Certificate of Sponsorship (COS) crisis for doctors on non-permanent visas – DAUK write to HEE

6 July 2022 

Dear Colleagues,

Certificate of Sponsorship (COS) crisis for doctors on non-permanent visa

We are alarmed to learn that many doctors currently on non-permanent visas are facing bureaucratic delays that could prevent them from starting new jobs in August 2022. This threatens them with homelessness and a lack of income. Aside from the human misery, injustice and suffering this is needlessly causing, this will impact badly on the NHS at a time of increasing crisis.

As you will be aware, a COS and BRP are vital piece of paperwork required for these doctors to obtain valid proof of employment, letting agreements, mortgages and future applications for permanent residence visas.

It is unacceptable that several of these doctors will end up homeless as letting agencies are not willing to renew rental contracts and lenders will refuse mortgages if their BRP expires in a few weeks time, while the jobs they have been accepted for will be left unfilled.

The combined delays at Health Education England and within the Home Office are leaving these doctors under extreme mental stress, as they have already given notice to previous employers, while new employers won’t allow them to start without a new BRP – which is impossible without a COS. Many have applied for a new BRP after receiving their COS but have not received it. We know of cases where doctors have emailed after 8 weeks and received generic replied stating that Ukrainians are being prioritised.\

The COS crisis is making doctors feel demotivated and undervalued, despite their contributions to the NHS. Many have been required to cancel major life events such as marriage due to this bureaucracy.

We therefore ask if HEE, the Home Office and the Department of Health could advise Trusts to do the following:

  1. Allow doctors on non-permanent visas in training posts to be issued with a temporary emergency BRP to allow them to take up their posts
  2. Where possible, support accommodation of these doctors by either providing a letter they can give to their letting agencies or by being their guarantor to prevent them from becoming homeless

We also request that: 

  1. Issuing of COS is expedited 
  2. HEE demands the Home Office expedite the renewal or issuing of new BRPs

The NHS needs all the doctors and healthcare professionals it can get. Placing these doctors in this highly stressful situation is both needless, easily overcome, and harmful on several levels. It also threatens to worsen the current staffing issued within the NHS. We hope you will take all reasonable and immediate steps to overcome this and await your reply. 

Yours sincerely

Dr Pushpo Hossain – IMG Lead

Dr Ellen Welch – Co-Chair

Dr Matt Kneale – Co-Chair

Doctors’ Association UK