Visa problems mean NHS is losing UK trained GPs, doctors warn
Authors: Abi Rimmer
Publication date: 04 Dec 2017
The NHS is losing GPs from overseas who have trained in the UK, because of difficulties and delays in applying for visas, doctors have warned.
Last month the House of Commons Health Committee put out a call for examples of cases where GPs from outside the European Economic Area had been unable to work or had been forced to leave the UK because of visa problems.
In August NHS England announced that it would aim to employ 600 GPs from overseas in 2017-18 and “at least” 2000 doctors from overseas by 2020-21. The NHS will spend £100m on agency fees over the next three years to recruit these doctors.
Despite these ambitions, figures shared with The BMJ in July showed that only 38 GPs had been recruited through the International GP Recruitment Programme.
John Coffey, a GP and training programme director from Lincolnshire, said it was frustrating that the NHS was actively recruiting GPs overseas when GPs who trained in the UK were struggling to remain and work. He said that in his part of Lincolnshire doctors from outside the EU who had completed GP training in the UK were struggling to get a tier 2 visa. Tier 2 visas are available to GPs from outside the EEA and Switzerland who have been offered a skilled job in the UK by a licensed sponsor.
“These doctors are trained in the area, they are settled, and they want to stay. Suddenly there are barriers in their way and they can’t work, and we are losing them,” said Coffey.
Part of the problem, Coffey said, was that it was difficult for general practices to get the certificate that allows them to act as a sponsor. “Our practice failed it three times because we didn’t know what to fill in.
“And doctors aren’t straightforward: they’re not 9 to 5 like other workers,” he said.
Coffey also said that the time it took for applications to be processed—six to eight weeks—prevented GPs from entering work sooner or from securing a job in time to meet the visa deadline.
He said that local practices were struggling to recruit and needed doctors from overseas to fill the gaps. “Across Lincolnshire we reckon we’ve had about 14 doctors who have finished their GP training and needed a visa extension. If 14 doctors can’t work in this county, then that’s a big loss.”
Visa process “seamless” . . . until CCT
Mervin Wong is a GP in Lincolnshire who went through the process of applying for a tier 2 visa. Originally from Brunei, Wong completed his medical degree in Scotland and undertook GP training in Lincolnshire. He said that during his training the visa process had been “seamless,” as it was covered by Health Education England.
“I finished the GP vocational training scheme in August 2016, and then the hard part came,” Wong said. “What happens after you achieve your certificate of completion of training (CCT) is HEE doesn’t cover your visas anymore. So I needed to find a job,” he said.
“The problem was that whereas in hospitals it’s always quite easy to get a job, and easy to get a visa sorted, to get a GP job it’s actually quite difficult.”
In Lincolnshire at the time, Wong said, only one general practice could sponsor visas, but it was in difficulty and wasn’t sponsoring any more doctors. “What I had to do then was to try to find a surgery that would be willing to hire me, be willing to listen to what I needed, from a visa perspective, and then actually go on to become a visa sponsor,” he said.
Wong eventually got his visa, which was partly due to the perseverance of his employer’s practice manager. “I have heard anecdotally of friends who have had issues with visas and GP practices who, unfortunately, after facing barriers with paperwork don’t follow on with it. It’s easier for them to try to get a local graduate than to go through the process to become a tier 2 sponsor.”
GPs taking any job
Another GP, from Nigeria, who wished to remain anonymous, was not so lucky. She was asked to leave shortly after finishing GP training in Lincolnshire. Complications with finding an employer who could sponsor her visa meant that she did not apply in time.
She had to wait for 12 months before reapplying to work in the UK. However, the process is even more complicated than it was when she was in the UK. “It’s not just about looking for a job, it’s about looking for a practice that already has sponsorship status or that is willing to apply for sponsorship status,” she said.
Other doctors in the same position have ended up taking any job they could get in the UK, rather than risk losing their visa, she said. “I know someone who ended up working in an urgent care centre in Cumbria, which was something he didn’t want.”
She added, “They box you into a situation where it’s either that or leave.”
- Rimmer A. MPs gather examples of GPs from outside Europe being unable to work in UK. BMJ 2017;359:j5377. [Link] [Link] .
- Gulland A. NHS plans to spend £100m on recruiting overseas GPs. BMJ 2017;358:j4077. [Link] [Link] .
- Rimmer A. International recruitment scheme brings 38 GPs to NHS. BMJ 2017;358:j3462. [Link] [Link] .
- Gov.UK. Tier 2 (general) visa. [Link] .
Abi Rimmer The BMJ