Nurses leaving: the "life-or-death consequences" of Brexit

The study, published as a recent IZA Discussion Paper, looked at the effects of the 2016 Brexit referendum, analysing administrative patient-level data from 131 English NHS hospitals. The researchers evaluated varying pre-referendum shares of EU nurses - the percentage of nurses from the European Union (EU) employed in NHS hospital organisations prior to the Brexit referendum. 

This allowed the team to estimate the causal effects of Brexit on hospital quality of care, specifically examining the effects on in-hospital mortality rates and unplanned emergency readmissions. Specifically, the study estimates that, over the three years after the 2016 referendum, the NHS faced a staggering 34 extra deaths per hospital with average exposure to the Brexit shock. In the study, the pre-referendum share of EU nurses in English NHS hospitals ranged from 0.5% to 22%, with an average of about 5.84%. Hospitals that had a higher proportion of EU nurses before the referendum were more exposed to the negative labour supply shock caused by the vote to leave the EU.

Effectively, the authors of the research find a staggering drop in the inflows of EU nurses straight after the referendum and a simultaneous sharp increase in the share of non-EU Overseas nurses hired by NHS hospitals. They also found that the pool of new NHS hospital nurse hires had lower experience or skills, as they were paid lower salaries. This workforce compositional change was the most likely mechanism for the increase in mortality and unplanned readmission rates, as the authors are able to rule out several other mechanisms, for example, changes in the patient's demographics, changes in other parts of the hospital workforce (consultants) and changes in hospital productivity (bed occupancy rates). 

Professor Giuseppe Moscelli, Professor of Economics and lead investigator of the study at the University of Surrey, said: "Brexit has had real life-or-death consequences for patients in our hospitals. The evidence we've gathered shows that the loss of more experienced or skilled nurses has led to a measurable decline in care quality. Our research provides two important take-home messages for taxpayers and policymakers. On the one hand, it underscores the critical role that skilled migrant nurses play within the healthcare system, particularly in emergency care, where the stakes are highest. On the other hand, it highlights the considerable reliance of the NHS on foreign nurses and the need to balance this dependence with policies that stimulate the formation and training of a higher number of domestically trained healthcare professionals, to prevent similar quality of hospital service deteriorations in the future." 

Source: University of Surrey

06.05.2025

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