The cross-border transfer of critically-ill children for life-saving surgery in Dublin is facing an uncertain future due to Brexit, it has been warned.
It has emerged that all doctors and nurses from Northern Ireland who also work south of the border in any capacity must be registered with Irish regulatory bodies by April 1 as a result of Northern Ireland leaving the EU.
This includes medics and nursing staff who travel with children who are being transferred to the Republic of Ireland for treatment unavailable in Northern Ireland, including babies born with life-threatening congenital heart defects.
Paediatric cardiac surgery is no longer carried out in Northern Ireland after a review of the service found that it was unsustainable.
At the time, Health Minister Robin Swann called for children's heart surgery to be retained in Northern Ireland after his son was born with a serious heart defect and needed a life-saving operation.
Despite a campaign by families and charities, a decision was made to set up a cross-border service and many surgeries now take place at Our Lady's Children's Hospital in Dublin, with other operations happening in hospitals in England. However, it has been claimed that the cross-border service is now under threat due to regulatory changes following Brexit.
A health professional involved in the delivery of the crucial cross-border service said: "I have been told that any doctor or nurse who doesn't have dual registration by the end of this month could be arrested if they work south of the border.
"This essentially means that an ambulance could be pulled over and the doctors and nurses on board being arrested. The Department of Health has said the timeframes for registration should be achieved and no adverse impact is anticipated but that isn't a guarantee, which is what parents of children with heart defects need right now.
"To me, there doesn't seem to a sense of urgency to get this resolved. The Department of Health has said it is working closely with the regulatory bodies in the south to get this sorted out but the fact is that doctors and nurses have to be registered in order to work and that isn't going to happen for a lot of staff by the end of the month.
"It all seems a bit ambiguous. The only way I can see this being sorted out is if there is a grace period or a memorandum of understanding put in place."
In February, Richard Pengelly, the Department of Health's permanent secretary, wrote to the chief executives of the trusts, the Business Services Organisation and the Health & Social Care Board (HSCB), warning them to "take urgent action".
He added: "I appreciate that it may be necessary to liaise with the HSCB on the financial implications of this inescapable requirement." It is understood that the cost of the regulatory changes will be more than £100,000.
A spokeswoman from the Department of Health said: "The regulators are taking an entirely pragmatic and practical approach. For example, the Medical Council of Ireland has now asked that applications are made by May 31 to align better with their annual registration cycle.
"The Nursing and Midwifery Board of Ireland has also now confirmed that it will be satisfied if applications are commenced by March 31.
"The trusts are now working with relevant employees within these timeframes which should be achieved.
"Given the feasibility of the timeframes being worked to, no adverse impact is anticipated."
The spokeswoman said no healthcare professional can work south of the border until they are fully registered with the southern regulatory body.