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Brexit is causing a staff shortage in the NHS with nurses from EU countries returning home and others facing racist abuse from patients.

The impact of June's European Union vote was revealed by Dame Julie Moore, chief executive of University Hospitals Birmingham NHS Foundation Trust.

This is the trust that runs the 1,000-bed Queen Elizabeth Hospital in Edgbaston, one of the largest hospitals in the country. Dame Julie is also interim chief executive of Heart of England NHS Foundation Trust, which runs Heartlands, Good Hope and Solihull Hospitals.

She warned that hospitals across the country were struggling to recruit staff because of cuts in training budgets.

She said: "We have traditionally also looked to the international market to come [to the UK] but I have to say Brexit has sent a bit of a shockwave through some of the staff we would have traditionally recruited.

"And, in fact, I have had some staff from the EU, from southern Ireland, looking to go back.

"Of great concern to me is some of the incidents of abuse that some of my staff have suffered from patients following Brexit, racist abuse.

"And if we wish to attract international staff over here then I think we are going to have to think very carefully about the messages we give and how we treat our staff.

"It's not just that we want to use them as a workforce. I think the exchange of knowledge and research are vitally important to the NHS.

"We have benefited as a country greatly from international collaborations and I would hate to see that lost in all of this.

"At the moment, I would say we haven't got enough nurses, doctors, clinical professionals, managers, anybody at the moment, and I’m not confident we are training enough to meet that demand."

It means Brexit is already contributing to a staff crisis in hospitals even though the UK has not officially begun the process of leaving the EU.

Dame Julie was speaking at Westminster to members of the House of Lords who are holding an inquiry into the state of NHS finances.

At University Hospitals Birmingham NHS Foundation Trust, around six per cent of nursing vacancies - just over one in 20 - are unfilled. But the problem was much worse at some other hospitals, she said.

"Some trusts are running with vacancy rates around ten to 15 per cent," she said.

Dame Julie said hospitals plugged staffing gaps by recruiting agency staff but in many cases these were actually regular employees who also worked for agencies on their days off.

"It's getting to a difficult point now.

"We've seen cuts in training budgets. . .there simply aren't the staff there to employ any more."

There was an increase in demand on NHS services, partly because people are living longer, she said.

And, at the same time, hospitals found they could not discharge patients even when they no longer needed treatment.

Sometimes this was a result of local councils being unable to provide care for people in their homes. However, University Hospital Birmingham also found that other nearby hospitals sent it patients for specialist care - and then couldn't take them back again when the specialist care was completed because they had become full up in the meantime.

Dame Julie said: "We are now seeing seven per cent more patients coming in through A&E. And we have more people we are unable to discharge.

"In my hospital, 100 beds are occupied by people who previously wouldn't have been."

She added: "As the surrounding hospitals become full, we are unable to discharge people back."

The Government has cut the the Department of Health's budget for non-frontline services such as medical training and public health by £1.5 billion this year.

It's part of plans to increase funding for the NHS by £10 billion. While funding for the NHS is increasing, some of this money is coming from other budgets - including training - which are overseen by the Department of Health but are not actually part of the NHS.

Jeremy Hunt, the Health Secretary, acknowledged overall health spending was not increasing by £10 billion after he was challenged by Sarah Wollaston, the Conservative chairman of the Commons health select committee.

He wrote to her in October, saying: "The Government has never claimed there was an extra £10 billion increase in the department of health's budget.

"I have always accepted that painful and difficult economies in central budgets will be needed in order to fund that plan."

Birmingham MP Gisela Stuart (Lab Edgbaston), the hospital's local MP and a supporter of Brexit, said: "Unfortunately, I'm not surprised that there is a shortage.

"I deeply regret that, both in Birmingham's medical school and across the city, training has been cut back."

Ms Stuart has been calling on the Government to confirm that the rights of EU citizens living and working in the UK will be respected after Brexit.

She chairs an inquiry, for think tank British Future, which is to publish a report in December on the rights of EU citizens in the UK.