Seniors doctors from overseas who have been appointed to fill key roles in hospitals around the UK are being blocked from taking up their jobs by the Home Office because their NHS salaries are too low under immigration rules.



The Guardian has learned of at least 20 doctors prevented from taking up posts in departments including intensive care in the past two months, causing anger and bewilderment among already stretched doctors.

“It is simply lunatic,” said one consultant involved. “It is important to note that salaries haven’t changed and they are competitive. What’s changed is the Home Office’s threshold for granting visas.”

The Home Office decision comes against the backdrop of a recruitment crisis in the NHS partly caused by the vote for Brexit.

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University Hospitals Birmingham confirmed that 18 staff had been turned down for tier 2 visas in the past two months, including 16 doctors in senior medical posts in trauma, plastic surgery and elderly care.

Addenbrooke’s hospital in Cambridge confirmed that three doctors recruited for the John Farman intensive care unit had been turned down because of a £55,000 salary threshold set by the Home Office.

The doctors, who are at middle-level registrar and senior clinical fellow positions, would typically be on salaries of between £30,000 and £45,000 and were recruited from the Caribbean, India and Pakistan.

Cambridge University Hospitals said it was “disappointed to learn that visas for three overseas doctors due to join us in February have been declined because they do not meet a criteria that includes a salary threshold of £55k”.

Andrew Johnston, the intensive care consultant who leads the department, said he was baffled by the decision. “The salary threshold seems so arbitrary,” he said. “There has always been quite a lot of overseas staff and it used to be that we would get them the EU, from places like Greece and Spain. That seems to have dried up now and the result is we are more reliant on overseas.

“These people we had lined up for February are qualified doctors who have passed the General Medical Council tests and the language tests and to suddenly be told by the Home Office we can’t have them means the medical staff, who are already under enormous pressure, will be put under even more pressure.”



Consultants may be asked to “act down” and cover the shifts the overseas doctors had been recruited for, but this may mean elective surgery has to be rescheduled.

One doctor, a qualified psychiatrist originally from India whose visa application was refused, said she was disappointed. She is already working in the NHS and had been selected for a specialised post in child psychiatry in the east of England.

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“I’m extremely distraught,” said the doctor, who asked not to be named. “I’m a little bit disillusioned as well because the process of selection for higher grades in psychiatry is so exhaustive. I really don’t understand why this has happened.”

Anna Conway Morris, a consultant psychiatrist responsible for coordination of recruitment for child and adolescent psychiatrist training in the east of England, said she thought she had “hit the jackpot” when this doctor’s CV came in. “We really need her. There is a nationwide shortage of psychiatrists, even worse in child psychiatry and, because of Brexit, EU citizens don’t want to come here,” she said.

One immigration lawyer said the Home Office had privately admitted the salary thresholds were inappropriate and “send the wrong message” to people overseas.

The Home Office said the doctors were not a priority because once the month’s quota of Tier 2 visa applicants has been met, the first on the list are people in shortage skills areas or people with PhDs. The doctors did not qualify on either of these categories.

“When demand exceeds the month’s allocation of Tier 2 (General) visas, priority is given to applicants filling a shortage or PhD-level occupations.



“The published shortage lists include a range of medical professionals, including consultants specialising in clinical radiology and emergency medicine, and we estimate that around a third of all Tier 2 places go to the NHS,” is said in a statement.