Hi everyone,
This is an important piece of information I received about the current problem we are facing which mentions that the date of implementation is from the 3rd April and not July as was being previously said.
This was prepared by the west London mental health NHS trust and addressed to the overseas doctors there.
I think this will give us a clearer view and clear some doubts!
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The letter sent to the IMGs
CHANGES TO THE IMMIGRATION RULES FOR POSTGRADUATE DOCTORS AND DENTISTS FROM 3 APRIL 2006
"I think, by now, that most of you have heard about the impending changes in the immigration rules for postgraduate doctors and dentists with effect from 3 April 2006 (as announced by the Department of Health on 7 March 2006). The changes apply to SHOs as well as to SpRs.
Press Release dated 7 March 2006 from Lord Warner, Health Minister:
“…We recognise that international doctors have made a huge contribution to the NHS since it was founded in 1948 and there will still be opportunities for overseas staff to come to the UK. We will continue to need small numbers of specialist doctors, who can bring their skills and experience to the NHS. However, increasingly the NHS will be less reliant on international medical recruitment…”
There was a meeting of personnel managers in London on 16 March 2006 and this was the main topic of the programme. As you can imagine, it provoked a lively discussion.
I attach a lot of information for you to read but, in the meantime, I have tried to summarise the main changes and do my best to answer your most pressing queries. Please use this information as a guide only since I need to get more answers and, as we all know, rules can change at very short notice. I’ll keep you updated as and when more information is available – just didn’t want you to languish over the weekend without some advice !
THE CHANGES:
In future, if Trusts offer a training grade post to an overseas doctor, they must apply for a work permit for that doctor and, in so doing, must be able to demonstrate that there were no suitable UK/EU candidates.
Some people think the changes are simply to ensure that no UK/EU medical graduate is left without a job. More cynical people (and I think I’m coming round to that idea) believe that this could be preparing the way for an overall reduction in training grade posts from August 2007. Although please bear in mind that, at present, we have no idea what the future numbers will be !
There is no need for Trusts to apply for a work permit for you now.
The new rules will come into force when your current permit-free training visa is due to expire.
If you currently have leave to remain under the Highly Skilled Migrants Programme, again there is no need for Trusts or for you to take any immediate action. If you are in your initial 12 month HSMP phase, I hope the current rules will continue whereby you can get a further 3 years and your HSMP will continue to be as “portable” as it is now and not linked to one employer only like a work permit.
Some people think the changes are simply to ensure that no UK/EU medical graduate is left without a job. More cynical people (and I think I’m coming round to that idea) believe that this could be preparing the way for an overall reduction in training grade posts from August 2007. "
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QUESTIONS AND ANSWERS:
Q. MY PFT EXPIRES ON 31 OCTOBER 2006 BUT I’M NOT TAKING PART II UNTIL SPRING 2007. WHERE DOES THAT LEAVE ME ?
A.You have two choices. Our recommended action would be for you to make an application now for leave to remain under the Highly Skilled Migrants Programme (initial grant is for 12 months though). With HSMP, you can move freely from Trust to Trust. You do have to pay for your HSMP, of course (just like your PFT) but you may feel it offers you more of a sense of security than getting a new work permit every 6 months.
The second course of action would be to wait for your next employing trust to apply for a work permit for you just for the 6 months you will be working with them. They can only start the process 3 months before you start work. The Trust has to pay for your work permit and it is for work in that Trust only.
Q. I AM AN OVERSEAS SpR ON 12 MONTHS’ OOPE AND DUE TO RETURN TO TRAINING ON 1 DECEMBER 2006. MY PFT EXPIRES ON 30 NOVEMBER. WHAT SHOULD I DO ?
A. Again, you have two choices. Our recommended action, based on the current situation, would be for you to make an application now for leave to remain under the Highly Skilled Migrants Programme (initial grant is for 12 months though). With HSMP, you can move freely from Trust to Trust but you have to pay for your HSMP.
The second course of action would be to wait for your next employing trust to apply for a work permit for you. They can only start the process 3 months before you start work. The Trust has to pay for your work permit.
Q. I CAME TO THE UK AS A REFUGEE AND NOW HAVE THE RIGHT TO REMAIN IN THE UK. DO THE CHANGES AFFECT ME ?
A.We asked that very same question ! The consensus was that, since you have the right to live and work in the UK, you must be treated like a UK/EU national. In that case, the changes will not affect you at all. We are waiting for clarification from the Department of Health/Home Office and will get back to you.
Q. DOES THIS MEAN THAT OVERSEAS TRAINEES WILL NEVER BE SHORTLISTED FOR JOBS IN THE UK ?
A. We do not think that is the intention BUT the guidance to Trusts is as follows:
“….When you make an application for a Work Permit you will have to demonstrate to Work Permits (UK) that there are no suitable EEA nationals who can take up the post. Once your closing date has passed, you will need to review how many applicants are EEA nationals and how many would require a work permit. Depending on how many posts you are filling, and how many applicants fall into each category, you will then need to decide whether to assess the EEA candidates first or whether to assess all of the applicants at the same time. The important thing is that, before making any offers of employment, you make sure that the suitable EEA nationals are considered in advance of those who require a work permit. If you are advertising a popular post, you may wish to restrict applications to only those doctors who do not need a work permit to take up the contract….”
The reality is that, at the moment, it would be impossible to fill all Psychiatry
SHO posts with UK/EU nationals. However, the total number of training posts from 1 August 2007 is another issue. If there is a significant reduction in training posts in
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all specialties, not just Psychiatry
, then overseas trainees will find it harder to get into training posts. But do bear in mind that part of the government’s plans for
Modernising Medical Careers (MMC) include a number of fixed-term training posts as well as non-training grade posts (although neither option may be what you want):
Fixed term specialist training –These appointments will be for a fixed period. They are likely to mirror the early years of training in a specialty/GP training programme and trainees will be assessed against explicit standards. The duration of such posts is yet to be determined, but they will probably be for no more than two years.
Career posts – These positions are service delivery posts with no formal specialty training elements. However, employer appraisal and relevant continuing professional development will be an essential part of these doctors’ careers. These posts will only be available in secondary care.
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2nd document
Changes to the Immigration Rules for Postgraduate Doctors and Dentists
On 7 March 2006 the Department of Health announced that the Home Office would be making changes to the immigration rules for Postgraduate Doctors and Dentists
The changes, which will come into effect on 3 April 2006, aim to amend the current specific category within the immigration rules which relate to Postgraduate Doctors and Dentists. In future, the only doctors and dentists who will be covered by the existing (“permit free”) arrangements are those who have completed their medical degree in the UK and have been appointed to a 2 year Foundation Programme.
The Home Office has also announced its longer term policy on managing migration, based on a points based system for people coming to the UK to work, study and train. The Home Office aims to introduce the new system in stages to replace the current arrangements and simplify the system for employers and migrants.
What does this mean for future recruitment?
You need to ensure that any offers of appointment you make are line with the new rules. When you advertise your post, applicants are likely to be British Citizens or fall into the following categories;
• EEA nationals
• Doctors and dentists with existing leave to remain under the current immigration rules for Postgraduate Doctors and Dentists
• Doctors and dentists who require a work permit
• Doctors and dentists who have leave to remain under the Highly Skilled Migrant Programme
• Doctors and dentists who are in the UK by virtue of another immigration category e.g. those with leave as a dependent – each specific case would need to be checked
EEA nationals have the automatic right to work in the UK and should therefore be considered in the same way as UK applicants for posts.
Doctors and dentists who have existing leave to remain as a Postgraduate Doctor or Dentist will be allowed to stay and train in the UK until that leave expires. Therefore, if the post on offer will be completed within the period of the doctor's/dentist’s existing leave, the employer (and the doctor/dentist) will not need to seek permission from the Home Office for the doctor/dentist to take up the post.
However, from 3 April 2006 doctors and dentists will only be eligible for leave as a Postgraduate Doctor or Dentist for their Foundation Programme, and then only if they have studied in the UK and meet all the other requirements. If you have offered a post to a doctor or dentist who currently has leave as a Postgraduate Doctor or Dentist, but their leave will expire before the end of the post, then they will need to apply for a different category of leave to complete the post. It is likely that the work permit system would be the most appropriate category - see the information on work permits below.
The majority of candidates for posts will require a work permit. This means that you need to apply to Work Permits (UK) for a work permit before you can employ the candidate. When you make an application for a Work Permit you will have to demonstrate to Work Permits (UK) that there are no suitable EEA nationals who can take up the post. In practice, this should involve very few adjustments to your recruitment processes. However, once your closing date has passed, you will need to review how many applicants are EEA nationals and how many would require a work permit. Depending on how many posts you are filling, and how many applicants fall into each category, you will then need to decide whether to assess the EEA candidates first or whether to assess all of the applicants at the same time. The important thing is that, before making any offers of employment, you make sure that the suitable EEA nationals are considered in advance of those who require a work permit.
If you are advertising a popular post, you may wish to restrict applications to only those doctors who do not need a work permit to take up the contract. This should reduce the number of applications you have to deal with.
Where a work permit is required, you, as the employer, need to apply for a work permit on behalf of the doctor/dentist. When this is issued, the doctor/dentist themselves will then need to apply for leave to remain as a work permit holder. If the doctor/dentist currently has leave under another category of the Immigration Rules (for example leave as a Postgraduate Doctor or Dentist) then they will not be able to take up the post until both the work permit has been issued and the doctor/dentist themselves has been granted leave to remain as a work permit holder.
Not all doctors and dentists will be able to change the basis of their stay (switch) within the UK. Those in the UK as a Postgraduate Doctor or Dentist can switch into leave as a work permit holder, but those with leave as a Visitor or as the dependant of another migrant cannot switch into leave as a work permit holder and will need to leave the UK and make the appropriate application for entry clearance from abroad.
Some doctors and dentists may have been accepted onto the Highly Skilled Migrant Programme (HSMP). Doctors and dentists who have leave under HSMP can take up any training or employment posts you offer, without the need for you or they to ask the Home Office for permission
How do I apply for a Work Permit?
Detailed information on applying for work permits can be found at
to download and complete, or to fill in on-line. You can also obtain a printed copy by calling 08705 210224 (9am – 5pm Monday to Friday).
What do I need to provide?
You will need to include the following with your application;
• Copies of the doctors’/dentists’ professional qualifications i.e. their GMC/GDC certificate
• Copies of references from past employers (on headed paper) to confirm the person’s work experience – these should include start and finish dates and details of the work undertaken
• Evidence that you cannot fill the post with a resident worker – see below
NB When applying for a Work Permit, you need to make sure that the name you include for the doctor/dentist is the same as the name given on their passport.
How do I demonstrate that there is no suitable EEA applicant?
In order to satisfy the need to test the resident labour market, you should include;
• Print out of the vacancy as it appeared on a website (if advertised on NHS jobs or similar portal) or a copy of the advertisement as it appeared in a recognised journal
• Confirmation of where the post was advertised
• Proof that the advertisement was placed within 6 months of the work permit application being made.
• Information on how many people applied for the post
• Information on how many people were shortlisted for the post
• Explanation, for each ‘resident worker’ who applied, why they have not been employed
NB When a Deanery is managing the recruitment to posts, they will have to provide the relevant information to employers so that they can apply for the Work Permit.
If you cannot meet all of these requirements (e.g. placing the advertisement within 6 months of the application), you need to include an explanation of this in a covering letter.
Work Permits (UK) expect vacancies to be placed in the most appropriate medium for reaching suitably qualified ‘resident workers’
What are the time limits on Work Permits?
Work Permits are granted for the duration of the contract, up to a maximum period of 5 years. As SHO posts will be phased out from August 2007, Work Permits for SHO posts will not be granted beyond 10 August 2007.
How much does a Work Permit cost and who is responsible?
The current cost of a Work Permit is £153. The employer is responsible for this fee. Further information can be found in the Payment Guidance Notes at
In addition to a valid work permit, the doctor also needs valid leave to remain.
Does an employer have to apply for a Work Permit for every post a doctor/dentist undertakes?
A Work Permit is required for every post that is undertaken in the NHS. When a doctor/dentist is appointed to a training programme, the employer should apply for a work permit to cover the duration of each employment contract (eg 6 months for SHOs and 12 months for SpRs) When the doctor/dentist moves employer as part of the programme, the new employer should make an application to change the employer on the work permit. This application should be made on the WP1 form but the advertisement section does not need to be completed.
How long does it take to apply for a Work Permit?
The service standards for processing work permit applications are:
70% of all applicants are decided within 5 working days of receipt at the payment handling services.
90% of all applicants are decided within 15 working days of receipt at the payment handling services.
When should I apply for the Work Permit?
If the doctor/dentist is outside the UK, you should apply no more than 6 months before they are due to start.
If they are already within the UK, you should apply before the person’s permission to stay in the country expires. Work Permits UK ask that you apply at least one month before the leave expires but no more than three months before this date.
Can doctors and dentists undertake locum posts whilst they are employed on a Work Permit?
Work Permit holder can undertake 20 hours supplementary employment each week as long as it is at the same professional level and not with an agency (excluding NHS Professionals).
What about those doctors and dentists who have already been appointed?
If you have offered a post to a doctor or dentist before 7 March (the date the rule changes were announced), and;
• that doctor/dentist does not have sufficient leave to complete the post they have been appointed to, and
• that doctor/dentist will take up post on or before 4 August
then you can apply for a work permit on their behalf without the need for you to demonstrate there was no suitable EEA candidate.
Applications for Work Permits should be made in the usual way. The normal switching provisions still apply – this affects who can take up the post without leaving the UK to make their application. This means that, for example, doctors and dentists in the UK with leave as a Postgraduate Doctor or Dentist can switch into leave as a work permit holder, but those in the UK as Visitors will need to go abroad and make the correct application for entry clearance as a work permit holder.
These special arrangements also apply to doctors and dentists who were ‘matched’ to a Foundation Programme before the announcement was made, regardless of whether a formal offer of employment has been issued by the employer.
In these cases, a letter from the Postgraduate Dean will need to be included with the application to confirm that the offer was made before the 7th March.
Any offer of employment that is made on or after 7 March (the date of the announcement), or for a post which starts after 4 August, will be subject to the normal Work Permit requirements, as set out above.
What about those doctors and dentists who are already employed but whose leave to remain expires before the end of their training programme?
In addition to the arrangements in the previous paragraph, doctors and dentists who are undertaking training programmes as a Specialist Registrar which are due to continue beyond their current leave to remain as a Postgraduate Doctor or Dentist can switch into the Work Permit system without the need to re-advertise their post. To benefit from these transitional arrangements, applications for Work Permits have to be submitted by the employer by 31 December 2006. Applications should be made in the usual way.
Are clinical attachments affected?
Following discussions with the Department of Health, the Home Office has also taken this opportunity to limit the amount of leave that can be granted specifically to undertake clinical attachments and dental observer posts to 6 weeks at a time or 6 months in total.
This is in line with the purpose of these posts, as a way for overseas doctors and dentists to familiarise themselves with UK working practices. They are designed to be filled for short periods only and not to be used as a way of remaining in the UK when there are no suitable training or employment posts available.
Where can I find out more about the new Immigration Rules?
The changes to the Immigration Rules were laid before Parliament on 10 March and will come into effect on 3 April.
The Statement of Changes in Immigration Rules will be incorporated into a consolidated version of the Immigration Rules which can be found on the IND website at:
Where can I find out more about the new managed migration system?
The proposal for a new points based system for managed migration was first announced in February 2005. This was followed by an extensive consultation period. The Home Office response to this consultation, A Points-Based System: Making Migration Work for Britain, was published on 7 March. This included further details of the new system.
A Points-Based System: Making Migration Work for Britain is available on the IND website at:
I think this makes it more complicated for people who have passed PLAB
but have still to get a job! All others will be forced into the HSMP route to keep themselves in the UK.
So what will happen to the former group who have wasted their time and money in preparing for work in NHS?
Well we from the subcontinnet are known to have sharp brains .. still it wil require a lot of thiking for how to get out of this prob
HSMP is the answer at the moment
for those who havent got in i dont think anyone has a clue to the answer
there is so much uncertainty in the system here
1 the NHS migth collapse becoz of debt
2 Nobody knows what will happen to the specialty training in th eUK esp with the reductin in training grade(that is what MMC wants- but WHY ? any answers?)
3. NO SHO posts from aug 2007, so only foundatio nand then basic specialty training posts 2 yrs then
specialty training 3 yrs
4. EU grads coming in
this is what format I have drawn out from the readin g that I ahev done , bu tif I am wrong pls do correct me and show some light on what th eoutcome of the picture in the UK will be for PG training for not just us overseas docs , but for their own gards
Oh yes barry
i must complement you on find these articles i have been circulating the 2nd article and puta link for it too and basically it seems to be a link form the DOH/Home office instructing how NHS trust should deal with IMGS,
but could you tell us a bit moe f the backgorund of the 1st article
thanks
These along with two other documents were received from one of my groups.
as far as I know the letter was signed by one Ms Annette Buckley of West London Mental Health NHS Trust. I am not sure of her portfolio.....will find out soon. Though the letter seems to be written in a "not to worry" sense for IMGs who can stay quiet with uncertainity staring at us.
There are two more documents which were sent:-
The first one was a letter to the Deans about the permit stuff. It runs likes this
To:
Postgraduate Deans
Directors of Postgraduate General Practice Education
7 March
Announcement on the changes to the immigration provisions for postgraduate doctors and dentists
On 7 March 2006 the Department of Health Office announced changes to the immigration rules for postgraduate doctors and dentists. The changes, which will come into effect shortly, will mean that all doctors and dentists who wish to work in the UK from outside the European Union will need to meet the requirements of an employment category, such as the work permit provisions.
For employers this will mean that any NHS trust wishing to employ a doctor or dentist from outside the EU will have to prove that a “home-grown” doctor cannot fill the vacant post.
The current immigration rules allow the category of Postgraduate Doctors and Dentists to train in foundation programmes, senior house office and equivalent grades and in specialist registrar and equivalent grades. For immigration purposes they are considered as being in training and not in employment. However, this will no longer be the case and these posts will be considered as employment posts for immigration purposes and therefore applicants will need to hold a valid work permit.
We have agreed transitional arrangements with the Home Office to cover those doctors who are in training programmes which continue beyond their current leave to remain. These transitional arrangements will also cover those doctors who have been offered a post before the announcement that will start on or before 4 August. In brief, these doctors will be able to switch into the work permit system without their employer needing to re-advertise the post. Further details on these arrangements will be available shortly.
NHS Employers are taking the lead in advising employers in England of these changes. They will be notifying employers via their usual channels and would be happy to discuss the details of these changes with you. You can reach Eileen Calline and Sarah Francis at NHS Employers on 0113 306 3030. The Health Departments in Scotland, Wales and Northern Ireland
are likely to issue information on these changes directly to employers in those countries.
The second one is a document to the case workers dealing with the work permits in the visa office which I think has already been circulated and with whom we all are familiar with, at least those who have gone to get thier visas renewed.
The march to London is slowly gathering momentum and I think we all should take part with the hope that there might be some last minute changes!
Otherwise the thought of going back to homeland after losing out in this gamble with no fault on our part looms large!
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