Navigating Certificate of Sponsorship for Nurses and Doctors Under the UK Health and Care Visa

As a global mobility manager or HR leader in a mid-sized organization, you're no stranger to the talent crunch in Europe's healthcare sector. The UK's National Health Service (NHS) and private care providers face chronic shortages of skilled nurses and doctors, with over 100,000 vacancies reported in 2025 alone. Sponsoring international healthcare professionals via the UK Health and Care Worker Visa isn't just a compliance checkbox—it's a strategic move to build resilient teams and deliver exceptional patient care.

At the heart of this process lies the Certificate of Sponsorship (CoS), a digital document issued by your organization that unlocks visa approval for eligible nurses and doctors. This guide, tailored for employers, demystifies the CoS requirements, application steps, and best practices under the 2025 rules. Whether you're a hospital trust, private clinic, or care home operator, mastering this will streamline your recruitment from abroad and position your organization as a magnet for top global talent.

Keywords: UK Health and Care Visa for nurses, sponsoring doctors UK, Certificate of Sponsorship healthcare professionals

What is the UK Health and Care Worker Visa?

The UK Health and Care Worker Visa is a dedicated route under the Skilled Worker framework, designed to fast-track skilled healthcare professionals into the UK. Launched to address post-Brexit labor gaps, it offers reduced fees, no Immigration Health Surcharge (IHS), and priority processing—typically within three weeks.

Key Eligibility Criteria for Nurses and Doctors

To sponsor under this visa, your candidates must meet these thresholds:

• Qualified Professionals: Registered nurses (e.g., SOC code 2231) or doctors (e.g., SOC code 2211) with relevant qualifications from their home country or the UK.
• Eligible Job Offer: Full-time role in the health or adult social care sector, such as staff nurse, senior care worker, or consultant physician.
• English Proficiency: IELTS 7.0 overall (or equivalent) for medical professionals; lower for nurses (4.0 in speaking/listening, 5.0 in reading/writing).
• Salary Threshold: Minimum £25,000 annually (pro-rated for part-time), or the "going rate" for the occupation—whichever is higher. For new entrants (e.g., trainee doctors), it's £20,960.
• Genuine Vacancy: The role must be advertised in the UK for 28 days unless exempt for shortage occupations like nursing.

This visa lasts up to five years, with pathways to indefinite leave to remain (ILR) after continuous employment. Dependants (spouses and children) can join, but note restrictions for care workers' families under post-March 2024 rules.

For HR teams, the real game-changer? No IHS means up to £5,000+ savings per applicant compared to the standard Skilled Worker Visa.

Why Employers Need a Sponsor Licence to Issue a CoS

Before assigning a CoS, your organization must hold a valid Sponsor Licence from the Home Office. This A-rated or B-rated licence proves you're a "genuine" employer committed to immigration compliance.

Who Qualifies as a Health and Care Sponsor?

Eligible entities include:

• NHS trusts, foundation trusts, and commissioning groups.
• Care Quality Commission (CQC)-registered providers for regulated activities.
• Local authorities delivering social care.
• Private practices with GMC, NMC, or HCPC registrations.
• GP federations or entities under NHS contracts.

Mid-sized organizations (e.g., regional hospitals or care networks) often qualify easily if they demonstrate robust HR processes.

How to Apply for a Sponsor Licence in 2025

1. Assess Readiness: Ensure no immigration breaches in the last five years. Appoint key personnel: Authorising Officer (senior leader), Key Contact (daily manager), and Level 1 User (CoS assigner).
2. Gather Documents: Business registration, organizational chart, HR policies, and proof of trading (e.g., accounts). For health sponsors, include CQC registration or NHS contract evidence.
3. Submit Online: Via the Sponsorship Management System (SMS). Fee: £536 for small/large charities or £1,476 for others (Worker licence).
4. Processing Time: 8 weeks standard; pay £500 for priority (1 week).
5. Compliance Duties: Report changes (e.g., worker absences >10 days), maintain records for audits, and use the SMS for CoS allocations.

Once licensed, you'll receive an annual CoS allocation based on your request—typically enough for your forecasted hires. Renew every four years to avoid disruptions.

Pro Tip for Global Mobility Managers: Integrate sponsor licence maintenance into your compliance calendar. Tools like Jobbatical's platform can automate vacancy tracking to justify higher CoS quotas.

What is a Certificate of Sponsorship (CoS) and Why It Matters for Sponsoring Nurses and Doctors

A CoS is an electronic reference number (unique 16-digit code) linked to a specific job offer. It's not a visa but the "golden ticket" that confirms your sponsorship commitment to UK Visas and Immigration (UKVI).

For nurses and doctors:

• It details the role, salary, start date, and SOC code.
• Includes a mandatory explanation of Health and Care eligibility (e.g., "Nurse meets NMC registration and £25,000 salary threshold").
• Valid for three months from issuance—applicants must apply within this window.

Without a CoS, no visa application proceeds. In 2025, health sponsors report 20% faster approvals when CoS details align perfectly with UKVI checklists.

Step-by-Step Guide: Assigning a CoS for UK Health and Care Visa

As an HR employer, assigning a CoS is straightforward via the SMS portal. Here's your roadmap:

Step 1: Verify Candidate Eligibility

• Confirm qualifications (e.g., nursing degree + NMC eligibility for nurses).
• Run a right-to-work check and ensure the vacancy was advertised.

Step 2: Request CoS Allocation (If Needed)

• Log into SMS and apply for more CoS if your quota is low. Provide recruitment forecasts—health sector requests are prioritized.

Step 3: Create and Assign the CoS

• In SMS, select "Assign a Certificate of Sponsorship."
• Input details: Job title, duties, salary (with breakdowns for allowances), hours, and location.
• Upload supporting docs if prompted (e.g., NHS contract for non-CQC roles).
• Tick the "Health and Care Worker" box and add the eligibility rationale.
• Generate the reference number and share it securely with the candidate (via email or portal).

Step 4: Guide the Applicant's Visa Journey

• Advise on biometrics appointment (within UK or abroad).
• Monitor via SMS for UKVI queries—respond within 5 days to avoid delays.

Step 5: Onboarding Compliance

• Collect passport and BRP (Biometric Residence Permit) on arrival.
• Report start date to UKVI within 10 days.

Timelines: From CoS assignment to visa grant, expect 3-6 weeks. For doctors in shortage specialties (e.g., psychiatry), leverage the Immigration Salary List for lower threshold

Salary Requirements and Financial Commitments for Sponsoring Healthcare Talent

Meeting salary rules is non-negotiable—UKVI audits aggressively. For 2025:

• General Threshold: £25,000 (or occupation-specific rate, e.g., £34,100 for nurses).
• Allowances: Genuine promotions or progression count toward the threshold.
• Employer Costs:
  
  • CoS fee: £239 per assignment.
  • Sponsor Licence: As above.
  • No IHS reimbursement, but visa fees are lower (£232 outside UK vs. £719 for Skilled Worker).

Budget for relocation support—many mid-sized orgs offer £2,000-£5,000 packages to attract top doctors from India or the Philippines.

Common Pitfalls in CoS for Nurses and Doctors (And How to Avoid Them)

• Inaccurate SOC Codes: Mismatch leads to refusals. Use the ONS list—e.g., 2231 for nurses, not generic codes.
• CQC Gaps for Care Roles: New sponsors must be registered; transitional rules apply for extensions.
• English Proof Delays: Pre-verify with secure tests.
• Quota Exhaustion: Forecast hires quarterly to avoid mid-recruitment halts.

Solution? Partner with immigration experts like Jobbatical to audit your process pre-submission.

The Business Case: Benefits of Sponsoring Under the Health and Care Visa

Beyond compliance:

• Talent Pipeline: Access 500,000+ global nurses/doctors annually.
• Cost Efficiency: 20-30% lower recruitment fees vs. agencies; ROI in 6-9 months via reduced overtime.
• Diversity Boost: Diverse teams improve patient outcomes by 15-20%, per NHS data.
• Retention: Visa stability encourages long-term stays, cutting turnover by 25%.

For mid-sized firms, this visa scales global mobility without enterprise-level overhead.

Partner with Jobbatical: Streamline Your UK Sponsorship Today

Navigating the CoS and Health and Care Visa doesn't have to be a solo HR marathon. At Jobbatical.com, our tech platform specializes in end-to-end immigration for Europe's healthcare sector. From sponsor licence applications to CoS assignments and compliance tracking, we handle the details so you focus on patient care.

Ready to sponsor your next nurse or doctor? Book a free consultation today!

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