We, in Scotland, have been leaders in delivering care through clinical networks and it is so sad to think that in years to come we will not be in the premier league. The central tenet to ERNs is centres of excellence delivering care through sharing of expertise as close to the patient as possible, ie the same as the rationale for managed clinical networks in Scotland. Of course, EU funding provides many benefits but it is not all about money, it is about the professional clinical and academic networks that had a common vision around the care of the person with a rare condition. We can have these networks in Scotland but they will never be able to replace what we can currently do across Europe.
Personally, I have invested a lot of energy in not just being part of these clinical and research networks but also in leading them. Moving some of this work to another EU Member State is becoming increasingly likely and I am being invited with open arms! Not only does this mean that, sometimes, my commute is going to become a bit longer, the obvious downside for Scotland is that over the last 18 years the skills and track record as well as the potential to attract funding in this field will drain away from here.