• Letter to Home Office signed by nine representatives of medical royal colleges and NHS Employers
  • Greater Manchester NHS writes to health secretary after 100 doctors’ visas blocked
  • Calls for shortage occupations to be excluded from cap on tier two visas available
  • NHS Employers says there is no urgency from the Home Office

NHS Employers and the medical royal colleges have called on the Home Office to exclude nurses from its tier two visa cap to free up places for doctors, it has emerged.

In a letter, signed by NHS Employers chief executive Danny Mortimer, Royal College of Physicians president Professor Jane Dacre and other royal college leaders, the group called for the cap on certificates of sponsorship to exclude applications for shortage occupation roles such as nursing.

Danny Mortimer

Danny Mortimer said NHS Employers has had constructive discussions with the government

The letter said this would help “alleviate pressure in the system [and] work for employers across all sectors”.

Mr Mortimer told HSJ NHS Employers has had “constructive discussions” with the Home Office and the Department of Health and Social Care about the proposal but has “not yet seen a change in policy”.

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

The group says its 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”.

Tier two visas are given to workers who have a skilled job offer and are not from the European Economic Area. HSJ reported this week the visa cap is causing “significant issues” for trusts that are unable to fill rota gaps due to shortages of certain doctors in the UK.

The group acknowledges the demand for nurses in all healthcare settings is continuing to increase but stresses the demand for nurses from overseas is having a “direct impact” on the availability of certificates of sponsorship for other professionals, including 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 says.

Mr Mortimer said there had not been “an urgency in terms of the formal response” to February’s letter. However, he acknowledged the DHSC understands the impact of the problem.

Mr Mortimer said the solution “isn’t about placing more posts on the shortage occupation list” as that will result in fewer work permits.

He added: “The more nurses we recruit the fewer work permits we will have available for doctors. As we understand it, the recruitment of shortage occupation list professions are protected. [Removing them from the cap] won’t affect their ability to access tier two permits.”

Meanwhile the Greater Manchester Health and Social Care Partnership also wrote a letter urging health secretary Jeremy Hunt and home secretary Amber Rudd to reconsider the refusal of 100 visas for international doctors ready to enter the UK.

The letter – which was sent in March and seen by HSJ – describes how a “very successful” postgraduate education programme for international doctors attempted to recruit 100 doctors for placements in various specialties.

“To our considerable shock and concern this application was refused by the Home Office and therefore we are unable to bring in these doctors to fill the various vacancies that exist in the trusts listed,” the letter says.

The programme is run by Wrightington, Wigan and Leigh NHS Foundation Trust in partnership with Edge Hill University and 34 trusts have joined the programme to accept doctors working in their chosen specialty.

A senior NHS official associated with the project told HSJ: “This is just a crazy decision. Crackers beyond belief. Right across the NHS we are trying to increase the numbers from overseas. The home office say the refusal was in our national interest but it’s in our national interest to have an NHS that’s properly staffed.”

They added: “The staffing situation is really dire and if the government don’t change their mind soon then these people might decide not to come.”


Updated at 2pm on 27 April to make clear the timing of the letter. Also updated at 5.30pm to include information from Greater Manchester.