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Immigration Reform: Caring for the Healthcare Sector

Every year we welcome healthcare workers from across the world to work in the UK. The COVID-19 pandemic has highlighted how many migrant workers are currently working in hard-to-fill healthcare posts, many of whom have played a critical role on the frontline during the pandemic.

In addition to the pre-existing challenges of sourcing well trained and experienced staff into a host of healthcare roles, the end of free movement to the UK for EU, EEA and Swiss nationals is likely to be a further pressure point for many employers recruiting within the NHS and the wider healthcare sector.

The end of EU free movement means that EU, EEA or Swiss citizens who want to work in the UK, and who were not in the UK on or before 31 December 2020, will now be treated in the same way as non-EU citizens when it comes to work visas, meaning they will require sponsorship under the UK’s new points-based system which came into effect on 1 January 2021. 

Whilst the end of free movement means that some employers in the sector may struggle to recruit new overseas staff to fill certain roles, other changes which have been implemented as part of the biggest reform to the UK’s immigration system in decades, have been designed to make international recruitment into health and social care roles more straightforward for both employers and employees.

R.I.P to the Resident Labour Market Test (RLMT)

The RLMT was designed by the Home Office to ensure that settled workers in the UK had the opportunity to apply for positions before those positions were offered to migrant workers. The advertising methods and supporting evidence that the Home Office required to satisfy the RLMT were extremely prescriptive and this was often a practical and administrative headache for employers, causing delays to recruitment into critical roles by weeks.

Under the new system, the RLMT no longer needs to be carried out when recruiting a migrant worker, although employers still need to retain evidence of the recruitment process and have a genuine vacancy to fill. The removal of the RLMT has made the process for recruiting migrant workers simpler, quicker and more streamlined for employers. We have already seen the positive impact of this for clients in the sector who can now fill vacancies without worrying about whether their recruitment methods meet the technicalities of a Home Office test.

The cap’s been scrapped

The Home Office has removed the annual cap on the number of individuals who can apply for a skilled worker visa from outside the UK. Previously the annual cap was 20,700 divided into an allocation of 1,700 skilled worker visas per month. The arbitrary cap meant that migrant workers recruited to fill much-needed roles could be refused a visa purely because the cap had been met in any given month.

The removal of this limit is a welcome move for the healthcare sector.  Employers will have greater flexibility over the number of migrant workers sponsored and it will also reduce the timeline for sponsoring skilled workers by up to four weeks as there is no longer a monthly allocation process to follow.

A-Level playing field

The required skill level for Skilled Worker sponsorship has been dropped from RQF Level 6 (Degree-level equivalent) to RQF Level 3 (A-Level equivalent).

This has opened up the prospect of sponsoring migrant workers in a number of roles that were not previously eligible for sponsorship. Examples of roles which are now eligible for sponsorship include senior care workers, facilities managers, pharmacy technicians, laboratory technicians and nursing assistants.

Cheaper visas for healthcare workers

The Home Office has retained the Health and Care Worker visa which was introduced last year. These visas allow medical professionals such as qualified doctors, nurses and adult social care professionals to come to, or stay in the UK, to work in an eligible job with the NHS, an NHS supplier or in adult social care. The government’s motivation for introducing this visa route was to ‘ensure UK health and care services have access to the best global talent’.

The principal benefit of this route is that it attracts reduced visa application fees (UK visa fees are reportedly among some of the most expensive in the world) and the applicant will also be exempt from paying the Immigration Health Surcharge, which can be up to £3,120 for a five year visa for someone without dependants. Being eligible for this type of visa and the financial concessions it brings goes some way to allowing the UK to compete with other countries for skilled healthcare workers.   

In demand: The Shortage Occupation List

The Shortage Occupation List is a list of jobs which are recognised to be in shortage in the UK, meaning the roles will have an advantage when applying for a skilled worker visa.

The recent changes have added senior care workers, and a number of other roles, including health services and public health managers and directors, residential, day and domiciliary care managers to the Shortage Occupation List.

To be eligible for a skilled worker visa, applicants must have a minimum of 70 ‘points’ under the points-based system.

A job on the Shortage Occupation List is worth 20 points. This, combined with the mandatory criteria (having an acceptable standard of English, an offer form a licenced sponsor and the required skill level, which  together score  50 points) will ensure people in those vital healthcare roles will score the 70 points necessary. In addition, the minimum salary requirement can be lower for roles on the Shortage Occupation List, meaning for example, that the minimum salary for a senior care worker role has reduced to £20,480 from £25,600 per annum.

Challenges lie ahead

Despite all of these changes being introduced, many employers feel that the changes do not go far enough.

Whilst the range of occupations eligible for sponsorship under the Skilled Worker visa have been widened considerably, not all healthcare roles are eligible for skilled worker sponsorship particularly in the social care sector. For example, the required skill level excludes care workers (but not senior care workers) from being eligible for sponsorship. In addition, it is likely that employers will need to increase salaries for more junior healthcare roles in order to meet the minimum salary requirements for sponsorship.

It is clear that the NHS and the social care sector would not be able to function without their international workforce. We therefore recommend employers who do not already have a Sponsor Licence in place should consider applying for one imminently to maximise their access to the widest possible recruitment pool now that free movement has ended.

Ashfords’ Immigration Team can advise on all UK business immigration matters, including Sponsor Licence applications, sponsor duties and compliance, and support with visa applications. For further information please contact Kirsty Cooke.

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