EMPLOYING A GP ON A TIER 2 VISA

1. EMPLOYING A GP ON A TIER 2 VISA FAQs / GUIDANCE

2. What is Tier 2 Sponsorship? • The Tier 2 visa is the most frequently used immigration route into the UK for skilled workers from outside the European Economic Area (EEA) • In order to be eligible to apply for a Tier 2 visa, a migrant worker must demonstrate that they have a confirmed job offer from an employer who is a licensed sponsor in the UK • The employing organisation (for example a GP practice, a GP Federation, a PCN etc) needs to apply to be a Tier 2 sponsoring organisation. This sponsorship will allow you to employ non-European Economic Area (EEA) workers • Once you obtain a Tier 2 Sponsorship licence, workers will then be able to apply for a Tier 2 visa to become one of your employees • Becoming a Sponsoring Organisation allows you to issue a Certificate of Sponsorship (CoS). This is a virtual document which results in the generation of a reference number. The doctor requires this number as part of their ‘Leave to Remain’ evidence when theyapply for a visa

3. Why should I obtain a Tier 2 Sponsor License? • Many practices have been carrying vacancies for a considerable length of time and this provides an additional source of candidates • It is a way of keeping good GP Trainees locally. Trainees qualify at two points in each year (Feb & Aug). A proportion of doctors training to be GPs locally require a Tier 2 visa to be able to continue to live and work in the UK (in June 2018, there were over 400 non-EEA GP Registrars nationally) • There are other GPs already working in the UK on a Tier 2 visa who may wish to change employers and will need a sponsor • Australian and New Zealand GPs who are now applying to the International GP Recruitment Programme will need a Tier 2 visa to live and work in the UK (this will expand to USA and Canada). Interest from these countries has already been high • Other roles in general practice may require sponsorship in future • Due to Brexit, we are unsure what will happen from an immigration point of view and securing a license may help to future-proof your practice • Your 4-year licence means you are ready to go if you already know you are going to have a further vacancy in the near future e.g. from planned retirement – and means you can already widen your applicant pool

4. FAQs How long is the sponsorship license valid for? Licences are valid for 4 years. You can surrender early if you no longer require it, however fees are not refunded How long does the process take? It can take up to 8 weeks to get a response to your application. Do you have to have a genuine position available to employ someone in order to apply to become a sponsoring organisation? Yes, you would ideally need to have a position available in order to apply. Usually, organisations would apply because they have long-standing vacancies that they have been unable to fill. However some organisations will apply knowing that they will have vacancies arising in the near future (for example retirement). You would however need to have a genuine position available in order to issue a Certificate of Sponsorship to a migrant (more on this later). The GP Trainees who need sponsorship, who employs them currently? Doctors in training are sponsored by HEE, however this relationship finishes at the end of their training. If they have lived in the UK for less than 5 years, they need to move onto a different visa so that they can stay in the UK. What are we required to pay these GPs? You would need to negotiate the rate of pay just as you would with any other newly qualified doctors – we recommend that the contract and negotiations are in line with BMA guidance. What happens if they aren’t a good fit for the team? As with any recruitment, you would need to ensure the doctor is a good fit for you and the practice – you aren’t obliged to take any doctor signposted to you who needs a visa How long are we required to employ them for? You would usually take the GP on as a salaried GP on a permanent contract. It is a normal employment relationship in thesense that both parties can give notice in line with the contract, in line with the T&Cs.

5. How am I best preparing for this process? • The process can be time-consuming and complex, however support is available • The next few slides outline the basics. If you are keen, you need to identify a lead practice member (usually the Practice Manager) who should read the guidance in detail. • You also need to be aware of the various time dependent elements – they all need to align for a seamless process • Please read all available information before starting your application • We recommend that you need to invest at least 2 days into the application process • Seek support if you need it (details to follow in later slides)

6. What are the qualities required by a Sponsor Organisation? • The Home Office has developed this system on the basis that those who benefit the most (the employer) play their part in ensuring that the system is not abused and that the migrant is a ‘suitable’ person. The Home Office considers 4 elements in possible sponsors: • Are you a genuine business? • Are you honest, dependable and reliable? • Are you able to carry out your sponsorship duties i.e. have sufficiently good recruitment and HR practices? • Will you be offering genuinely skilled work? • These conditions are not difficult for practices to comply with

7. How do you apply to become a Sponsor? • The application form is ONLINE – but as with all forms like this such as tax returns, we recommend that you prepare the information in advance • A separate document which walks practices through the forms and shows them all the information they will be asked for is also available • Once you have started the application you can save it and come back later to finish and submit • Further information and additional background reading can be found at: https://www.gov.uk/tier-2-general and https://www.gov.uk/governament/publications/sponsor-a-tier-2-or-5-worker-guidance-for-employers

8. What are the time dependent elements? • You must have a genuine vacancy to employ a non-EEA candidate. It must pass the “Resident Labour Market Test” (more on this later) and be within the right timescale • A doctor already on a visa e.g. as a GP Trainee, can only apply to change it a maximum of 3 months before it expires • The online application has to be followed up within 5 days by posting original documents or copies of some of the documents which need to be certified – make sure you have all this to hand before starting the process

9. What is the Resident Labour Market Test? • You can only recruit a migrant if you have completed a Resident Labour Market Test (RLMT) and you can show that no suitable settled worker (i.e. from the UK or EEA) is available to fill the job. • You must have a genuine vacancy • It must have been advertised: • Either for a continuous period of 28 days, OR in 2 stages, each of which must be for at least 7 days and be within a minimum 28 day period and • In 2 forms (i.e. online and in a journal, or online in 2 different settings which can include your practice website) • If you are offering a salary of less that £73,900 p.a. one of these adverts must be on the JobCentre website (Universal Jobmatch) which is free to use. Please note that this does apply to part-time roles, even if the FTE salary equates to more than £73,900 p.a

10. What is the Resident Labour Market Test? • You must ensure you specify ALL the requirements of the job within your adverts, as you cannot turn decline a candidates based on something which is not stated within it. Adverts must state: • Job title • Main duties and responsibilities of the job • Location of the job • Indication of the salary package or salary range or terms on offer • Skills, qualifications and experience needed • Closing date for applications, unless it is part of a rolling recruitment programme • For example – you interview 2 candidates, one needing a visa and one not. They are evenly matched however the visa-requiring candidate is more suitable because they have paediatric experience. If you didn’t specify this in the advert, your request for a visa could fail because this vacancy would not pass the RLMT, i.e. it could have been filled by someone in the UK if the requirement for paediatric experience was stated • You must issue a Certificate of Sponsorship (i.e. completed all the processes to become a sponsor) within 6 months of a Resident Labour Market Test

11. Who needs to be involved from the practice? • There are 4 key personnel required for sponsorship. The first 3 must be named on your application, however these 3 roles can all be done by the same person if needed • Authorising Officer – most senior person responsible for recruitment – e.g. Clinical Director, Senior Partner or Practice Manager • Key contact – main contact for the Home Office • Level 1 User – carries out the day to day sponsorship activities (more can be nominated once you have your licence – best to keep small numbers but enough to cover sick leave etc). Level 1 Users can undertake all functions on the online Sponsorship Management System (SMS) • Level 2 User – more limited - can only assign Certificates of Sponsorship and advise the Home Office of missing workers • Each person must be permanently employed in the UK, subject to DBS clearance and paid by you as staff (with minor exceptions)

12. How much will it cost? • There are some costs associated with the application, however NHS England will reimburse the following: • Thelicence application costs (even if unsuccessful): • The Certificate of Sponsorship fee - £199 • And the first 2 years of the Immigration Skills Charge:

13. Which type of Sponsor is my practice? • If 2 out of the 3 conditions below apply (which they will to most GP practices): • Your turnover is less than £10.2 million per year? • Your balance sheet total is less than £5.1 million per year? • You employ less than 51 people? • Then you are considered a small sponsor and the charges are at the lower level: • Initial application fee Tier 2 small sponsor licence - £536 • Assigning each Certificate of Sponsorship - £199

14. Sponsor Duties • As a UK sponsor licence holder, you operate under a legal requirement to inform the Home Office of certain organisational and employee changes via the online Sponsor Management System (SMS) • The Home Office relies on the information held on the SMS to monitor and communicate with all 27,000+ licence holders • There are penalties for those employers that fail to comply and fail to keep their records updated • The Home Office has powers to downgrade, suspendorrevoke your licence. This has the potential to impact your current sponsored migrant employees and your ability to recruit and employ sponsored migrants in future

15. What else should I be aware of? • You will need to undertake a Resident Labour Market Test for each migrant you wish to sponsor (not just the first one which links to your application) • Tier 2 Visas can be granted for up to 5 years with a possible 1 year extension. • After 5 years living in the UK the Tier 2 doctor may be eligible to apply for Indefinite Leave to Remain. If granted they no longer need a Tier 2 sponsor. • Remember that doctors who have trained here may already have 3 or more years residency just from their GP training • You need to check whether the Immigration Skills Charge also needs to be paid. If applicable the very most you would have to pay if they needed to do the whole 5 years on a Tier 2 visa is £1820 (minus the NHSE reimbursement) • Any GP you sponsor must earn a minimum of £55,965 p.a. FTE.

16. What else should I be aware of? • Self-employment status is possible – so you can employ Tier 2 doctors as partners but you need to be able to prove this • Tier 2 doctors can do other work (supplementary) at the same or higher salary level for others e.g. they can do OOH sessions for maximum 20 hours per week. However if the Tier 2 doctor wanted to work part time for two employers, BOTH employers must be sponsors and must have gone through the RLM test process • The Home Office may visit you at any time (unannounced) to check you are doing everything correctly. They also expect that you will report things like unauthorised or prolonged absence • A doctor who has previously worked abroad needs a criminal records certificate (equivalent to DBS) from everywhere they have lived for 12 months or more in the previous 10 years

17. Who can I contact for further support? • GM Workforce Programme Managers: • - Gemma Bradshaw – gemma.bradshaw1@nhs.net • - Kerry Porter – kerryporter1@nhs.net • The National Recruitment Team can also provide further assistance at: • england.intrecruitment@nhs.net – Subject “Tier 2 Application” • The IGPR and National Teams have a directory of other organisations who have been through this process. The National Team can also provide subject matter expert support from these practices • Home Office Employer Enquiry Helpline Telephone: 0300 123 5434Monday to Thursday, 9am to 4:45pm, Friday, 9am to 4:30pm