• Chief executive says Home Office visa cap puts more pressure on junior doctors due to rota gaps 
  • BMA warns the cap is threatening patient care and safety
  • Over 1,500 medical visa applications refused between December and March alone

The government’s tier two visa cap is “not logical” and is “threatening patient care and safety”, HSJ has been told.

Chief executives across the NHS are finding visa applications for overseas doctors are being rejected in greater numbers than before which they say is putting more pressure on existing staff.

In some cases, trusts are successful in just a handful of cases out of a hundred or more applications.

Manchester University Foundation Trust told HSJ it had 23 visas refused by the Home Office in the year to April 2018.

University College London Hospitals FT told HSJ between January and May they filed 19 applications for tier 2 visas for eight doctors from outside the EEA but none were accepted.

Tracy Dowling, chief executive of Cambridgeshire and Peterborough FT, told HSJ the trust’s “only option” was to recruit overseas doctors when they have not had any applicants from the UK, but they are “not allowed to recruit an appointable person” because of the visa cap.

“It is not logical to have such a cap when we are not able to recruit from within the UK,” Ms Dowling said. “We would like to see a lifting of the restrictions on these visas.”

Ms Dowling said that recruiting overseas doctors who could “provide a very high level of service”, would benefit patients but she warned the cap puts more pressure on junior doctors because of rota gaps.

HSJ previously reported that the Greater Manchester Health and Social Care Partnership wrote to health secretary Jeremy Hunt and home secretary Amber Rudd urging them to reconsider the refusal of 100 visas for international doctors ready to enter the UK.

Andrew Foster, chief executive at Wrightington, Wigan and Leigh FT, which is part of the partnership, said the government’s visa cap could “permanently damage” a scheme run by the trust to recruit overseas doctors.

Mr Foster told HSJ that the Learn, Earn and Return scheme, which has been running in the region and spearheaded by the trust for 12 years, has not encountered problems getting visas for doctors before 2018.

“Last year, where we got 60 doctors and we had no trouble with the visas. This year, [during] the first two months we were denied all visas and in the latest round we have been successful in less than 10 cases out of the 100,” he said.

“You have one branch of government that is trying to tackle a dire workforce crisis in the NHS but another branch of government is saying no,” Mr Foster said. It is government policy to reduce immigration of the people we really need in this country? I wouldn’t have thought so.”

The British Medical Association is still waiting for a response from the Home Office to a letter sent in February calling on ministers to exclude nurses from its tier two visa cap to free up places for doctors.

Chaand Nagpaul, BMA council chair, said the visa cap was “threatening patient care and safety”.

“The tier two visa quota has been reached for the sixth month in a row, yet there are still thousands of posts unfilled, with vacancy rates rising,” he said.

Danny Mortimer, chief executive of NHS Employers, told HSJ many employers could “again not get certificates of sponsorship for doctors during May”.

Mr Mortimer warned that the NHS is “fast approaching the major August intake and changeover period for many doctors in training”.

“An urgent solution is needed to clear the backlog, account for any increase in applications linked to the August changeover and provide a sustainable approach to the management of the system,” he said.

According to Home Office data acquired by the Campaign for Science and Engineering, between December 2017 and March 2018, 1,518 medical applications for tier 2 visas were refused due to the cap.

During this period, almost 1,000 speciality registrar and equivalent applications were refused, from 143 refusals in December rising to 346 in March.