The UK's imminent departure from the EU next month meant the NHS could face a potential "triple whammy" of a 'no-deal' Brexit, a tough winter, and a major flu outbreak, NHS Providers warned.
Chris Hopson, its chief executive, described the prospect as "a frontline NHS chief executive's worst nightmare".
The warning was echoed by the British Medical Association (BMA) which warned this week that a disorderly exit from the EU would exacerbate the challenges posed by winter pressures on the NHS and leave the health service struggling to provide safe care to patients.
A BMA analysis emphasised that leaving the EU without a deal would impact on the supply of medicines, patient access to care, and the NHS workforce, but said that "no part of the health service would be left unscathed".
In a forward to the briefing, A health service on the brink: the dangers of a 'no deal' Brexit, Dr Chaand Nagpaul, BMA council chair, said: "Cancelled operations, missed cancer treatment targets, and patients in corridors waiting for hours on end to be seen; recent winters have seen unprecedented scenes unfold in our hospitals, GP surgeries and across the NHS, with patients suffering and staff under increasing pressure as resources and capacity struggle to keep up with rocketing demand.
"Add to that chaos a 'no-deal' Brexit, and the disintegration of the health service becomes an ever more real prospect."
The briefing identified 40 areas in healthcare where it said the Government had so far failed to demonstrate readiness for a disorderly exit.
The BMA repeated a call for the public to be given a final say on Brexit.
Last week the Royal College of Physicians (RCP), and 16 other health organisations, wrote to Prime Minister Boris Johnson asking for him to put patient safety and protecting the nation's health at the heart of negotiations to leave the EU, and inviting Matt Hancock, Secretary of State for Health and Social Care, to join an EU exit strategy committee.
Fears of Flu Vaccine Shortages
The letter, also signed by executives at the Royal College of Emergency Medicine, the Royal College of GPs, and the Royal Colleges of Surgeons, highlighted the damaging effect that even a moderate flu season this winter could have on the NHS.
"Your EU exit strategy must include provision for different flu scenarios, and the Secretary of State is well placed to coordinate that," they wrote.
One of the signatories, Prof Andrew Goddard, president of the RCP, later told BBC TV's Newsnight programme that no one should be complacent about vaccine shortages that could follow the UK crashing out of the EU. "We are likely to not have enough flu vaccine, we are likely to not have the vaccination coverage that we've had in previous years, and that is likely to have an impact on the NHS," he said.
"Current emergency care performance – the worst in over a decade – shows how much pressure the NHS is currently under, with real concern that we are heading for a very difficult winter," commented Chris Hopson of NHS Providers.
"Levels of flu in Australia – often a good predictor for levels of UK winter flu – are the highest for some years though it's too early to be sure what this means for us."
Reassurances to Patients
The Department of Health and Social Security said it was working closely with partners across the health and care system, and industry, on robust preparations that should ensure the continuity of supply of medicines and medical products when the UK left the EU.
A Government spokesperson commented: "We want to reassure patients that our plans should ensure that supplies of vaccines remain uninterrupted when we leave the EU on 31st October, whatever the circumstances."
Last month, the Government announced a £25 million contract to set up an express freight service to deliver medicines and medical products into the UK, within 24 to 72 hours, to help ensure continuity of supply in the event of a no-deal.
Last weekend, The Sunday Times reported that it had seen confidential files that warned the NHS to prepare for expected drug shortages. The files were reported to list medicines impossible to stockpile, including those for schizophrenia, bipolar disorder, epilepsy, and trigeminal neuralgia.
The report led to a much-publicised spat on radio between prominent Brexiteer Jacob Rees-Mogg, Leader of the House of Commons, and a doctor involved in medical contingency planning for Operation Yellowhammer, the Government's contingency plan for a no-deal Brexit.
Speaking on LBC, Dr David Nicol asked Mr Rees-Mogg what level of patient mortality he was prepared to accept if the country left the EU without a deal in place. The Leader of the House accused Dr Nicol of "scaremongering" and said he should be "ashamed".
Dr Nicol responded: "Can I remind you I wrote the plans of mitigation."
But Mr Rees-Mogg told him: "Well you didn't write very good plans if you hadn't worked out how to mitigate, had you?"
