Dissertation: The Impact of Brexit on NHS Staffing Issues

This dissertation explores the multifaceted impact of Brexit on NHS staffing, focusing on the resulting challenges and issues. The introduction highlights the significance of Brexit's effect on the healthcare sector, particularly concerning staffing shortages and high employee turnover rates. The research aims to analyze the effects of Brexit on NHS nursing staff, determine the nature of these effects (positive or negative), and propose potential solutions to address staffing issues. The methodology section outlines a descriptive research design, utilizing interpretative research philosophy and a mixed research approach. Data collection methods include questionnaires, personal interviews, and secondary sources like books and journals. The study employs both qualitative and quantitative data analysis, including thematic analysis, to interpret findings related to nursing staff shortages and the impact of Brexit on staff. The literature review synthesizes existing research, citing various studies that discuss the decline in NHS staff due to Brexit, emphasizing factors such as poor working conditions, uncertainty surrounding work status, and economic issues like the declining value of the pound. The report aims to provide a comprehensive overview of the impact of Brexit on the NHS workforce.

Business and Management
Dissertation

TABLE OF CONTENTS
TOPIC : THE IMPACT OF BREXIT ON NHS STAFF ................................................................1
INTRODUCTION ..........................................................................................................................1
Research aim : To analyse the impact of Brexit on NHS Staff..................................................1
Research objectives .....................................................................................................................1
RESEARCH QUESTIONS ........................................................................................................1
RESEARCH METHODOLOGY ...............................................................................................1
RATIONALE FOR SELECTING THE TOPIC (50)..................................................................2
LITERATURE REVIEW ..............................................................................................................2
REFERENCES................................................................................................................................4

TOPIC: THE IMPACT OF BREXIT ON NHS STAFF
INTRODUCTION
Brexit has will have a significant effect on different industries in the UK including the
health care sector. The UK decision to leave the EU has brought economic crisis in the country.
Brexit or political instability in the nation has given rise to various major issues. In the context of
the NHS, changes in political factor has given rise to staffing issues and have lead to high
employee turnover rate in health sector. Brexit had direct as well as significant effect on the
NHS nursing staff.
The report focuses on analyzing the issue of Brexit in a particular sector and on a
particular branch of the economy, the medical care. The study will determine the context that has
given rise to staffing issue within the NHS. Project will include the detail about the
methodologies used by the investigator for conducting the study. Some figures that show the
extent of the under staffing?
Research aim: To analyse the impact of Brexit on NHS Nursing Staff.
Research objectives
 To determine the effect of Brexit on NHS staffing.
 To analyses the type of effect that is positive or negative Brexit have on staffing of NHS.
 To suggest possible solution which can be applied for dealing with the staffing issues
which has been arced due to Brexit.
RESEARCH QUESTIONS
 Has Brexit increased the shortage of nurses in the NHS?
Good to see you have narrowed this down a bit.
 What impact Brexit have on staff of NHS?
 How the staffing issues can be resolved?
RESEARCH METHODOLOGY
Research methodology can be defined as the strategies, techniques, philosophies utilized
by the scholar for executing various research activities. The different methods utilized by
scholar helps them in reaching to the conclusion. It is very much important for researcher to
utilized an appropriate technique or methods for conducting the investigation procedure, as this
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factor has great effect on the outcome. In the present study, the scholar has used the following
research methodologies these are:
Research type:It is considered to be as special arrangement made by scholar in order to gather
data or information related to research topic. The research design can be categorized into three
categories these are descriptive, experimental and semi experimental. Descriptive research
designed in generally includes case studies, survey, naturalistic observation etc. Semi
experimental study involves field experiments (Paghale, Saffari and Fakhraddini, 2018).
Experimental research includes experiments with random assignment. The selection of research
design is completely based on nature of the study or problem found during the investigation.
In the present study, researcher will use descriptive research design. This specific
research design has been selected considering the nature as well as objective of study. Reason for
selecting descriptive research design is that by utilizing this design scholar can easily define the
characteristics of phenomenon (Kumar, 2017). It also enables investigator to collect n-depth
information that might be either qualitative or quantitative in nature.
Research philosophy: It involves the belief about the way information or facts related to the
research topic should be collected. The different types of research philosophies are Ontology,
Epistemology, positivism, realism , interpretivism and Axiology. Ontology is research
philosophy which is based on nature of reality. It can be further classified into two these are
subjectivity as well as objectivity (Suryani, 2018). Epistemology support scholar in gaining
knowledge about specific field of the study. In the present research, investigator will utilize
interpretative research philosophy. The reason for selecting the interpretativism research
philosophy is that it helps scholar in developing in depth understanding about the problem which
is very much crucial in order to make an appropriate decision.
Research approach: It can be considered to be as a systematic plan or procedures which
comprises various belief or assumption made during the execution of different activities such as
data collection, analysis and interpretation. Selection of research approach is completely based
on the nature of problem. Different types of research approaches are inductive and deductive. It
is important for investigator to select the research approach considering the purpose of
investigation procedure(Blamey and Thompson, 2017) .
Mixed research approach will be used by the scholar in present investigation. This
specific research has been selected as investigator will use both qualitative as quantitative data in
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study. The reason for selecting the mixed research approach is that it can be utilized by scholar
for getting answers to broad range of questions which is very much crucial in order to reach
conclusion. Other rationale for selecting the mixed research approach is that ability to secure
large amount of funds for the study. In addition to this scholar have strong relationship with
other scholars those who have expertise in the field. In addition to this scholarly reason for
selecting the mixed research approach is that research is not certain about the standard
quantitative instrument would capture the many aspects of our research participants’ orientations
and experiences which might have negative influence on success,
Sampling: It is the activity which is conducted in order to select the few participants from the
large population. This activity is executed considering the limitation of time and resources
(Quinlan, Babin and Griffin, 2019.). Sampling is done by researcher as it is not possible for
them to collect data from large population. It is very much important for researcher to be very
much careful while selecting the sample. While selecting the participants from large population ,
researcher must ensure that respondents those who have been selected are representing the whole
populations. There are mainly two types of sampling technique these are probability and non-
probability sampling. Probability sampling can be categorized into different segments such as
cluster, random , systematical sampling etc.
In the present investigation, research will select 30 participants by utilizing the
probability sampling method. In addition to this, purpose sampling technique, as scholar already
knows the target group of people from whom information can be gathered. Nurses will be
selected as the participant. The nurses have been selected as scholar perceive that the problem is
related to nursing staff so they are the people who can provide the information about the
appropriate reason for leaving of job by their colleagues.
Data collection: it is considered to be as an essential activity in research, as without collecting
the facts or figures scholar can not execute research further. Without data or information,
investigation does not have any meaning. There are mainly two sources from where data can be
gathered these are primary and secondary. The researcher will gather information from both
primary and secondary sources in present investigation.
In the present study, personal interview and questionnaire will be used for collecting
primary information. Questionnaire will be designed by researcher considering the purpose of
investigation. In addition to this, questionnaire will consist of close ended questions relevant to
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the topic of research. The reason for including the close ended questions in questionnaire is that,
scholar perceive that this strategy will assist them in getting the relevant answer s to questions
from respondents. Questionnaire form will be circulated to participants through Email. In
addition to this, scholar will conduct both personal as well as telephonic interview for gathering
the information related to the research topic.
Books and Journals will be utilized for gathering secondary information. Both primary
and secondary source of data will be used in order to collect detailed information about the topic
(Chambers, 2017).
Data analysis: It is the procedure which includes refining of information which has been
collected during investigation. This is considered to be as an important activity in research as it
helps scholar in eliminating unwanted information. It also supports scholar in making the
research report presentable as well as understandable to user. Data analysis includes various
activities such as interpretation of information gathered through the utilization of analytical as
well as logical reasoning to determine patterns. It also includes identification of common
patterns within the responses as well as critical analyze of them in order to accomplish desired
research objectives. Data analysis provides researcher an ease in reaching to conclusion.
In present investigation, as researcher will use both quantitative as well as qualitative data
analysis . Qualitative data analysis will be utilized analyzing the facts related to the reason of
shortages if nursing staff in NHS. Whereas, quantitative data analysis will help researcher in
identifying the number of nursing staff which has left their job due to the Brexit. In addition to
this, Thematic analysis will be used by the investigator. Graphic, charts, table will be used for
making the information presentable as well as easily understandable by user. The different
themes related to the topic will be created based on the questions as well as asnswers provided
by the respondents.
RATIONALE FOR SELECTING THE TOPIC
The reason for selecting the particular topic is to analyze the sudden shortage of
workforce in NHS. Other rationale for choosing specific topic for research is determining the
reason that made large number of EU nurses to leave the NHS. In addition to this, the
investigator has an interest in analyzing whether Brexit is the main issue in the staff crisis.
Increase in cost of agency staff and Decrease in quality of care is considered to be as a negative
effect of Brexit on Nhs recruitment of new staff.
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LITERATURE REVIEW
According to the survey report of Nursing and Midwifery Council, Brexit has encouraged
nurses to work outside the United Kingdom McKee, (2018). As per the view of Appleby and
Dayan,(2018 ), Free movement of people within European Union has significant effect on
staffing within the NHS. The author has stated that, due to poor working conditions in the factor
which has given rise to high employee turnover rate in NHS.this is not due to free movement
though and does not follow on from the sentence before it According to the perspective of
Dayan, (2018),
Brexit appears to already be having an effect, particularly on the recruitment and
retention of EU nationals in some parts of the workforce which is contributing to shortages of
key staff. As per the view of Wildman, Baker and Donaldson (2017), states that the important
reason there is high employee turnover rate in NHS is that, management in organization is more
concerned about the decline in demand of services or products rather than issues faced by its
staffis his due to brexit – again hard to see the connection. This is the factor which has lead to the
high level dissatisfaction in NHS workers. According to the thinking of Simpkin, V. L. and
Mossialos,(2017), the company is terminating employees contracts, as business entity considered
contracting less employees as an advantage. As Brexit has already impacted the financial
performance of the organization in negative way therefore, firm has adopted this strategy for
saving costs. As per the view of Burdett and Fenge, (2018), hostile attitudes and incidents are
believed to be a factor in EU doctors’ increased interest in working outside the UK. According
to this perception, low salary or wages in NHS have encouraged staff to search for new job
opportunities.
The author states that Costa-Font, (2017), many of employees that is nursing staff in
NHS have resigned their job due to uncertainty surrounding their work status, as the effect of
Brexit on their job is not clear. According to the opinion of Britnell, (2018), decline in wages as
well as amendments in pension policy have led to the high staff turnover rate in UK. As per the
view of Robinson (2017) , decline in value of Pound has encouraged NHS nursing staff to
migrate to other nations for better job opportunities. The author also states that the restriction
imposed by the Government on free movement of labor has led to the shortage of nursing staff in
NHS. According to the opinion of the fall in EU applications has placed increased pressure the
UK’s visa’s system as employers are switching recruitment strategies to outside the EU.
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As per the view of Dolton, Castellanos and Rolfe (2018 ) uncertainty over the future right
to settlement for EU citizens in the UK has encouraged European people, those who have been
working in NHs, to leave their job. According to the perception of McKee (2018 there is a
shortage in nursing applications from the EU which is believed to have resulted from the
referendum vote to leave EU and form the uncertainty about the outcome and its implications.
The author also states that management in the NHS is planning to recruit employees outside EU,
this being the reason for the shortage of workforce. In the UK in 2017, for the first time in a
decade, more nurses left the profession than joined. The NHS in England has approximately
40,000 registered nursing vacancies. Non-EU nursing staff are currently listed on the Shortage
Occupation List. This action was taken in recognition of the severe gaps in domestic nursing
workforce, which have not been resolved.
As per the view of Brexit - the impact on the NHS workforce (2018), Free movement of
people within the EU has had a significant impact on staffing within the NHS. Approximately
200,000 EU27 nationals work in the wider health and care sector about 5% of the total
workforce. According to the report of college of nursing uncertainty posed by the Brexit
negotiations to date has already affected staffing levels. According to the joint report on progress
in article, it has been stated that brexit have impact on those employees who are already working
in NHS not on those who might be employed in the future.
According to the opinion of Menon and Gudgin, (2018), due to high risk, many nurse in
NHS is choosing to leave organization because of increase in uncertainty in the Brexit
negotiations. As per the view of Evans,(2017), chances of uncertainty as well as decline in
security have negative impact on workforce especially nursing staff in NHS. The author states
that Brexit have direct as well as significant effect on the morale of nursing staff. In addition to
this, political instability in the country has led to the high level of stress on nursing staff of NHS
effect of which can be seen on their performance at workplace. According to the perception of
McCrae,(2018), besides actions taken by government to reassure nursing staff about their ability
to live and work in an enterprise, nursing staff in NHS is still feeling insecure, unwelcome as
well as uncertain about their future, these are few factors which has encouraged nursing staff to
leave their job. As per the survey report of BMA it has been found that approx. Forty five
percent of nursing staff in NHS is planning to leave their job and also UK. The authors stated
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that the reason of leaving job or UK by nursing staff in NHS is anxiety which is caused due to
high level of concern about effect of Br exit.
According to the survey conducted by General medial council has depicted that the
nursing staff coming in United Kingdom from European Union has felt to nine percent in year
2017. As per the view of Simpkin and Mossialos,(2017). NHS is facing difficulty in recruiting as
well as retaining nursing staff. According to the opinion of Costa-Font,(2017), NHS organization
is now required to employees overseas in order to operate business smoothly. The author
Appleby,(2018), has stated that NHS is requited to formulate as well as implement effective
services in order to meet such types of situation in the future. According to the view of Harrison,
(2017), nurses in Nhs have fear of loosing more than £2,500 in real terms by 2020 when
inflation is taken into account. As per the opinion of Moore (2017)the nursing staff in Nhs might
have fear of new rules which might restrict them to do overtime job or extra shifts. The author
have also stated that new policy introduced by Nhs related to the off-payroll working has
encouraged nursing staff to leave job.
Professional consultancies services are playing significant role in ensuring the health
service continues to meet safe staffing levels. According to the view of Glasper,(2017 ),
management in Nhs is required to establish few standards for staffing as this will assist them ion
attracting more number of highly talented, skilled as well as experienced workers. As per the
study conducted by Nursing and midwifery council, there has been great decline in registration
of nursing staff which has negative effect on the growth of lab our market. According to the
view of Nhs and United Kingdom is becoming a less attractive place to work is naturally a cause
for brexit or political instability. Particularly as social care and health services will continue to
depend on workers from outside the UK in the short to medium term As per the opinion of Bolet,
Olivas Osuna and Kaldor, (2018), Nhs is required to work with other health and social care
institutions in order to provide an appropriate response to the concern of workforce related issue.
According to the perception of Wells and Cunningham (2017), Nhs can organize pre
employment schemes, as this strategy will assist business entity in attracting workers, As per the
view of Foster,(2017), it is required by NHS organization to employ workforce from the
domestic country, as this will support an Enterprise in eliminating such type of issues in the
future. The author Majeed,(2018) states that government in nation is required to develop post-
Brexit immigration system. According to the opinion of Evans, (2017), Employers of NHS
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themselves has a different program which has been designed to assist in looking differently at
attracting and retaining a talented or diverse workforce. The author has stated that the above
statement has been made considering the apprenticeship as well as other events organized by
NHS for enabling easy access to employment by people. According to the perception of Buchan,
Gershlick and Seccombe, (20174), it is required by the management in NHs to develop an
effective culture as well as environment at workplace, as this strategy will help firm in retaining
as well as attracting more nursing staff.
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