BMJ survey reports lack of NHS planning for Brexit: impact on drug supplies unknown

Simon Collins, HIV i-Base

A report in the BMJ reports a lack of comprehensive or consistent planning for Brexit across the NHS. [1]

This includes crucial areas such as continued supply of medicines and implications of immigration changes on the NHS workforce.

Results were from a survey to all NHS trust and health boards across the UK, using freedom of information requests.

Main findings include:

  • Only 9% of trusts in England (15/161 that responded, out of a total of 231) have new structures in place to oversee plans for Brexit.
  • This compares to 66% of health boards in Wales, Scotland and Northern Ireland (14/21 that responded, out of a total of 25).
  • Only 25% of trusts have a risk assessment plan (47 out of 182 that responded). 
  • Individual trusts report different approaches to government requests not to stockpile medicines or to write longer prescriptions. For example, some trusts are expecting potential interruptions in treatment of six weeks and others for 12 weeks.
  • A lack of centralised NHS leadership – with the Department for Health and Social Care for England pushing responsibility for planning to individual trusts.
  • Centralised support from the Scottish government is likely to have helped with local planning.
  • Even where plans were in place, most were limited due to the uncertainly of any details for a planned Brexit.


Guidelines for implications of Brexit for HIV positive people were recently published by the UK Community Advisory Board (UK-CAB), a national network of HIV treatment advocates. [2]

These include asking people to have sufficient HIV medications to cover the months either side of the proposed date for Brexit. HIV medicines are commonly prescribed for three to six months, which will hopefully cover any short-term interruptions in drug supply and the period when the NHS is most likely to be stressed by changes.

The lack of planning is directly related to the unknown outcomes from not yet having a structured plan to leave the EU, although any of the outcomes where the UK leaves the EU (soft, hard or no-deai) are all likely to damage the NHS, compared to remaining in the EU.


  1. Iacobucci G. NHS trusts struggle to produce Brexit plans amid continuing uncertainty. BMJ (20 December 2018).
  2. UK-CAB recommendations on Brexit, HIV and access to HIV medications. (19 December 2018).


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