NHS bosses want to remain in the EU – but not for the reasons you expect

This is not an exit poll or an extensive research study of the whole NHS, but it does reveal the strength of feeling on a generation-defining decision from a public service that relies on immigration

80 per cent believed that Brexit would impact negatively on the recruitment of health and care staff (PA)

Brexit campaigners say that leaving the EU would enable us to spend £350m extra a week on our cash-strapped health and care system. Remain campaigners argue that the economic shock following Brexit could hit NHS funding at the worst possible time and that the impact of extra migrants on the NHS is massively overblown.

But what of those who actually lead and manage NHS trusts? What do they think?

NHS Providers, the membership organisation for NHS hospital, ambulance, community and mental health trusts, asked trust leaders what they thought.

Europe is frequently identified with red tape, unnecessary rules and limiting laws, often with good reason. In terms of procurement and competition rules, over 40 per cent of trust leaders felt that leaving the EU would have some positive impact or even a very positive impact. "EU procurement rules are unnecessarily labyrinthine" summed up the general mood. Though, of course, that assumes we would have the freedom to set something different.

Surprisingly, on the impact of Brexit concerning the money available for the NHS, the view from the frontline is neutral: 40 per cent felt that leaving the EU would have no impact, and just over a third believed it would have some or a very negative impact.

However once we get to the heart of what the NHS is about – its staff, its knowledge base, its research capacity, what matters to patient care – it is clear that staying in the EU does matter, and our trust leaders have strong views. None of our respondents believed that leaving the EU would be positive for research and innovation. Indeed, 80 per cent felt that it would have some or very negative impact.

Likewise, 80 per cent believed that Brexit would impact negatively on the recruitment of health and care staff. Not entirely surprising when you consider just how dependent the NHS is on EU staff. We’re struck, for example, by just how many hospital trusts we’ve visited over the last two years who have mounted successful and much needed nursing recruitment campaigns in Portugal, Greece, Ireland and Spain.

Nearly two thirds of our leaders feared for what Brexit would mean in terms of sharing learning and knowledge, which is fundamental to clinical outcomes and providing the best possible care to patients. Many of our senior doctors depend on European networks not just for funding research but for testing and developing their learning and knowledge. Medical innovation is, patently, a global activity and our trust leaders felt that being part of a wider community in the EU was profoundly beneficial.

And the response to the big question was clear cut. A substantial majority – 75 per cent of leaders – felt that leaving the EU would have a very negative impact or some negative impact on the NHS as a whole. Of course, this is not an exit poll nor is it extensive research of the whole NHS. It is a survey of trust leaders. But it does show the strength of feeling on what could be a generation defining decision.

As we have told the Commons Health Select Committee, their overwhelming conclusion is that Britain should remain in the EU.

Chris Hopson is Chief Executive and Dame Gilll Morgan is Chair of NHS Providers, the membership organisation for England’s 238 hospital, ambulance, community and mental health trusts