Visa sponsorship: supporting IMG GPs in the UK

Dr Uwadiae Ima-Edomwonyi shares his top tips for both practices and international medical graduate GPs in how to approach and facilitate the visa sponsorship process, looking at the common obstacles and sharing helpful resources

Many practices in the UK are keen to support newly qualified international medical graduate (IMG) GPs, who trained within the NHS, but require visa sponsorship to remain in the workforce. If you’re a practice looking to recruit a GP in this situation, or a GP needing visa sponsorship, here is an explainer of how the process currently works.

For practices: Becoming an approved sponsor

You’ve found the right GP for your team, but they need work visa sponsorship. What’s next?

Become a licensed sponsor

If you haven’t already, apply for a Home Office sponsor license as a skilled worker sponsor. This process verifies your practice can support sponsored staff and takes 4 – 8 weeks.  The application is submitted via the Home Office portal; the fee is £574 for small businesses and charities, or £1,579 for medium and large organisations. The majority of GP practices and primary care businesses will fit the small business criteria:

• Annual turnover is £15 million or less
• Total assets are worth £7.5 million or less
• 50 employees or fewer

Only very large GP provider organisations or primary care federations (for example those operating multiple sites with high consolidated turnover or more than 50 employees) would fall under the medium or large business category.

You’ll submit details about your practice (including CQC and HMRC registration, and business structure) and nominate staff to manage the process.

As of last year, GP practices no longer need to renew their visa sponsorship licences. Prior to this, practices hosting staff from abroad would have to renew their sponsorship licence every four years, at a cost of £536.

Assign a Certificate of Sponsorship

Once licensed, you will issue your new GP a Certificate of Sponsorship (CoS) specifically for their role. Request a CoS allocation online through the Sponsorship Management System (SMS) , which costs £199 per doctor. Complete the CoS details accurately: Job title – General Practitioner; SOC code – must match approved job codes.

The job must meet the most recent salary and skill requirements for GPs. The current minimum salary for skilled worker visas is at least £41,700. The set ‘going rate’ for full time GPs (in England) is higher at £73,113; so depending on the role’s details, whichever threshold is higher is the one that should be used.

If you are a GP surgery looking to become a visa sponsor, you can find more information here.

For GPs: Securing your visa

If you’re finishing GP training or switching practices within the UK and need a work visa, here’s what your journey will look like.

Secure a job offer from a sponsoring practice and get your CoS

Or one willing to apply for a sponsorship license. Your new employer must be a licensed sponsor – some areas/regions have a publicly available list of such practices. The practice will assign you a unique CoS number, which you’ll use for your application.

Apply for the Health and Care Worker visa

Submit your application for a Health and Care Worker visa (on the UKVI website) up to three months before your role starts. Include your CoS, passport, proof of English if needed, GMC registration, CCT confirmation, and details of your job.

Application fees are £304 for a three-year visa and £590 for a longer one. Ensure you meet the minimum salary and financial requirements (usually at least £1,270 in your account, unless your employer certifies maintenance)

Start work once your visa is approved

Processing times are typically fairly quick under the Health and Care Worker route, so you can usually begin promptly; I know of a colleague who got a response three working days after application! But, do be prepared that it could take up to three weeks.

Common pitfalls and challenges for practices

Delays in the process

Applications for a sponsor licence or GP’s visa may be delayed by incomplete paperwork, errors, or slow UKVI processing. This can disrupt start dates and affect workforce planning for your practice.

Complex compliance obligations

Sponsors must maintain detailed records, report changes, and use the SMS accurately. Mistakes or lapses, like missing updates on employment status or incorrect CoS allocations, can result in fines or losing your sponsor licence.

Adjusting to policy changes

Immigration rules and salary thresholds change frequently. The increase in general salary thresholds earlier this year means that some job offers fall short, even in general practice. Practices may unintentionally make offers below new thresholds, rendering candidates ineligible – so do keep an eye on any changes that may affect your practice or sponsored GP.

Financial and administrative burden

Beyond application and CoS fees, practices may underestimate the HR time and resources required to maintain compliance and respond to audits or Home Office site visits. Engaging with legal advice is often recommended but adds some cost.

Unclear rejections

Sometimes, sponsor or visa applications are refused for reasons that are not clearly communicated, leaving practices unsure how to fix the issue for future attempts.

Common challenges for GPs needing sponsorship

Finding a sponsoring practice

Not all practices are willing or able to sponsor due to the costs, time and compliance pressures. This limits job opportunities for GPs requiring a visa, with only a minority of practices set up for sponsorship.

Increased competition and uncertainty

There is a rising demand for roles that offer visa sponsorship, and this obviously intensifies competition. GPs may receive job offers that fall short of the salary threshold, or struggle to find practices willing to sponsor amidst shifting immigration policies and budgets.

Switching visas

For GPs transitioning from training or other visa types (eg, Graduate Visa) timing is crucial. If your graduate visa expires before you apply to switch into a Skilled Worker visa, you immediately lose your right to live or work in the UK. Your application must be submitted before your Graduate visa expires, while you are still lawfully in the UK. The switching process can take up to eight weeks for a decision, bearing in mind, home office backlogs or late CoS assignment.

Limited information and changing rules

GPs and practices both often report finding guidance fragmented or outdated, particularly following the rapid rule changes, making it harder to navigate requirements confidently.

Right to work checks

Mistakes or delays in right to work evidence e.g expired visas during transition, can result in the GP being unable to start work on time, and even breaches for the employer

More useful information

Visa fees reimbursement schemes

Some regions have schemes where visa fees are reimbursed for GPs and – in some cases – for practices as well. Newly qualified GPs in some regions like Bath and Northeast Somerset, Swindon and Wiltshire (BSW), specially offer reimbursement of visa costs for newly qualified GPs taking up sponsored roles at approved practices. Coventry and Warwickshire Training Hub (CWTH) Visa Reimbursement scheme offers a one off, financial reimbursement for associated visa costs, for both GPs and practices.

Please check your local training hubs, as some schemes may have scaled back or stopped.

ARRS GP roles

The Additional Roles Reimbursement Scheme (ARRS) is a key NHS initiative supporting the recruitment of newly qualified GPs into primary care, often funding fixed-term or developmental roles. However, visa sponsorship for ARRS GP positions remains limited and inconsistent across regions. Some PCNs and practices with ARRS funding may provide sponsorship in specific instances, but this is not widespread.

The RCGP and BMA have both highlighted concerns about lack of clear, consistent sponsorship pathways within ARRS, and continue to advocate for better support to attract and retain IMG GPs.

Supporting each other

This journey is one of partnership. Practices get to keep skilled, well-trained GPs, and GPs can build lasting careers in the NHS. Plenty of support is available, from training hubs, local HR, ICBs and NHS employers, so be proactive and work together to make the sponsorship process smooth and successful for everyone. By navigating the journey together, practices can support talented GPs to stay and thrive in UK general practice.

Dr Uwadiae Ima-Edomwonyi is a GP and GP Trainer (Clinical Supervisor) in Greater Manchester