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Lifting the tier 2 visa cap: what does it mean for the NHS?

By Rachel Harvey Associate and business immigration specialist at law firm, Shakespeare Martineau.
3 August 2018

Following a passionate campaign by NHS staff and medical groups, the Government’s decision to exclude NHS staff from the tier 2 visa cap suggests that it has finally seen sense.

Figures revealed that the NHS in England alone is short of nearly 10,000 doctors. This rethink of the tier 2 system will not only ensure the UK healthcare sector is able to maintain a high level of patient service, but will also free-up more certificates of sponsorship for businesses in other sectors to plug talent gaps and recruit skilled workers.

Introduced in 2008 by Theresa May with the aim of controlling net migration into the UK, the current points-based immigration system must be navigated by any employer who wants to recruit workers from outside the EU. When they are recruiting new hires from outside the UK, employers must be licensed by UK Visas and Immigration and apply for a Restricted Certificate of Sponsorship.

Since 2011, there has been an annual cap of 20,700 for these, divided into monthly allocations and in order to be eligible for a certificate, employers are required to meet a minimum amount of points. This is based on a number of factors, including salary, whether or not the job is on the shortage occupation list, certain PhD level jobs and the result of the resident labour market test, unless they can show that they are exempt.

With the NHS coming under greater pressure than ever before, the Government’s decision to remove doctors and nurses from its cap on skilled non-EU migrants will be welcomed by many in the UK healthcare sector. In February 2018, NHS England had 35,000 nurse vacancies and nearly 10,000 doctor posts unfilled, according to an NHS Improvement report. This is largely the result of post-brexit uncertainty, with many European nationals having left the UK and many no longer perceiving it as an attractive place to work.

As well as finally making it easier for NHS trusts to fill vacancies, this more flexible approach to immigration will benefit all UK sectors, removing some of the competition they face when recruiting from outside of the EU. Currently, around 40 per cent of monthly restricted certificate applications are for healthcare roles.

While employers will still have to navigate the current costly and complex system, this long-awaited reform will free up hundreds of certificates of sponsorship for other highly-skilled workers, such as engineers, IT professionals and teachers.

While this Government announcement about immigration is certainly a positive step, further changes and creative thinking are still needed if the UK is to remain an attractive option for skilled overseas talent. For example, one criticism of the new measure is that rather than looking outside of the UK to address the significant NHS skills gap, more should be done to nurture domestic healthcare talent.

Following the abolishment of NHS nursing bursaries in 2017, there is a risk that potential trainees will increasingly opt for other careers offering greater salaries and lower levels of stress.

Questions still remain unanswered for employers looking to recruit EU employees after the implementation period ends. Ensuring greater certainty in this area and that EU doctors and healthcare workers feel welcome is essential if the NHS is to attract sufficient applications to fill positions and maintain patient service levels.

Moving forward, it is also vital that the UK immigration system retains an element of flexibility by taking into account the growth of new and developing UK sectors, such as IT and FinTech. A strong example to emulate from overseas would be Australia, which uses a flexible, points-based system, assessing demand for workers in different sectors and adjusting requirements accordingly.

Sajid Javid’s announcement will undoubtedly have come as a welcome relief for the UK healthcare sector and wider business community alike, making it easier to fill vacancies through the Government’s tier 2 visa route.

However, in order to truly address the current NHS crisis and avoid compromising the health of its patients, it is essential that more is done to promote the UK healthcare sector as an attractive place to work. How far the Government’s latest measure goes in addressing the significant challenges facing the sector – only time will tell.

Rachel Harvey is an associate and business immigration specialist at law firm, Shakespeare Martineau.


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