Nurses from Spain may be more likely to quit the health service in the event of a no-deal Brexit, because NHS experience will no longer be recognised in their home country, it has emerged.
Currently, Spanish nurses working in the NHS can accrue points that help improve their employment prospects in health services in Spain.
“I know a lot of nurses – especially the young ones – who have gone to Ireland”
Joan Pons Laplana
However, if the UK leaves the European Union without a deal NHS work experience will no longer be recognised in Spain, prompting fears of a mass exodus, according to warnings that first emerged in Health Service Journal.
Official figures show Spanish nurses made up nearly 17% of the EU NHS nursing workforce – 3,370 nurses – as of June 2018, making them the second largest group of EU nursing staff after nurses from the Republic of Ireland.
Yet Nursing Times has been told many are now looking for jobs outside the UK because they want to ensure they can get a good job back home.
Joan Pons Laplana, a Spanish nurse who came to work in England in 2000, explained the regional points-based system in Spain, where points are awarded based on qualifications and work experience, could make it hard for newly-qualified nurses to find jobs there.
“If you stay in Spain it is very difficult to get points because often the only work on offer is holiday cover or maternity cover if you are lucky. When I qualified as a nurse I spent most of my time delivering pizzas,” he said.
Like many others, he had come to England to gain work experience that would also be recognised in Spain, said Mr Pons Laplana, who is a transformation nurse at James Paget NHS Foundation Trust and currently on secondment as a clinical fellow at NHS Digital.
- Exclusive: The nurse helping to find digital solutions to frontline NHS challenges
- Two nurses to help develop new generation of NHS digital tools
“The main reason a lot of Spanish people come to England is became they come here as a newly-qualified nurse without much work experience,” he said. “They work here three, four, five years and get a lot of points and when they go back and a vacancy comes up they have a much better chance of getting it.”
Any final deal with the EU would need to include an agreement between nursing regulators in the UK and Spain to allow current arrangements to continue.
“What we clearly need is certainty for our staff and clarity from regulators and professional bodies2
But Mr Pons Laplana said he knew Spanish nurses who had already left the NHS because of the risks of a no-deal scenario, with many choosing to work in the Republic of Ireland, which was now their “first choice”.
“I know a lot of nurses – especially the young ones – who have gone to Ireland. One of the reasons people used to come to England is because they wanted to improve their English and now they can have the same in Ireland,” he said.
“Other reasons include the fact the working conditions here in England have deteriorated and also that the pound is not as strong as it used to be which means the salaries in Ireland are now more attractive,” he added.
He warned that ongoing uncertainty and concern about harming their nursing careers was likely to deter Spanish nurses from working in the NHS altogether.
“If I am a young nurse and know that I can go to 27 countries and get points to go back to Spain or go to England where I get nothing, I will not go to England,” he said.
“Spanish nurses are the second largest group coming from Europe and my prediction is they will no longer come to the UK to work,” said Mr Pons Laplana.
NHS Employers confirmed information had been sent to Spanish nurses from the Spanish nursing regulator to alert them to the fact Brexit “may have an impact on their continued registration”.
joan pons laplana
Meanwhile, there is evidence trusts are already planning for the impact of losing Spanish nurses en masse.
Board papers from Bolton Clinical Commissioning Group show Bolton NHS Foundation Trust looks set to lose at least four theatre nurses.
“Spanish nursing regulators have indicated that they will no longer recognise UK nursing experience for Spanish nationals post-Brexit and this has meant some of our Spanish nurses in theatres have indicated that they are looking to return to Spain this year,” said the document.
The trust said it had been in discussion with four theatre nurses and their jobs were already being advertised “in anticipation of the possibility of those staff leaving”.
Managers would also speak to five other Spanish nurses working elsewhere in the trust, the document said.
Mr Pons Laplana said he had raised the issue with the Spanish embassy in London and the Spanish nursing regulator but had been told it “was not a Spanish problem”.
He said he had also alerted UK nursing unions and contacted the Department for Health and Social Care.
The organisation NHS Employers said nurses needed urgent reassurance that professional experience gained in the UK would be recognised by other EU countries post-Brexit.
“Some of our Spanish nursing colleagues have received information saying that when the UK leaves the EU, it may have an impact on their continued registration with the Spanish regulator,” said NHS Employers chief executive Danny Mortimer.
He said: “This reflects the fact that unless resolved through a deal between the UK and various EU regulators, experience in ‘third countries’ (which the UK becomes) won’t necessarily be accepted for registration purposes.”
A spokesman for NHS Employers confirmed the body was seeking clarity on the situation.
“What we clearly need is certainty for our staff and clarity from regulators and professional bodies – and quickly,” added Mr Mortimer.
“The future relationship with the EU will need to set out clearly how professional experience gained in the UK might be recognised by EU member states, and vice versa,” he said.
The Department of Health and Social Care said it would seek to ensure qualifications and experience were recognised.
“Nursing staff working within the NHS are trained to an exceptional standard so they can provide a high level of care for the patients they look after,” said a spokesman.
He said: “In the event of a no-deal exit from the EU, we will seek to put in place arrangements to ensure that nursing qualifications and experience gained within the NHS are recognised in EU member states in the same way that they are in other countries.”