With this week marking one year until Britain officially leaves the EU, HuffPost is running a series of blogs answering big questions still left unanswered about our Brexit future. Today, GP and BMA treasurer Dr Andrew Dearden write on how leaving the EU will affect the NHS. Follow the series on #BrexitFuture

Today marks one year since Article 50 was triggered and one year to go until we formally cease to be a member of the European Union.

The challenges posed to our health service by Brexit are considerable: from the workforce and Northern Ireland to regulation and research, there is barely a part of the health service that will be unaffected by the UK’s decision to leave the EU.

Health services must be a priority during the Brexit negotiations – it is in everyone’s interest. There has been some progress, but it has been slow and is patchy across different areas of the NHS. This is why, with just one year to go before the UK leaves the EU, we’re calling on negotiators on both sides of the table to urgently agree a Brexit deal that provides certainty for doctors, health services and patients across Europe.

The most significant issue around Brexit facing the British and the European medical profession is its workforce. EU nationals play an invaluable role in health and social care in the UK and have been vital in addressing the staff shortages seen across the NHS. Put simply, our health service would not be able to cope without them. Unfortunately, there has been little clarity from the government on exactly what the future holds for EU citizens and their families living in the UK, many of whom have dedicated years of service to the NHS and medical research in the UK, or on what a future immigration model would look like. Last week David Davis announced that EU citizens arriving in the UK before the end of 2021, what is known as the “transition period” will enjoy the same guarantees as those who arrive before Brexit, but we need more detail on what will happen beyond that timeframe. It is vital that any future immigration system is flexible enough to ensure the NHS can recruit and retain doctors, researchers, and other NHS workers in sufficient numbers and that the professional qualifications of medical staff continue to be recognised in the UK and in the EU. Our NHS and patient care are all the richer for having a diverse workforce – it’s crucial we don’t lose valuable experience and expertise because of Brexit.

In her Mansion House speech, I was pleased to see the Prime Minister state that she wanted to explore associate membership of the European Medicines Agency. The EMA helps provide the UK with timely and safe access to medicines, and likewise helps the EU access medicines that are developed here in the UK. We want to see the government work closely with the EMA through a formal agreement to continue to support and participate in their assessments for medicines approvals. Exactly what an associate membership might look like is yet to be seen. Theresa May has also confirmed that we will leave Euratom, and while she has acknowledged that it would be beneficial to work closely with it, she hasn’t fully outlined what a future relationship with it might look like. Membership of Euratom is vital to ensure patients in the UK get consistent and timely access to radioisotopes for cancer treatment. These isotopes have a short half-life and cannot be stockpiled which is why continuous and timely access to them is vital for patient safety. While they can be imported from outside the EU, Britain’s reliance on products from within it means failure to work closely with Euratom after Brexit could see isotopes not reaching patients in time or reaching them with a low level of activity. We need to see a concrete agreement with Euratom so that patients have consistent and timely access to lifesaving treatment.

The Prime Minister has also repeated pledges to maintain a soft border between Northern Ireland and the Republic of Ireland, but negotiations have so far been fruitless on making these promises concrete. It is vital that a solution to the Irish question is found. Often separate health services in Northern Ireland and the Republic do not have enough demand to provide cost-effective, highly specialist medical services and the only viable way to provide these services to patients is to deliver them across both countries. Over the last two decades, real progress in the provision of all-island healthcare has improved care for patients and allowed both Northern Ireland and the Republic to retain highly trained doctors, who otherwise may not have had the patient demand necessary to warrant their full-time expertise.  If border restrictions are introduced following Brexit we risk reversing this progress and damaging patient care.

As I have outlined here, there is much to be done, and not a huge amount of time left to tie up all these loose ends. Done wrong, Brexit could seriously undermine the provision of healthcare in the UK and Europe, which is why it’s imperative that negotiators on all sides agree a Brexit deal that provides certainty for the NHS. Because while Brexit will fundamentally alter both the UK and the EU, it absolutely must not threaten patient safety.

Dr Andrew Dearden is a GP and treasurer of the BMA