RCGP and BMA leaders have written to the Government to demand a ‘permanent, sustainable solution’ to visa sponsorship issues for international medical graduate (IMG) GPs.
As it stands, IMG GPs who typically spend three years completing their training in the UK are unable to meet the threshold of five years to apply for Indefinite Leave to Remain upon qualifying.
And, with most GP practices not signed up to the visa sponsorship scheme, most IMGs are finding it ‘difficult’ to stay in the country, the GP leaders warned.
In letters to Home Secretary Shabana Mahmood and Primary Care Minister Stephen Kinnock, GP leaders from both organisations proposed:
- Exempting all doctors from the proposed increase to the qualifying period for settlement from five to 10 years
- An accelerated route to indefinite leave to remain after three years
- Umbrella sponsorship, with an overarching organisation acting as a sponsor for two years post-Certificate of Completion of Training (CCT).
The BMA letter, signed by the GP registrar committee co-chairs and GP committee chair, said: ‘At a time when the NHS is facing acute shortages in general practice and an unprecedented demand for GP services, it is alarming that doctors who have been trained within the UK system, invested years in NHS service, and achieved CCT, are left without viable employment options.’
‘While many training placements are covered under Health Education England’s (HEE) sponsorship, this protection ends abruptly at the point of CCT, leaving highly skilled, UK-trained GPs at risk of unemployment or forced emigration.
‘This not only undermines the value of UK-based speciality training but also represents a significant loss to the NHS workforce, especially in underserved and rural areas that desperately need qualified GPs.’
The correspondence highlighted a joint BMA and RCGP survey of IMG registrars which found 72% of respondents said finding a job which would sponsor a visa was ‘difficult’ or ‘very difficult’.
This figure rose to 82% among respondents who were less than four months from gaining a CCT.
The survey of 521 registrars requiring a visa to work in the UK also found just under 60% planned to leave the UK entirely if their difficulties finding a GP job continued.
The RCGP estimated in its letter, signed by chair Professor Kamila Hawthorne and its GP registrar co-chairs, that 1,600 newly qualified GPs will need a visa this year.
The BMA letter cited the limited list of visa-sponsoring practices and the current GP unemployment crisis as the primary causes of this issue.
It called on the Government to halt plans to increase the qualifying time to obtain settlement, from five to 10 years, saying it ‘would further exacerbate this problem, tying doctors to sponsored employment for a further five years’.
GP registrar committee co-chair Cheska Ball said that sponsorship rules had created a ‘ludicrous’ situation, which is a ‘colossal waste of taxpayers’ money’.
She said: ‘Employers don’t want to spend more money on sponsoring an individual because it’s an added cost.
‘There are already many, many people applying for this job role who do not need that added cost.
‘Consequently, this group of doctors is then really struggling to find work because they cannot get the sponsorship that they need in order to stay in the country. So what can they do? They leave, of course.
‘They need to find an alternative means of getting sponsorship that is also a colossal waste of taxpayers’ money.
‘We need to get the public to know this, because it’s ludicrous – they are throwing money away because they train us and then they do not give us access to the jobs.’
Last month, the RCGP shared figures that estimated 4,200 GPs will receive their CCTs and qualify in 2025 – up by nearly half (49%) in the last five years.
A Home Office spokesperson said: ‘There are already existing rules which allow trainee GPs to find employment after the conclusion of their training.
‘Immigration Rules allow for newly qualified GPs four months to find a sponsor and subsequent work, after their training has concluded.’
They said further details on the new Earned Settlement rules will be available after the completion of a consultation, which will be launched later this year.
The Department of Health and Social Care has been contacted for comment.
BMA letter in full
Dear Home Secretary,
Re. Urgent Concerns Regarding Sponsorship Barriers for Newly Qualified GPs Post-CCT
Many congratulations on your appointment as Home Secretary. We are writing as co-chairs of the BMA’s GP Registrar Committee to call for urgent action to address the significant barriers that some GP registrars and newly qualified GPs face in securing employment upon completion of their Certificate of Completion of Training due to the lack of access to visa sponsorship. This situation not only causes significant stress and uncertainty for the doctors affected but also threatens to further deepen the ongoing workforce crisis in general practice. We urge you to implement a permanent, sustainable solution to the problem in the best interests of doctors and their patients.
A recent survey of GP registrars by the BMA and RCGP revealed over 71% of respondents (372) found getting a job which sponsors a visa either “difficult” or “very difficult”. This figure was even greater (82%) among the GP registrars less than 4 months from CCT.
Strikingly, almost 60% (311) of all the respondents said they plan (or would have planned) to leave the UK and work as a GP elsewhere if their difficulty with finding a GP job linked to visa problems continues (or had continued). Seventeen per cent said they plan (or would have planned) to stay in the UK and work as a doctor, but not as a GP.
This is primarily due to the restrictive list of visa-sponsoring practices and the limited capacity of GP employers to act as sponsors under the Skilled Worker visa route. This is compounded by the current unemployment crisis and lack of funding and resource available to GP practices to hire GPs.
At a time when the NHS is facing acute shortages in general practice and an unprecedented demand for GP services, it is alarming that doctors who have been trained within the UK system, invested years in NHS service, and achieved CCT, are left without viable employment options.
While many training placements are covered under Health Education England’s (HEE) sponsorship, this protection ends abruptly at the point of CCT, leaving highly skilled, UK-trained GPs at risk of unemployment or forced emigration. This not only undermines the value of UK-based speciality training but also represents a significant loss to the NHS workforce, especially in underserved and rural areas that desperately need qualified GPs. The previous Government introduced a grace period that allows GPs to remain in the UK for an additional four-months beyond qualification. However, our survey findings clearly demonstrate this has been insufficient in alleviating the problem.
The Government’s proposed increase in the qualifying time to obtain settlement from five to ten years would further exacerbate this problem, tying doctors to sponsored employment for a further five years. Not only would this create additional uncertainty and stress associated with being beholden to visa restrictions, but it would place an additional financial burden on doctors who would have to pay the associated visa costs for both themselves and their dependents.
As well as exempting all doctors from the proposed increase to the qualifying period for settlement, we urge the Home Office to consider the following:
- an accelerated route to indefinite leave to remain after three years
- umbrella sponsorship, with an overarching organisation acting as a sponsor for two years post CCT
This issue affects not only the doctors themselves but also the continuity and accessibility of care for patients across the country. These individuals have contributed meaningfully to the NHS and deserve a fair opportunity to continue doing so.
We have previously raised this matter with your predecessors, but it remains a significant and urgent problem. We trust the Home Office will take this matter seriously and agree to meet with us urgently to resolve this.
Source: BMA
A version of this story first appeared on our sister title Pulse.
