A ‘no-deal’ Brexit that ends healthcare arrangements between the UK and the EU could end up costing the NHS as much as £500 million a year, warns a new paper published by the Brexit Healthcare Alliance, on the back of an analysis by the Nuffield Trust.

Travel insurance for trips to Europe may become unaffordable for British people with existing health problems, while the health service could face additional pressure if British citizens living abroad were no longer able to access reciprocal healthcare, it says.

The Alliance, which includes patient groups, charities, NHS bodies and medical research organisations, has kicked off a campaign that calls on Brexit negotiators on both sides to take steps to avoid this ‘worst case scenario’.

“Patients stand to lose out dramatically if UK nationals travelling to and living in the EU are no longer able to benefit from free healthcare and EU citizens will also lose out by not being able to get free healthcare here,” said NHS chief executive Niall Dickson, co-chair of the Brexit Health Alliance.

The paper, Maintaining reciprocal healthcare for patients after Brexit, also reiterates the warning that UK pensioners currently living in the EU may be forced to return to the UK if a satisfactory deal is not reached.

The Nuffield Trust estimates that an extra 190,000 could require hospital beds in the UK if reciprocal healthcare arrangements are stopped, creating new demand for 1,600 nurses alone, as well as doctors, other health professionals and support staff.

It estimates that the end cost of this to the NHS would be around £500 million a year, given that the total cost of caring for those returning from abroad would be about £1 billion, minus the £500 million which the UK would no longer have to pay in reimbursements to other EU member states.

To prevent such a scenario, the Alliance is calling for straightforward and appropriate access to reciprocal healthcare for both UK and EU patients, and that there be no increased burden for both UK and EU health providers if they are required to handle new, more complex administrative and funding processes, should current arrangements be discontinued.