The United Kingdom’s vote to leave the European Union (EU) was associated with major shifts in health care worker migration and worsening physician shortages in England, according to a new study published in JAMA Health Forum. The findings suggest Brexit changed where the UK recruited doctors and nurses without resolving persistent workforce shortages.
Researchers found that an immediate decline followed the 2016 Brexit referendum in doctors and nurses arriving from EU countries. Although recruitment from non-EU countries increased in subsequent years, physician vacancies in England’s National Health Service (NHS) continued to rise, while overall nurse immigration declined.
Like many high-income countries, the UK relies heavily on internationally trained health professionals to meet workforce needs. Before Brexit, health care workers from EU countries could move relatively freely to the UK. Researchers examined how the referendum affected these migration patterns and whether changes in international recruitment contributed to workforce shortages.
Researchers from the Harvard Pilgrim Health Care Institute, Massachusetts General Hospital, London South Bank University, and the WHO Europe Human Resources for Health Group analysed health workforce data from 2008 to 2019. The study included more than 418,000 physicians and 358,000 nurses who migrated to Organisation for Economic Co-operation and Development (OECD) countries. Researchers compared trends in the UK with those in 32 other high-income OECD countries before and after the referendum.
The Brexit referendum was associated with an immediate decline of about 825 physicians and 2,771 nurses arriving from EU countries in 2016. In the years that followed, immigration from non-EU countries increased by an estimated 3,110 physicians and 1,437 nurses annually. Despite this increase, NHS physician vacancies in England grew by an estimated 383 positions, indicating that increased recruitment from elsewhere did not fully offset workforce pressures.
“The Brexit referendum changed where the United Kingdom recruited its health care workforce, with fewer clinicians arriving from Europe and more from countries in Africa and Asia. Our findings show that these shifts were not enough to prevent growing physician shortages within the National Health Service,” said lead author Tarun Ramesh, a research fellow at the Harvard Pilgrim Health Care Institute.
The researchers also found that migration from EU countries began declining well before the UK formally left the EU in 2020. Senior author Hao Yu, an associate professor of population medicine at Harvard Medical School and the Harvard Pilgrim Health Care Institute, said the findings demonstrate that health care workforce migration can be highly sensitive to policy signals. Uncertainty surrounding future immigration rules was associated with changes in the flow of doctors and nurses even before the formal withdrawal.
The researchers said the findings have broader implications for countries considering immigration restrictions. Policymakers should consider how such policies could affect health care staffing and access to care, particularly in health systems that depend heavily on internationally trained professionals. They should also consider the consequences of increasing recruitment from countries in Africa and Asia that may already face shortages within their own health care workforces.
More information: Tarun Ramesh et al, Health Care Workforce Immigration to the UK After Its European Union Membership Referendum, JAMA Health Forum. DOI: 10.1001/jamahealthforum.2026.2868
Journal information: JAMA Health Forum Provided by Harvard Pilgrim Health Care Institute
