern, as any changes in medicines for people with RA could cause a flare. The Government has confirmed that this protocol will only apply to suitable medicines, which does not include biologics, where the medicines need to be prescribed by brand for clinical reasons. This will come as a relief to many people with RA. However, concerns remain around other medicines (with the exception of biologics) where no such confirmation has been received. It is worth noting, however, that there is currently a motion to overturn these regulations by the Opposition, particularly in light of concerns raised by the Royal College of General Practitioners and the British Medical Association.

It has also been noted that, although the devolved administrations (Wales, Scotland, Northern Ireland) are responsible for Health and Social Care, the UK Government’s Department for Health and Social Care has overall responsibility for ensuring the continuity of the supply of medicines, and devolved nations have opted to utilise the UK Government’s contingency arrangements.

Whilst NRAS remains politically impartial, the charity’s Chief Executive co-signed a letter on 22nd February 2019 urging the Prime Minister to prevent the UK leaving the EU without a negotiated deal, due to the impact that this could have on people with RA and JIA. This is available to read here.

We are grateful for so many people getting involved in our campaign to ask MPs about the implications of the UK leaving the EU in relation to RA. The high volume of correspondence to the Minister for Health has ensured that we have obtained all of the above information, and NRAS is therefore able to pass this on more widely. A big thank you to everyone who participated!

Update 4th March 2019:

NRAS understands that the Scottish Chief Pharmaceutical Officer has established an NHS Scotland Medicines Shortages Response Group consisting of a range of health professionals that will have a Scotland-specific focus on aspects such as information sharing, intelligence gathering and steps that may need to be taken specifically in Scotland. The expertise of this Group will provide critical information that the Scottish Government can feed in to a new UK-wide Medicines Shortages Response Group in the event of a ‘no deal’ Brexit.