Almost half of NHS doctors from continental Europe are considering quitting the UK because of Brexit, and nearly one in five has already made solid plans to do so, according to a new survey.
The survey of 1,720 doctors from European Economic Area countries, conducted by the British Medical Association (BMA), found that their main reasons for considering leaving were Britain's decision to quit the EU; negative attitudes towards EU workers in the UK; and uncertainty over future immigration rules.
The BMA said that 12,000 EEA nationals make up 7.7% of the NHS doctor workforce and are "vital" to ensuring that the health service can provide high-quality, reliable and safe patient care.
The organisation urged the Government to guarantee permanent residence rights for EU doctors and medical researchers, as well as a flexible future immigration system which supports health and medical research in the UK.
BMA treasurer Andrew Dearden said: "That so many EU doctors are actively planning to leave the UK is a cause for real concern. Many have dedicated years of service to the NHS and medical research in the UK, and without them our health service would not be able to cope.
"We need clarity on what the future holds for EU citizens and their families living in the UK, and an end to the uncertainty and insecurity that could see many voting with their feet.
"It's also vital that any future immigration system is flexible enough to ensure the NHS can recruit and retain doctors and other NHS workers in sufficient numbers. 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."
Of the EEA doctors questioned for the survey, 45% said they were considering leaving the UK, with a further 29% saying they were not sure whether they would leave or not. Some 77% said a negative outcome to negotiations on the rights of EU citizens in the UK after Brexit would make them more likely to consider leaving.
Some 18% of those questioned said they had already made plans to leave the UK, with Germany, Spain and Australia the most popular destinations.
But a Department of Health spokesman said: "This survey does not stand up to scrutiny. In fact, there are actually more EU doctors working in the NHS since the EU referendum, more EU graduates joining the UK medical register and 3,193 more EU nationals working in the NHS overall."
Thoracic surgery trainee Dr Marco Nardini said that Brexit was "definitely a key factor" in his decision to move back to Italy in August 2017 after spending almost two years in the UK.
"One of my main concerns was around whether my qualifications would continue to be recognised abroad and in the UK," he said. "There's so much uncertainty at the moment - moving back to Italy and completing my training here seemed like the safer option rather than chasing a title from England which may not be recognised in the EU."
Shadow health secretary Jonathan Ashworth described the survey's findings as "extremely worrying".
"Theresa May must urgently safeguard the future of EU workers and stop treating them as bargaining chips in her reckless Brexit negotiations," said Mr Ashworth. "Failure to do so seriously risks increasing staff shortages and exacerbating the already dire crisis in our health and care system."