Brexit has worsened the UK’s acute shortage of doctors in key areas of care and led to more than 4,000 European doctors choosing not to work in the NHS, research reveals.

The disclosure comes as growing numbers of medics quit in disillusionment at their relentlessly busy working lives in the increasingly overstretched health service. Official figures show the NHS in England alone has vacancies for 10,582 physicians.

Britain has 4,285 fewer European doctors than if the rising numbers who were coming before the Brexit vote in 2016 had been maintained since then, according to analysis by the Nuffield Trust health thinktank which it has shared with the Guardian.

In 2021, a total of 37,035 medics from the EU and European free trade area (EFTA) were working in the UK. However, there would have been 41,320 – or 4,285 more – if the decision to leave the EU had not triggered a “slowdown” in medical recruitment from the EU and the EFTA quartet of Norway, Iceland, Switzerland and Lichtenstein.

Demand for labour (that’s all employment plus vacancies) has recovered to almost exactly its pre-pandemic level. But the data indicates that the increase in vacancies is not due to a surge in demand for labour, but because the labour force is shrinking: it dropped by 1.6% or 561,000 between the first quarters (Jan-March) of 2020 and 2022, which is greater than the increase in job vacancies over the same period (492,000).

Notably, people’s reasons for being economically inactive have changed over the past couple of years. Following the first COVID lockdown, the large drop in labour supply among 16-64s (those of working age) was mainly driven by rises in long-term sickness (139,000) and early retirement (70,000).

The drop in the workforce also masks a considerable churn within it, which may be adding to employers’ difficulties in recruiting staff. During the first lockdown, the number of EU workers fell by some 300,000. This has partially recovered, as you can see in the chart below, but there are still around 100,000 fewer than at the start of the pandemic.

Yet this has been more than offset by continued long-term growth in the number of non-EU foreign-born workers in the UK, increasing by some 170,000 since the start of the pandemic. Brexit, in other words, in tandem with the pandemic, has been a source of churn in the labour market.

The rise in the rate of job vacancies appears remarkably uneven across local authority districts in Great Britain. The two maps below show the change from before the pandemic in February 2020 (on the left) to July 2021 (on the right), the most recent month for which we have been able to compute data. This is likely to still be indicative of the most recent geographic pattern.

It shows huge increases in vacancies in relatively few districts, while most others show either modest increases or falls. The highest rates are particularly found in remoter rural areas, particularly in the south-west and north-west of England, and in parts of inner London.

Many of these districts are dependent on foreign labour, particularly for agriculture in rural areas, and hospitality and other sectors in London. Again, this may be a sign of the effect of Brexit and the pandemic choking off the growth in the number of EU workers.

Farmers are anxiously awaiting further detail from the government on imminent changes to their subsidy payments, with many reluctant to trust the Department for Environment, Food and Rural Affairs (Defra) to manage the transition, the leader of one of the UK’s biggest farming organisations has said.

“Quite a few have said to me: ‘Well, we’re not at all clear what Defra is doing,’” Mark Tufnell, the recently installed president of the Country Land and Business Association (CLA), told the Guardian. “[They say:] ‘We don’t think that Defra know what they’re doing,’ and ask me: ‘What do you know?’”

The CLA represents about 28,000 farmers and owners of rural businesses in England and Wales, including some of the biggest landowners and a large number of smaller ones, with about 18,000 members farming less than 300 acres. Members are hoping for more details of post-Brexit support for farmers at the organisation’s conference on Thursday, where the environment secretary, George Eustice, will set out what support farmers can expect when their basic farm payments are cut by between 5% and 25% this year before being phased out entirely over the next six years.

Rural firms are set to lose out on hundreds of millions under revised funding plans unveiled in the recent Budget, the Country Land and Business Association has warned.

The CLA, which represents 28,000 rural businesses and farmers, has criticised the government for removing support aimed at levelling up the rural economy.

The group found that spending plans under the UK Shared Prosperity Fund (UKSPF) will lead to a shortfall of £315 million for rural businesses over a seven-year period.

The figure represents the discrepancy in funding assigned to tackling regional economic disparities through the EU’s Structural and Investment Funds (ESIF), versus what will be received under the UKSPF to bolster rural productivity.

But the government’s new plans signal a marked shift from previous EU investment models, where rural areas benefitted from a ringfenced fund every year. 

Closer inspection of the 2021/2022 Budget shows that there will be no dedicated funding in the UKSPF for rural businesses, as the ESIF rural fund had already been allocated for 2020/2021.

Shoppers have spotted fake carrots in Fakenham, cardboard asparagus in London, pictures of oranges and grapes in Milton Keynes, and 2D washing liquid bottles in Cambridge. Sainsbury’s has also used outline drawings of packaging to fill shelves.

The tactic comes as shortages of HGV drivers and pickers and packers on farms and food processing plants lead to low availability of some items in supermarkets. Problems at ports, where handlers are struggling to cope with a surge in deliveries for the festive season, are also leading to shortages.

Bryan Roberts, a retail analyst at Shopfloor Insights, said he had only begun to see the cardboard cutouts of fresh produce in the past year, but said similar tactics had been in place elsewhere in supermarkets for some time. “It has become quite commonplace. It is not only because of shortages, but because a lot of the larger stores are now simply too big.”

He said the cutouts were one of an array of tactics being used to fill space, including filling meat fridges with bottles of tomato sauce or mayonnaise, spreading packs of beer out across whole aisles, and erecting large posters or other marketing material.

Tesco, which has boasted that its sales have been boosted by its ability to keep shelves stocked, said the fruit and vegetable pictures were not linked to the recent supply chain issues and had been in use for many months.

Traditional supermarkets, which can stock more than 40,000 product lines, have been honing their grocery ranges to improve efficiency so they can cut prices and compete more effectively with discounters such as Aldi and Lidl, which sell fewer than 3,000 different products.

That process has only been accelerated by Brexit and the pandemic which have led to staff shortages and difficulties in shipping goods. Supermarkets and manufacturers have reduced the range of different types of pasta, coffee or teas they sell to make it easier to keep goods flowing.

Farmers hit by a shortage of seasonal workers have resorted to giving produce away for free rather than seeing it left to rot.

York-based raspberry grower Richard Morritt threw his gates open to the public after failing to attract staff.

Others have done the same, and the National Farmers Union (NFU) has repeated calls for government help.

A government spokesperson said it was looking at ways to help the sector recruit more domestic labour.

Mr Morritt said in previous years the majority of his pickers came from eastern Europe.

In 2020, he had relied on furloughed workers and university students but this year he said “the shortage of labour has made it unviable”.

To stop the fruit going to waste he allowed members of the public to pick it for free.

At least 18 councils across the UK confirmed on Thursday that they are experiencing ongoing disruptions to their bin collection services. 

It is due to staff self-isolating and a lack of heavy goods vehicle (HGV) drivers for bin lorries.

The Local Government Association (LGA) told the BBC that the delays were primarily affecting garden waste.

However, some councils are also delaying recycling collections in order to prioritise general waste. 

It comes as three councils in Devon wrote to Home Secretary Priti Patel on Thursday, asking for the government to grant temporary visas for trained European HGV drivers to ease the shortage.

“At the time of writing, North Devon Council are attempting to fill seven [bin lorry driver] vacancies, Torbay Council eight vacancies, and Teignbridge Council 10 vacancies,” wrote councillors Steve Darling, David Worden and Alistair Dewhirst. 

“This equates to approximately 20% of the HGV workforce in driver vacancies and it is proving very challenging to fill this resourcing gap given the dynamics of this labour market.” 

The UK currently has a shortfall of about 100,000 HGV drivers, after many EU workers returned home following Brexit and during the pandemic. 

Ministers say UK employers should hire locally to fill the gap, but the councils said it would take time to train the next generation of drivers. 

British food and drink exports to the EU fell by £2bn in the first three months of 2021, with sales of dairy products plummeting by 90%, according to an analysis of HMRC data.

Brexit checks, stockpiling and Covid have been blamed for much of the downturn, but the sector has said the figures show structural rather than teething problems with the UK’s departure from the EU.

“The loss of £2bn of exports to the EU is a disaster for our industry, and is a very clear indication of the scale of losses that UK manufacturers face in the longer-term due to new trade barriers with the EU,” said Dominic Goudie, the head of international trade at the Food and Drink Federation (FDF).

He called on the government to “stop prevaricating” over proposals to help exporters “shut out of trading with the EU”.

The leaders of Britain’s five largest business groups have warned the government that firms face “substantial difficulties” at UK ports since Brexit, with the prospect of a “significant loss of business” if the situation is allowed to continue.

Following a round table meeting on Thursday evening with Cabinet Office minister Michael Gove, a letter was issued by the CBI, the British Chambers of Commerce, the manufacturers’ group Make UK, the Federation of Small Businesses and the Institute of Directors.

The letter said the government needed to act quickly to overcome “the sizeable obstacles” faced by exporters.

With hold-ups at UK ports worsening and many lorries making return journeys empty following difficulties obtaining customs certificates, the business groups said ministers needed to act quickly.

The letter was published after Gove appeared to play down the significance of the difficulties faced by businesses struggling to overcome customs barriers, and what they described as a lack of coherent advice from government departments about new EU trading rules following Brexit.

Gove said after the meeting, which the business leaders believed was private, it is understood, that “some businesses are facing challenges with specific aspects of our new trading relationship with the EU”.

He added: “I want to let them know that we will pull out all the stops to help them adjust.”

The business groups said: “A range of problems were discussed, including the substantial difficulties faced by firms adapting to the new customs processes, sizeable obstacles to moving goods through the Dover-Calais route and the shortage of informed advice from both government and specialist advisers alongside a number of others.”

They warned that grace periods agreed with the EU would expire over the next two months at a time when cross-border traffic, which is usually low in January, was due to grow. Unless measures were put in place to smooth customs procedures, the situation would deteriorate, they said.

The “end of the seafood industry” on the south coast of England could be caused by post-Brexit export problems, a Dorset fish merchant has said.

Charlie Samways said extra paperwork and IT issues mean perishable seafood exports from West Bay were taking twice as long to reach customers in the EU.

As a third country outside the European Customs Union, UK exports are subject to new customs and veterinary checks.

The government said it was in contact with the industry to address issues.

Mr Samways, whose family has operated in West Bay for 60 years, buys seafood from 150 local fishermen, much of which is exported to customers in France, Spain and Italy.