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Tier 2 Visas for Practices

(with thanks to Wessex LMC)

Tier 2 visas are an immigration route for non-European Economic Area (non-EEA) clinicians wanting to work in the UK. They are also a route for practices struggling to recruit so you may wish to consider this alternative pathway to employees. Practices can apply to be a Sponsoring Organisation which can issue a licence to sponsor these clinicians.

Financial support from NHS England to cover the applications costs ended on 31st March 2020. However it may be that practices will be able to approach their CCG for reimbursement of costs associated with becoming a Tier 2 sponsoring organisation. Despite this uncertainty there may be some organisations for whom it may still be beneficial to apply for a sponsorship licence and therefore employ someone who requires a Tier 2 visa.

Practice benefits

  • It will allow you to employ your registrar following their CCT if they are a non-EEA doctor
  • Access to an expanded workforce to employ from
  • Once you hold a sponsor licence it is valid for 4 years

Requirements of the practice

Significant trust is placed with the sponsorship organisation and the Home Office needs to establish 4 criteria when considering licence applications:

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

How do you apply?

Applying to hold a Tier 2 visa Sponsor Licence is quite a commitment. As with any application procedure it is important to ensure your supporting documentation is up to date and correct. Preparation is the key to success. NHS England recommends you invest a minimum of 2 days into the application process so be aware of this commitment at the outset but accept it could take longer. The process can seem a complex multi-stepped process with complicated guidance, but this is probably because the official Home Office guidance must cover all sectors and all eventualities. While not a substitute for the official guidance hopefully this simplified version will be beneficial for your practice and your patients if your vacancy can be filled.

Be aware there are time sensitive requirements along the way. Where relevant these have been highlighted below to help you prepare. For example, to prove your organisation is genuine and has an established trading presence in the UK you must ensure that all supporting documentation and the submission sheet is received within 5 working days from the date that you submit your online application. Other time sensitive actions are highlighted in this document.

The process is an online application -

GPs included on the Shortage Occupation List - October 2019

On 29th May 2019 the Migration Advisory Committee published its recommendations that all medical practitioners including GP's should be added to the shortage occupation list (SOL). This means that the recruitment process for non-EEA GPs will be significantly quicker as since 7th October 2019 there is now no need for practices to satisfy the Resident Market Labour Test (RMLT)

The most recent changes to the SOL can be viewed at here.

Online process for Tier 2 General Licence

The Department of Health and Social Care have a useful guide for Practices on BECOMING A TIER 2 VISA SPONSOR

Once you have all your documents to hand, the online form should take about 25 minutes to complete. If you get part way through it and need to stop, you can save the application mid-process. It is recommended to save each page as you complete it as your session will time out after 20 minutes of inactivity. You must be connected to a printer in order to print your submission sheet. Ensure the email address provided does not block/redirect to junk.

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

Organisation details, Authorising Office, Key Contact, Level 1 user, other users & representatives*
The number of CoS you need (ie. 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 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 insurer
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 premiss 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 of you are a teaching practice
Details of any criminal convictions or civil penalties
Payment details (card details)

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

  • Authorising Officer – the most senior person responsible for recruitment
  • Key Contact – main contact for Home Office
  • 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.
  • (Optional personnel) Level 2 user – 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.

**Once you have successfully applied for a licence you have an online account can apply to give out more.

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

NHS England have provided a useful PowerPoint presentation which can “walk” you through how the online application looks page by page - Tier 2 Visa Applications presentation.

What next and how much does it cost?

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
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 £1476.

Once you have a licence there is a cost for each certificate you issue which can be claimed back from NHS England. (Certificates are free for citizens of Croatia, Macedonia and Turkey.)

How long will it take to get a licence?

80% of applications are dealt with within 8 weeks.

What next?

The Department of Health and Social Care have a useful guide for Practices "CREATING AND ASSIGNING CERTIFICATES OF SPONSORSHIP"

Once you have the CoS details you need to give them to the clinician so that they can apply for their Tier 2 visa. They must submit their application within 3 months following the CoS being issued as after this it expires. 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.

If you are a GP who is applying for a Tier 2 visa you are able to apply to claim your personal visa costs. Email for details.

Remember as a practice once a licence is granted you are acting in an official capacity for the Home Office and need to log onto your online account regularly to ensure it remains up to date. A useful tip from one of our Practice Managers who has been through the process is to diarise a monthly log in to remain compliant in your responsibilities.

Immigration and Covid-19

If you are a doctor who has applied for a Tier 2 visa and are awaiting a decision on your application please see here for the most up to date advice from the government.

If you are a practice who is sponsoring a Tier 2 visa clinician then please see here for the most up to date advice from the government about employee absence due to Covid-19.

Health and Care Visa

The Government recently committed to streamlining the process for eligible overseas healthcare professionals to come and work in the NHS. Since 4th August 2020 the process has been streamlined and made cheaper for applicants. In addition there is a dedicated support staff available, enabling Health and Care Visa sponsors to contact UK Visa and Immigration’s specialist team if they have any issues with the application process or eligibility for the health and Care Visa. Sponsors can contact UKVI’s dedicated NHS team at the following email address:

Applicants are still required to meet the usual Tier 2 requirements.

For more information for applicants and employers can be found here.


Certificate of sponsorship

This is a virtual document that enables a migrant to work in the UK. It is issued from a Tier 2 licence holder. Each certificate has its own number which a worker can use to apply for a visa. They must be used within 3 months from when they are assigned.

What is the shortage occupation list?

The shortage occupation list (SOL) is an official list of occupations for which there are not enough resident workers to fill vacancies. If a position is on the SOL then a sponsor can issue a Tier 2 certificate without the need to demonstrate the Resident Labour Market Test (RLMT) has been carried out.

Can a federation apply to be a Tier 2 sponsor to recruit?

It is important that the sponsor that issues the certificate of sponsorship is the employer of an individual and the structure of the organisation fulfils the necessary requirements. For example a large federation who is the key employer for a group of salaried doctors across different sites can become a Tier 2 visa sponsor and issue certificates.

Further Resource list

For information on Tier 2 visas visit

The BMA in conjunction with NHSE published a step by step guide to applying for a visa sponsorship licence. The guide has been tailored to primary care needs. It does not replace official Home Office sponsor guidance but should help you work through the registration process.

For information on the skilled worker route visit NHS Employers

Tier 2 Queries - Email addresses


Updated on Monday, 13 June 2022, 1911 views

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