The NHS European Office took part in Health Education England’s (HEE) engagement exercise exploring the pros and cons of student doctors achieving full General Medical Council (GMC) registration at the point of graduation from medical school. At the moment this is achieved a year later, after the completion of Foundation Year 1 (FY1). If implemented, this recommendation, from the Shape of Training independent review by Sir David Greenaway, would mean that shortened UK graduate entry medical degrees would, as currently constituted, no longer meet the requirements of European law on recognition of professional qualifications. In addition, graduates with full registration from some other European countries, would be eligible to compete with UK medical trainees for places on Foundation Year 1 programmes.
HEE’s stakeholder exercise resulted in a report for UK government and devolved administrations to consider, with patient safety considerations uppermost. If the Greenaway report’s recommendation is accepted, change in the point of registration would require primary legislation so, whilst it could have far-reaching effects in future, it would not affect any current medical students.
European Parliament agrees new EU rules on professional mobility
On 9 October 2013, members of the European Parliament voted to agree new rules governing the movement of healthcare professionals across Europe.
The vote follows months of negotiations and the NHS European Office engaged significantly with the revision of the directive, securing important changes for the NHS, including whether and when incoming migrants can be subjected to language checks, mechanisms to prevent bad healthcare professionals from travelling to other EU countries to treat patients and the minimum standards for length and content of training. Read our press release.
The NHS European Office has produced a briefing which provides an overview of the key aspects of the new directive and its implications for NHS organisations. The full text of the new directive is also available for download.
In December 2014 the NHS European Office co-authored an article in Clinical Medicine (journal of the Royal College of Physicians) on the implications of the new directive for medical professional mobility in the European Union.
Implementing legislation: European Professional Card and Alert System
At the end of June 2015 the EU published new regulations to improve protection for patients from potentially dangerous healthcare professionals, and which will also cut red tape for certain professionals wanting to move within the EU to practise their professions.
After 18 January 2016, regulatory bodies across Europe will be required to operate a warning system to alert each other when a professional is banned from practising in one country, to stop them posing a danger to patients in another EU country.
At the same time general care nurses, pharmacists and physiotherapists will be able to apply on line under accelerated procedures for a European Professional Card (EPC), which will cut down on bureaucracy and enable them to provide services more easily in other EU countries. Further professions may become eligible for the EPC in due course, but the warning system will apply to all regulated healthcare professionals.
The new provisions are contained in Commission Implementing Regulation (EU) 2015/983
Consultation on language checks
Following changes to EU rules to allow health practitioners from the EU to undergo language checks, where necessary, the UK Government launched a consultation on updating national law in line with the new EU legislation. Professionals will have to prove they can communicate effectively in English before being allowed to register and practise in the UK.
If you would like to view information on the now closed consultation, please visit the gov.uk website.
The new EU directive at a glance
The NHS European Office worked hard with the European institutions and other stakeholders for three years, following the revision of this directive from start to finish in order to secure the best possible improvements for the NHS.
Our main influencing priorities and key issues for the NHS were outlined in our briefing Mobility of health professionals across Europe which we produced after the publication of the European Commission’s proposal for a revised directive in December 2011.
Key outcomes from an NHS perspective are:
- Language competence can be checked after recognition but before granting access to the profession where the profession to be practised has patient safety implications. Employers have a role in ensuring that employees have the necessary language knowledge to perform their professional duties in the workplace.
- Regulators will have to proactively warn all other member states, within three days, when a health professional is banned or their practice is restricted – a big improvement on the current situation whereby they only have to react to requests for information from other competent authorities. As a result, rogue professionals can currently all too easily escape detection outside their own country.
- Minimum training requirements for doctors changed to five years and 5500 hours (currently six years or 5500 hours). NHS European Office fought hard for this - it means that UK medical degrees comprising four years at university, plus a clinical training year (Foundation Year 1) can continue.
- Continuing professional development should be actively encouraged by member states to ensure that health professions covered by the automatic recognition regime (doctors, nurse, midwives, dentists, pharmacists) are able to update their knowledge, skills and competences in order to maintain a safe and effective practice and keep abreast of professional developments.
- No partial access to professional registration for health professionals (public health or patient safety implications). To gain recognition of their qualification, each individual must meet all the minimum training requirements for their profession.
The Health Service Journal published an article by the NHS European Office on the proposed changes to the directive. Eurohealth magazine also published an article offering the patient perspective on the proposed changes.