Doctors and Nurses out of the Tier 2 Visa Cap

4 mins

Posted on 19 Jun 2018

It took just over six months with constant pressure from MPs, Immigration lawyers, business leaders and an all-out campaign from the NHS for UK Visas & Immigration (UKVI) to listen to the problem at heart: the NHS was severely understaffed and needed specialist doctors and nurses from overseas to fill vacant positions. 

On Friday 15 June 2018, it was finally confirmed that doctors and nurses will no longer be part of the ‘annual quota’ under the Tier 2 (General) visa route.  

What is the annual quota on Restricted Certificates of Sponsorship?

Under the Tier 2 route, in an effort by UKVI to control net migration, there are restrictions on the number of non-European migrants looking to enter the UK to commence employment with a UK employer. This is known as the annual ‘cap’ on ‘Restricted Certificates of Sponsorship’. The number of Restricted Certificates (commonly referred to as work permits) available to employers every year is limited to 20,700. Forty percent of this quota (8,000 certificates) were previously assigned to workers in the NHS, leaving only 12,000 or so certificates available for everyone else. 

How does the points system work for Restricted Certificates of Sponsorship?

Restricted Certificates of Sponsorship are processed on a points based system. The more points you score, the higher the chance you will have of being granted one. Jobs in a ‘shortage occupation’ (an official list of jobs recognising professions with not enough UK Resident workers to fill the position) are awarded the most points, followed by PHD-level jobs and after that, points can be scored on the salary itself - the higher the salary, the more points you will score.  Due to the surge in Restricted Certificates being requested and granted, it often came down to the job with the highest salary being granted a Restricted Certificate of Sponsorship, with a minimum salary of £50,000 plus.

What has been the result of the cap on the NHS and UK companies?

As a result of this cap and what’s now called the ‘Brexit effect’ (lower number of European nationals migrating to the UK since the referendum), from December 2017 the Tier 2 quota has been oversubscribed every month as skilled jobs are not being filled by the UK resident workforce. This has resulted in employers, including the NHS, having to recruit more workers from overseas.  It has also crippled the NHS and in many hospitals positions for specialist doctors, as well as nurses, have been vacant for many months, directly affecting patient care.  

This visa shortage has not just damaged the NHS, but also companies looking to recruit top talent from overseas. Employers have been struggling to recruit overseas workers and specialist skilled staff (with valid job offers), who have had their RCoS requests refused with no right of appeal.  

What is the impact of the Tier 2 decision? 

As a result of UKVI’s decision, the NHS will now be able to recruit the thousands of skilled doctors and nurses it needs without dipping into the quota. The decision has been welcomed by NHS bosses who described it as a ‘huge relief’. The decision also embraces the Home Secretary Sajid Javid’s recent statement of creating a more ‘relaxed’ environment for Immigration. He had the following statement to make: 

I recognise the pressures faced by the NHS and other sectors in recent months. Doctors and nurses play a vital role in society and at this time we need more in the UK. That is why I have reviewed our skilled worker visa route.’

The additional 40% quota which will not now be used by the NHS will certainly benefit other employers who require skilled workers in industries such as tech, commodities and finance. However, given the previous backlog with the oversubscription of applications for Restricted Certificates, it is likely that it may still take many months for the process to even out, and for businesses to get the key skilled individuals that they need.  

If you would like to talk to me about anything covered above, please give me a call on 0207 329 9090 or drop me an email on

The articles published on this website, current at the date of publication, are for reference purposes only. They do not constitute legal advice and should not be relied upon as such. Specific legal advice about your own circumstances should always be sought separately before taking any action.

Back to top