Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/316752 
Year of Publication: 
2025
Series/Report no.: 
IZA Discussion Papers No. 17797
Publisher: 
Institute of Labor Economics (IZA), Bonn
Abstract: 
Restrictive immigration policies may force firms to abruptly change their workforce composition. But how does this impact the performance of these organizations? We study the effects of the 2016 Brexit referendum, which led to a drop in the share of EU nationality nurses in English hospitals. Using high-quality administrative patient-level data and a continuous difference-in-differences design which exploits the different pre-referendum hospital exposure to the shock, we estimate the causal effect of the workforce composition changes on hospital quality of care. We find that, in the post-referendum period, emergency patients admitted to NHS hospitals with a mean pre-referendum share of EU nurses faced an increase in mortality risk, equivalent to about 1,485 additional deaths per year. These findings are consistent with a theory model that predicts a decrease in the quality of newly hired hospital workers to avert labour shortages. We provide empirical evidence in support of this mechanism by showing that the foreign joiner nurses hired in the post-referendum period were assigned to lower salary grades than those hired prior to the referendum, indicating lower levels of skills and job experience.
Subjects: 
patient care
migration
worker mobility
labour supply
hospital quality
Brexit
JEL: 
J45
J61
J68
I11
C26
Document Type: 
Working Paper

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