Working hours protections for more than 1 million NHS staff could be in jeopardy in the wake of Britain’s decision to leave the EU, HSJ has been told.

Trade union leaders have said protections for staff on the Agenda for Change pay framework would be need to be re-examined and if necessary “contractualised” to ensure they are not lost.

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They also warned of the economic impact of the referendum vote on overseas staff working in the health service. NHS England medical director Sir Bruce Keogh stressed the need to make European staff feel welcome and valued in the NHS.

Friday’s landmark referendum outcome has thrown into doubt the future of the European Working Time Directive and its impact on the NHS. It will cease to apply if the UK leaves the EU and does not join the European single market.

The proposed junior doctors’ contract includes an average 48 hour working week and if that is adopted by the British Medical Association it will become a legally binding contract. However, the working hours for Agenda for Change staff are not protected by contractual rules.

Chair of the NHS staff council and Unison’s head of health Christine McAnea said limits on working hours would have to be improved.

She said: “The European Working Time Directive would have to be contractualised for Agenda for Change staff.

“We want an assessment of what are the terms and conditions that NHS staff have got that derives from European legislation and how do we ensure they are protected. We need an analysis of that and whether they can be lifted and shifted into Agenda for Change. We will have to look at that.”

Danny Mortimer, NHS Employers chief executive, said: “There are clear contractual commitments for junior doctors which meet or exceed the details set out in the EWTD. A yes vote in the BMA referendum [on the junior doctors contract] will mean that these rules are legally binding between the NHS and trainee doctors, regardless of the post-2018 settlement for the rest of the economy.

“There are a range of employment and regulatory agreements that exist within the EU that impact on the people working in the NHS. We will consult with our members about these and will, working with our trade union and European office colleagues, assist the government and regulators to ensure that there is a careful settlement of these issues over the next two years.”

Ms McAnea raised fears over the economic impact of the referendum decision.

“There has to be a message going out straight away to reassure the 55,000 EU workers in the NHS that they are still a valued part of the NHS and assuring them that they are essential workers and are not going to be kicked out anytime soon and have a right to remain and work in the NHS,” she said.

She also raised the concern about the economic impact on overseas staff working in the NHS, saying: “If inflation raises and the value of the pound falls then particularly if they are using that money to support their families back home then the value of that money will go down.

“It puts the government’s pay policy in jeopardy. They can’t maintain a 1 per cent pay cap at a time when inflation is starting to go up. If this results even in a short term economic crisis and we go back into recession then the impact that has on the economy will have a massive impact on the NHS.”

A spokesman for the Royal College of Midwives said: “The RCM will redouble its efforts to safeguard its members’ employment rights, the status of the profession and women’s maternity entitlements and protections.

“We will also be seeking assurances about the position and future of the many valued EU citizens who work in the NHS.”

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