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    This is our full-length article in regards to why GP practices should consider supporting Tier 2 Visa GPs, and guidance as to the process and how to become a supporting practice. If you’d like to read a briefer snap-shot on the same subject then view our shorter article here.

    Tier 2 Visas Guidance for GP surgeries

    If you’d like to gain a competitive edge in recruiting a Salaried GP to your practice then it’s worthwhile considering becoming a practice that supports a Tier 2 Visa. If you already have all the required documents then the initial online form to become a sponsoring practice should only take around 25 minutes – please read on to learn more.

    Why should your GP surgery support a Tier 2 Visa?

    • Becoming a supporting practice allows you to recruit GPs from a larger pool of candidates, including GPs that other surgeries locally are unable to hire – it is a great opportunity for you to steal a march on other local practices
    • If your current GP registrar requires a Visa it will currently be supported by HEE, but to retain them as an employee beyond their training you need to become a supporting practice
    • Once your practice holds a licence it is valid for 4 years meaning if your Tier 2 GP receives Indefinite Leave to Remain (ILR) in future then you can use the licence on another GP

    What is a Tier 2 Visa?

    Tier 2 Visas are an immigration route for non-European Economic Area (non-EEA) clinicians who would like to continue working in the UK. Surgeries across the UK choose to become supporting practices, historically this has been in locations that are challenging to recruit GPs but in recent years with the great shortage of GPs this has also become commonplace in more urban areas which have traditionally been easier to recruit to, including London.

    Which GPs require a Tier 2 Visa?

    In my experience when speaking with practices about the possibility of sponsoring a GP who requires a Tier 2 Visa there appears to be a common misconception that these must be GPs who are coming from abroad with no experience of working in the NHS and UK primary care. This is incorrect. GPs requiring sponsorship are already qualified, living in UK and have completed the last 4 years of training in the UK including their ST1, ST2 and ST3 years. They are doctors with experience working within NHS primary care and will fit in like any other newly-qualified GP.

    How much does it cost?

    The application cost is £536 for small businesses, and £1,476 for medium and larger businesses. You are classified a small business if your annual turnover is £10.2 million or less or you have 50 or fewer employees.

    Once you have a licence there is a cost of £199 for each Certificate of Sponsorship you issue (i.e. for each GP you hire) which can be claimed back from NHS England.

    Is there any funding available?

    There has previously been support to GP practices from NHS England which covered application costs until March 2020. Although this funding is no longer available, it is advised that practices approach their CCG for reimbursement of costs associated with becoming a Tier 2 sponsoring organisation. Practices we recruit for have been partially or fully-funded by their CCGs in this regard, and CCGs (or ICSs) have a vested interest in their locality being well-staffed with GPs.

    A step-by-step guide on how to hire a GP who requires a Tier 2 Visa

    1. Requirements of the practice

    The Home Office needs to establish 4 criteria when considering licence applications, none of which will be a barrier to a GP surgery becoming a sponsoring practice:

    • You are a genuine organisation operating lawfully in the UK
    • You are honest, dependable and reliable
    • You can carry out your sponsorship duties, i.e. you have robust HR and recruitment processes
    • You are offering genuine skilled, appropriately remunerated employment
    1. Fill in online Application Form

    The process begins with an online application and can be viewed at:

    If you have all the required documents available (detailed in the table below) then the online form should only take about 25 minutes to complete. If you get part way through and need to pause then you can save the application mid-process. It is recommended to save each page as you go because your session will time out after 20 minutes of inactivity.

    To complete the application form you will need to have collated the following information:

    Organisation details, Authorising Officer, Key contact, Level 1 user, other users and representatives*

    The number of CoS you need (i.e. how many clinicians you are looking to sponsor during your first year as a sponsor) and your reasons for this number **

    The names and trading dates of your organisation if it has traded under another name in the last 4 years

    Your organisation’s size and sector

    Documents required depend on an organisation, a simplified list is below (also see note ***)

    Mandatory document – Corporate/Business bank statement

    Mandatory document – Employers liability Insurance certificate for at least £5m from an authorised dealer

    Mandatory document – Practice CQC registration details

    Supporting documentation – any further 2 from the following list:

    ·        HMRC Registration – PAYE reference number/Account office reference number

    ·        Proof of business premises ownership/fixed assets ownership/lease

    ·        Supporting letter from your bank manager

    ·        HMRC Registration – VAT

    ·        HMRC company tax forms CT603 and CT600

    GMC Registration details of the Senior Partner and your RCGP registration details if you are a  teaching practice

    Details of any criminal convictions or civil penalties

    Payment details (card)

    *Key personnel – the online form requires named persons to have certain responsibilities (these roles can all be done by the same person).

    **Once you have successfully applied for a licence you have an online account where you can apply for further licenses.

    *** It is your responsibility to check exactly which documents need to support your application, more details can be found here – Home Office will carry out an online check for the CQC and GMC documentation.

    Level 1 user – carries out the day-to-day sponsorship activities, more can be nominated once licence granted. Must be employee, director or partner. They are the person with the access to the Sponsor Management System, the online gateway between you and UK Visa and Immigration.

    Level 2 user (optional) – have fewer permissions than a level 1 user as can only assign CoS and report worker activity, if for example the worker doesn’t come to work.

    1. Print and post your Submission Form

    Once your online submission is complete you will need to print out the submission sheet and send it to UK Visa and Immigration with the supporting documents as soon as possible but within 5 days.

    Their address is: Sponsor Casework officers, Sponsor applications team, UK Visas and Immigration, PO Box 3468, Sheffield, S3 8WA

    Most GP practices will be classified as small businesses. The Sponsoring Licence application fee for small businesses is £536. You are classified a small business if:

    • Your annual turnover is £10.2 million or less
    • You have 50 employees or fewer

    The fee for medium and larger businesses is £1,476.

    1. Begin your hunt for a GP

    We’d recommend beginning your hunt for a GP by now. We’re in a GP-shortage market and it can take months to find a GP, so let’s get started!

    If you’d like to have a no-obligation chat with us about the likelihood of recruiting in your area or market-rate salaries, or anything relating to recruiting a GP, then call us on 0113 350 1308.

    1. Wait for the Home Office to approve your Application

    The Home Office stats that 80% of applications to become a supporting practice are dealt with within 8 weeks, so once you’ve sent off your application form you just have to sit back and wait. As a result, our recommendation is to get the wheels in motion as soon as possible!

    1. Once you’ve found a GP – Certificate of Sponsorship

    Now that you’ve been approved as a sponsoring practice and you’ve found the GP you would like to recruit, the next stage is to then apply for a Certificate of Sponsorship (CoS) number from the Home Office.

    The CoS is a virtual document that enables a migrant to work in the UK and is issued from the Tier 2 licence holder – you.

    Once you have the CoS details you need to give them to the GP you are hiring so that they can apply for their Tier 2 visa. They must submit their application within 3 months after the CoS being issued otherwise this will expire. This document will allow the individual to apply to UK Visas and Immigration to work for the duration of the contract up to a maximum of 3 years in the first instance. We have also written an article for GPs who require Tier 2 Visas, this can be read here.

    1. That’s your work done – that wasn’t SO bad, was it?

    You’ve done everything you can and it’s now in the hands of the GP and shortly the Home Office. Hopefully it won’t be too long, but if there is a backlog then it is possible for the GP to pay additional costs to fast-track the application if required, which can be done within 24 hours.

    A recent example from a GP surgery in the North East who applied to become a supporting practice:

    Kathryn Munro, Practice Manager of Peaseway Surgery in Newton Aycliffe, has recently made the application to become a Tier 2 sponsoring practice:

    “We were asked by Menlo Park if we would be supportive of employing a GP who required Tier 2 Sponsorship. I had heard the process could be quite laborious so hadn’t really considered it as an option previously. Using this route to recruit, we have been lucky to uncover an excellent GP who requires sponsorship who will be joining us shortly.

    “Following our offer of employment to the candidate, Alexa sent me a detailed overview of the initial application process which was really useful, and in reality it was straightforward and not as time consuming as I had anticipated. The GP we have hired will only require sponsorship for approximately 1 year which means we will be able to utilise other GPs requiring this type of support for future hires. I would recommend the scheme to other practices, especially those who have found recruiting GPs a challenge.”

    Our advice on how to get started

    Our advice to GP surgeries who are considering sponsoring a Tier 2 Visa is to start now!

    It’s wise to make the decision to become a sponsor before you have a specific GP in the frame for the role due to the timeframes involved with the Home Office.

    The reason for this advice is because many GPs who require a Tier 2 Visa, who are normally coming to the end of their ST3 year, are not aware of the timeframes involved for a practice to become visa-sponsoring, and as a result they leave their job-hunt too late! However, as a positive for your practice, this means that if you’ve already put the work in to become an approved sponsor it means that the Tier 2 GP will have limited options elsewhere and therefore is more likely to accept an offer of employment from you because you are ready to offer a CoS number – meanwhile other surgeries are starting an 8-week wait!

    Finally, if you are approved to support Visas and don’t find a GP who requires a Visa then don’t worry, you have 4 years initially to find a GP to support so the time and money you have invested will not go to waste.





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