Immigration, Workforce Composition, and Organisational Performance: The Effect of Brexit on NHS Hospital Quality

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ID: 320085
2026
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Abstract
Abstract Restrictive immigration policies can force organisations to alter their workforce composition, with unclear effects on organisational performance. We study the effects of the 2016 Brexit referendum, which reduced the share of EU-nationality nurses in English hospitals. Using administrative patient-level data and a continuous difference-in-differences design, exploiting hospitals’ pre-referendum exposure, we estimate the causal impact of a negative labour supply shock on care quality. Hospitals with higher pre-referendum EU nurse shares experienced higher post-referendum emergency patient mortality, equivalent to 1,238 additional deaths annually in the three years after the referendum. Consistent with theoretical predictions, hospitals responded to labour shortages by relaxing hiring standards: foreign nurses recruited after the referendum were appointed to lower salary grades, suggesting lower skills and experience.
Reference Key
openalex_W7167722612 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Henrique Castro-Pires, Kai Fischer, Marco Mello, Giuseppe Moscelli
Journal the economic journal
Year 2026
DOI
10.1093/ej/ueag088
URL
https://doi.org/10.1093/ej/ueag088
Keywords Keywords not found

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