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Letter of note

HSJ reported earlier this week that the government’s tier two visa cap is causing significant issues for trusts unable to fill rota gaps.

Trust leaders have told of doctors being appointed from outside the EU but having their certificates of sponsorship refused. Tier two visas are given to workers who have a skilled job offer and are not from the European Economic Area.

The story has been gathering momentum, with urgent calls for a fix from across the health world and coverage in the national media by Friday.

Now, NHS Employers and several royal colleges have proposed a solution.

In a letter to the Home Office, the group calls for the cap on certificates of sponsorship to exclude applications for shortage occupation roles such as nursing. The proposal “enables the NHS to employ the doctors it has recruited in recent months and who are needed now to manage the patient demand in the system”.

The letter was sent in February but has not previously been reported.

The group acknowledges that the demand for nurses is still rising but stresses the demand for nurses from overseas is having a “direct impact” on the availability of certificates for other professionals, including doctors. Basically: the more nurses the NHS recruits, the fewer work permits there are available for doctors.

The impact of the visa cap increases temporary staffing costs and affects the reputation of the NHS and its credibility with the global medical professional community, the letter adds.

NHS Employers chief Danny Mortimer told HSJ there have been “constructive discussions” with the Home Office and the Department of Health and Social Care but this has “not yet seen a change in policy” and “there hasn’t been an urgency in terms of the formal response”.