New EU law to support mobility of health professionals across Europe

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24 / 12 / 2015 9.09am

On 16 December 2015, the Department of Health opened a six-week consultation to seek views on new EU law which will underpin changes set out in the Mutual Recognition of Professional Qualification (MRPQ) Directive – the European Qualifications (Health and Social Care Professions) Regulations 2015.

The new regulations and revisions in the directive come into force from January 2016. The aim is to further facilitate the free movement of EU citizens by making it easier for professionals qualified on one member state to practise their profession in another, while ensuring they are competent to do so through appropriate checks and procedures. The directive covers all professions, for example, vets and architects and not just healthcare.

Key changes for the NHS

The EU directive already includes provisions on:

  • knowledge of languages
  • minimum standards of training
  • temporary service provision
  • conditions for recognition
  • recognition of professional traineeships
  • compensation measures.
The consultation seeks views on the new elements being introduced which will apply to doctors, dentists, general care nurses, midwives and pharmacists from January 2016 – these include:

  • Changes to minimum training requirements for health professions benefiting from automatic recognition based on a set of common training frameworks and principles.
  • The introduction of the European professional card (EPC).  The EPC is an electronic ‘certificate’ (as opposed to a physical card). The certificate will store proof of qualifications and additional information needed to gain recognition in other member states -enabling professionals to move more freely and quickly on a temporary or occasional basis, or to establish themselves in another member state on a more permanent basis. Details of how this will be practically applied (such as documentation required to obtain the card, copies and translations) is outlined within the new regulations.  Professionals providing services in another member state on a temporary or occasional basis will only have to make a declaration every 18 months (currently 12 months) and procedures can be accelerated using the EPC.   
  • A new provision enabling partial access to regulated professions for certain professionals. The principle of partial access allows a professional who is qualified in their home state to practice a subset of a regulated profession’s activities in another member state without having to gain qualifications or recognition for practising the broader profession.  This is subject to specific conditions: 
    • the professional is fully qualified in his/her home state to carry out the activity for which partial access is sought
    • the differences between the professional activities in home and host states are so wide that the application of compensation measures would amount to requiring the applicant to complete the full programme of education and training required to have access to the full professional in the host state
    • The profession activity can be objectively be separated from other activities falling within the regulated profession in their host state.
Due to the nature of these conditions, the professional regulators will retain their duty to consider partial access applications on a case-by-case basis.  However, professional regulators will be able to reject applications, if this is justified, such as if applicants do not meet the required criteria or for reasons of patient safety.

  • A new Europe-wide alert mechanism which is aimed at enhancing patient safety across the EU. The alert mechanism will provide professional regulators in host states, with a faster and more reliable system for identifying certain professionals who have been restricted or prohibited from practising in another EEA state using the internal market information (IMI) system.  The revised directive will pose a duty on professional regulators to notify their counterparts in other states within three calendar days (not working days) of any decision to restrict or prohibit that individual from certain practising rights. Professional regulators will be permitted to exercise some discretion when making decisions as long as they ensure that any decisions made are in line with the objectives of the alert mechanism, which is to protect patients. 
  • Language controls - in addition to powers being given to enable regulators to carry out proportionate checks on professionals where there is a concern about their English language capability in 2014, the government is considering introducing new legislation, which will require all public sector organisations, including the NHS, to ensure that all staff in public-facing roles can communicate effectively, to what is expected to be at least ‘level 2’ (equivalent to a C or above at GCSE). The changes will be implemented through the new Immigration Bill which is anticipated to come into force in the Autumn 2016.

    Further guidance in regard to employers responsibilities to assess a healthcare professionals language competency can be found on our website.  Guidance was updated in July 2014 and remains current and correct.  Further amendments will be made to this document once more information is known about changes under the Immigration Bill.
Employers may find it helpful to refer to the briefing document which was produced by the NHS European Office in October 2013 which remains accurate and correct in regard to the changes now being introduced.  This document and further background information about our engagement with employers which has helped inform the changes to the directive so far, can be found on our Mobility of health professionals across Europe section of the website.

Responding to this consultation
NHS Employers will be working closely with colleagues in the NHS European Office early in the New Year to further consider any impact on current employment practice, with a view to providing a response to the Department of Health by their deadline of 20 January 2016.  

To download a copy of the consultation, please refer to the Department of Health website.

Background
The free movement of European citizens to live and work within the European Union (EU) is one of the fundamental pillars of the European single market. Recent EU legislation on the recognition of professional qualifications (to take effect January 2016) updates the framework within which doctors and other registered professionals can migrate freely between EU member states to practise their profession. UK organisations lobbied extensively to change aspects of the original proposals, in particular those that threatened to water down public protection in the interest of free movement. The legislation finally adopted significantly increases safeguards for patients and the public. 

The revised law covers the rules to be applied by regulators on (for example) assuring language competence, an alert mechanism to warn regulators in other member states of practitioners subject to sanctions, fast track registration based on mutual recognition of professional qualifications, agreed minimum education and training requirements for mutual recognition, and encouragement of continuing professional development.  The draft implementing regulations which underpin the directive come into force in January 2016.  

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