Tag Archives: month

UK hits visa cap on skilled workers for third month in row

NHS and other key employers face staffing crisis as Home Office refuses visa applications

Home Office UK visas & immigration building in Croydon


The cap on skilled worker numbers operates on an annual quota of 20,700 with a fixed number of spaces available each month. Photograph: Alamy Stock Photo

Britain has hit its cap on visas for skilled non-European workers for an unprecedented third month in a row, deepening the staffing crisis facing the NHS and other key employers.

When the monthly quota was reached in December and January for the first time in seven years immigration lawyers had expected it would prove to be a blip, but they now fear it is turning into a long-term problem.

More than a third of the tier-2 work visas issued by the Home Office go to medical and other staff recruited to work in the NHS. Migration experts expect that among the first group to be turned away will be doctors and other healthcare staff, software developers and scientists.

The next set of quarterly immigration figures will be published on Thursday. They are expected to show increasing evidence of a “Brexodus” over the past year, with an accelerating decline in the numbers of EU nationals coming to work in Britain while increasing numbers return home.

The Home Office sent out hundreds of emails to UK employers and businesses last week telling them that their applications for the certificates of sponsorship required to recruit mostly highly skilled workers from outside the EU had been refused because they did not meet the minimum points score set for the February quota.

The cap on skilled worker numbers operates on an annual quota of 20,700 with a fixed number of spaces available each month. Until last December the monthly quota had only been exceeded in one month since the cap was introduced by Theresa May as home secretary in 2011.

The Home Office confirmed that the minimum salary for a job to qualify for a skilled work visa was normally £30,000, or £20,800 for a graduate recruit. However, in December it was set at £55,000 and in January tier-2 visa applications for jobs paying less than £46,000 a year were refused unless they were PhD-level roles or were for jobs on the official shortage occupation lists.

The points-based immigration system prioritises applicants according to their advertised salary, with the minimum annual pay changing according to the number of applicants above the quota and their points rating. This hits the NHS particularly hard.

Q&A

Does the UK have enough doctors and nurses?

The UK has fewer doctors and nurses than many other comparable countries both in Europe and worldwide. According to the Organisation for Economic Co-operation and Development (OECD), Britain comes 24th in a league table of 34 member countries in terms of the number of doctors per capita. Greece, Austria and Norway have the most; the three countries with the fewest are Turkey, Chile and Mexico. Jeremy Hunt, the health secretary, regularly points out that the NHS in England has more doctors and nurses than when the Conservatives came to power in 2010. That is true, although there are now fewer district nurses, mental health nurses and other types of health professionals.

NHS unions and health thinktanks point out that rises in NHS staff’s workloads have outstripped the increases in overall staff numbers. Hospital bosses say understaffing is now their number one problem, even ahead of lack of money and pressure to meet exacting NHS-wide performance targets. Hunt has recently acknowledged that, and Health Education England, the NHS’s staffing and training agency, last month published a workforce strategy intended to tackle the problem.

Read a full Q&A on the NHS winter crisis

Nichola Carter, an immigration specialist at Carter Thomas solicitors, said: “From the information I’m receiving it is starting to look like the threshold for rejection in February could be around the £50k mark. Initially it was thought that December and January were just blips. Now it’s starting to feel like this could be a long-term issue.”

She said employers were increasingly seeking to sponsor skilled workers because they needed certainty in their recruitment plans.

“The government has to step in now and either change the points or the criteria or create exemptions. Calls for NHS workers to be removed have already been made.”

Carter added that she had seen two applications refused for clients last week: a software developer and a designer for a bespoke luxury goods manufacturer.

All jobs offered to skilled workers from outside the EU that are not on the official shortage occupation lists have to be advertised in Britain first for a set period unless the salary will be at least £159,600.

“I know of employers who are now willing to pay £65,000 for a job they were previously offering a salary of £35,000 for just to make sure they get a visa in the next round of allocations,” Carter added.

The immigration law firm Fragomen confirmed that the cap had been reached for the third time. “Since the quota has been exceeded three times consecutively it is highly likely to be exceeded again next month due to the volume of reapplications. Applicants can reapply next month provided the job advertisement is still valid. There is no right of appeal following refusal.”

Danny Mortimer, the chief executive of NHS Employers, has pressed the Home Office to exempt medical staff from the quota, saying NHS organisations were “increasingly concerned at their inability to obtain permits for essential medical colleagues”.

A doctor on an NHS ward


More than a third of tier-2 work visas issued by the Home Office go to medical and other staff recruited by the NHS. Photograph: Peter Byrne/PA

A Home Office spokesperson said: “It is important that our immigration system works in the national interest, ensuring that employers look first to the UK resident labour market before recruiting from overseas.

“The tier 2 visa route is intended to fill gaps in the labour market. 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.”

UK hits visa cap on skilled workers for third month in row

NHS and other key employers face staffing crisis as Home Office refuses visa applications

Home Office UK visas & immigration building in Croydon


The cap on skilled worker numbers operates on an annual quota of 20,700 with a fixed number of spaces available each month. Photograph: Alamy Stock Photo

Britain has hit its cap on visas for skilled non-European workers for an unprecedented third month in a row, deepening the staffing crisis facing the NHS and other key employers.

When the monthly quota was reached in December and January for the first time in seven years immigration lawyers had expected it would prove to be a blip, but they now fear it is turning into a long-term problem.

More than a third of the tier-2 work visas issued by the Home Office go to medical and other staff recruited to work in the NHS. Migration experts expect that among the first group to be turned away will be doctors and other healthcare staff, software developers and scientists.

The next set of quarterly immigration figures will be published on Thursday. They are expected to show increasing evidence of a “Brexodus” over the past year, with an accelerating decline in the numbers of EU nationals coming to work in Britain while increasing numbers return home.

The Home Office sent out hundreds of emails to UK employers and businesses last week telling them that their applications for the certificates of sponsorship required to recruit mostly highly skilled workers from outside the EU had been refused because they did not meet the minimum points score set for the February quota.

The cap on skilled worker numbers operates on an annual quota of 20,700 with a fixed number of spaces available each month. Until last December the monthly quota had only been exceeded in one month since the cap was introduced by Theresa May as home secretary in 2011.

The Home Office confirmed that the minimum salary for a job to qualify for a skilled work visa was normally £30,000, or £20,800 for a graduate recruit. However, in December it was set at £55,000 and in January tier-2 visa applications for jobs paying less than £46,000 a year were refused unless they were PhD-level roles or were for jobs on the official shortage occupation lists.

The points-based immigration system prioritises applicants according to their advertised salary, with the minimum annual pay changing according to the number of applicants above the quota and their points rating. This hits the NHS particularly hard.

Q&A

Does the UK have enough doctors and nurses?

The UK has fewer doctors and nurses than many other comparable countries both in Europe and worldwide. According to the Organisation for Economic Co-operation and Development (OECD), Britain comes 24th in a league table of 34 member countries in terms of the number of doctors per capita. Greece, Austria and Norway have the most; the three countries with the fewest are Turkey, Chile and Mexico. Jeremy Hunt, the health secretary, regularly points out that the NHS in England has more doctors and nurses than when the Conservatives came to power in 2010. That is true, although there are now fewer district nurses, mental health nurses and other types of health professionals.

NHS unions and health thinktanks point out that rises in NHS staff’s workloads have outstripped the increases in overall staff numbers. Hospital bosses say understaffing is now their number one problem, even ahead of lack of money and pressure to meet exacting NHS-wide performance targets. Hunt has recently acknowledged that, and Health Education England, the NHS’s staffing and training agency, last month published a workforce strategy intended to tackle the problem.

Read a full Q&A on the NHS winter crisis

Nichola Carter, an immigration specialist at Carter Thomas solicitors, said: “From the information I’m receiving it is starting to look like the threshold for rejection in February could be around the £50k mark. Initially it was thought that December and January were just blips. Now it’s starting to feel like this could be a long-term issue.”

She said employers were increasingly seeking to sponsor skilled workers because they needed certainty in their recruitment plans.

“The government has to step in now and either change the points or the criteria or create exemptions. Calls for NHS workers to be removed have already been made.”

Carter added that she had seen two applications refused for clients last week: a software developer and a designer for a bespoke luxury goods manufacturer.

All jobs offered to skilled workers from outside the EU that are not on the official shortage occupation lists have to be advertised in Britain first for a set period unless the salary will be at least £159,600.

“I know of employers who are now willing to pay £65,000 for a job they were previously offering a salary of £35,000 for just to make sure they get a visa in the next round of allocations,” Carter added.

The immigration law firm Fragomen confirmed that the cap had been reached for the third time. “Since the quota has been exceeded three times consecutively it is highly likely to be exceeded again next month due to the volume of reapplications. Applicants can reapply next month provided the job advertisement is still valid. There is no right of appeal following refusal.”

Danny Mortimer, the chief executive of NHS Employers, has pressed the Home Office to exempt medical staff from the quota, saying NHS organisations were “increasingly concerned at their inability to obtain permits for essential medical colleagues”.

A doctor on an NHS ward


More than a third of tier-2 work visas issued by the Home Office go to medical and other staff recruited by the NHS. Photograph: Peter Byrne/PA

A Home Office spokesperson said: “It is important that our immigration system works in the national interest, ensuring that employers look first to the UK resident labour market before recruiting from overseas.

“The tier 2 visa route is intended to fill gaps in the labour market. 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.”

UK hits visa cap on skilled workers for third month in row

NHS and other key employers face staffing crisis as Home Office refuses visa applications

Home Office UK visas & immigration building in Croydon


The cap on skilled worker numbers operates on an annual quota of 20,700 with a fixed number of spaces available each month. Photograph: Alamy Stock Photo

Britain has hit its cap on visas for skilled non-European workers for an unprecedented third month in a row, deepening the staffing crisis facing the NHS and other key employers.

When the monthly quota was reached in December and January for the first time in seven years immigration lawyers had expected it would prove to be a blip, but they now fear it is turning into a long-term problem.

More than a third of the tier-2 work visas issued by the Home Office go to medical and other staff recruited to work in the NHS. Migration experts expect that among the first group to be turned away will be doctors and other healthcare staff, software developers and scientists.

The next set of quarterly immigration figures will be published on Thursday. They are expected to show increasing evidence of a “Brexodus” over the past year, with an accelerating decline in the numbers of EU nationals coming to work in Britain while increasing numbers return home.

The Home Office sent out hundreds of emails to UK employers and businesses last week telling them that their applications for the certificates of sponsorship required to recruit mostly highly skilled workers from outside the EU had been refused because they did not meet the minimum points score set for the February quota.

The cap on skilled worker numbers operates on an annual quota of 20,700 with a fixed number of spaces available each month. Until last December the monthly quota had only been exceeded in one month since the cap was introduced by Theresa May as home secretary in 2011.

The Home Office confirmed that the minimum salary for a job to qualify for a skilled work visa was normally £30,000, or £20,800 for a graduate recruit. However, in December it was set at £55,000 and in January tier-2 visa applications for jobs paying less than £46,000 a year were refused unless they were PhD-level roles or were for jobs on the official shortage occupation lists.

The points-based immigration system prioritises applicants according to their advertised salary, with the minimum annual pay changing according to the number of applicants above the quota and their points rating. This hits the NHS particularly hard.

Q&A

Does the UK have enough doctors and nurses?

The UK has fewer doctors and nurses than many other comparable countries both in Europe and worldwide. According to the Organisation for Economic Co-operation and Development (OECD), Britain comes 24th in a league table of 34 member countries in terms of the number of doctors per capita. Greece, Austria and Norway have the most; the three countries with the fewest are Turkey, Chile and Mexico. Jeremy Hunt, the health secretary, regularly points out that the NHS in England has more doctors and nurses than when the Conservatives came to power in 2010. That is true, although there are now fewer district nurses, mental health nurses and other types of health professionals.

NHS unions and health thinktanks point out that rises in NHS staff’s workloads have outstripped the increases in overall staff numbers. Hospital bosses say understaffing is now their number one problem, even ahead of lack of money and pressure to meet exacting NHS-wide performance targets. Hunt has recently acknowledged that, and Health Education England, the NHS’s staffing and training agency, last month published a workforce strategy intended to tackle the problem.

Read a full Q&A on the NHS winter crisis

Nichola Carter, an immigration specialist at Carter Thomas solicitors, said: “From the information I’m receiving it is starting to look like the threshold for rejection in February could be around the £50k mark. Initially it was thought that December and January were just blips. Now it’s starting to feel like this could be a long-term issue.”

She said employers were increasingly seeking to sponsor skilled workers because they needed certainty in their recruitment plans.

“The government has to step in now and either change the points or the criteria or create exemptions. Calls for NHS workers to be removed have already been made.”

Carter added that she had seen two applications refused for clients last week: a software developer and a designer for a bespoke luxury goods manufacturer.

All jobs offered to skilled workers from outside the EU that are not on the official shortage occupation lists have to be advertised in Britain first for a set period unless the salary will be at least £159,600.

“I know of employers who are now willing to pay £65,000 for a job they were previously offering a salary of £35,000 for just to make sure they get a visa in the next round of allocations,” Carter added.

The immigration law firm Fragomen confirmed that the cap had been reached for the third time. “Since the quota has been exceeded three times consecutively it is highly likely to be exceeded again next month due to the volume of reapplications. Applicants can reapply next month provided the job advertisement is still valid. There is no right of appeal following refusal.”

Danny Mortimer, the chief executive of NHS Employers, has pressed the Home Office to exempt medical staff from the quota, saying NHS organisations were “increasingly concerned at their inability to obtain permits for essential medical colleagues”.

A doctor on an NHS ward


More than a third of tier-2 work visas issued by the Home Office go to medical and other staff recruited by the NHS. Photograph: Peter Byrne/PA

A Home Office spokesperson said: “It is important that our immigration system works in the national interest, ensuring that employers look first to the UK resident labour market before recruiting from overseas.

“The tier 2 visa route is intended to fill gaps in the labour market. 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.”

UK hits visa cap on skilled workers for third month in row

NHS and other key employers face staffing crisis as Home Office refuses visa applications

Home Office UK visas & immigration building in Croydon


The cap on skilled worker numbers operates on an annual quota of 20,700 with a fixed number of spaces available each month. Photograph: Alamy Stock Photo

Britain has hit its cap on visas for skilled non-European workers for an unprecedented third month in a row, deepening the staffing crisis facing the NHS and other key employers.

When the monthly quota was reached in December and January for the first time in seven years immigration lawyers had expected it would prove to be a blip, but they now fear it is turning into a long-term problem.

More than a third of the tier-2 work visas issued by the Home Office go to medical and other staff recruited to work in the NHS. Migration experts expect that among the first group to be turned away will be doctors and other healthcare staff, software developers and scientists.

The next set of quarterly immigration figures will be published on Thursday. They are expected to show increasing evidence of a “Brexodus” over the past year, with an accelerating decline in the numbers of EU nationals coming to work in Britain while increasing numbers return home.

The Home Office sent out hundreds of emails to UK employers and businesses last week telling them that their applications for the certificates of sponsorship required to recruit mostly highly skilled workers from outside the EU had been refused because they did not meet the minimum points score set for the February quota.

The cap on skilled worker numbers operates on an annual quota of 20,700 with a fixed number of spaces available each month. Until last December the monthly quota had only been exceeded in one month since the cap was introduced by Theresa May as home secretary in 2011.

The Home Office confirmed that the minimum salary for a job to qualify for a skilled work visa was normally £30,000, or £20,800 for a graduate recruit. However, in December it was set at £55,000 and in January tier-2 visa applications for jobs paying less than £46,000 a year were refused unless they were PhD-level roles or were for jobs on the official shortage occupation lists.

The points-based immigration system prioritises applicants according to their advertised salary, with the minimum annual pay changing according to the number of applicants above the quota and their points rating. This hits the NHS particularly hard.

Q&A

Does the UK have enough doctors and nurses?

The UK has fewer doctors and nurses than many other comparable countries both in Europe and worldwide. According to the Organisation for Economic Co-operation and Development (OECD), Britain comes 24th in a league table of 34 member countries in terms of the number of doctors per capita. Greece, Austria and Norway have the most; the three countries with the fewest are Turkey, Chile and Mexico. Jeremy Hunt, the health secretary, regularly points out that the NHS in England has more doctors and nurses than when the Conservatives came to power in 2010. That is true, although there are now fewer district nurses, mental health nurses and other types of health professionals.

NHS unions and health thinktanks point out that rises in NHS staff’s workloads have outstripped the increases in overall staff numbers. Hospital bosses say understaffing is now their number one problem, even ahead of lack of money and pressure to meet exacting NHS-wide performance targets. Hunt has recently acknowledged that, and Health Education England, the NHS’s staffing and training agency, last month published a workforce strategy intended to tackle the problem.

Read a full Q&A on the NHS winter crisis

Nichola Carter, an immigration specialist at Carter Thomas solicitors, said: “From the information I’m receiving it is starting to look like the threshold for rejection in February could be around the £50k mark. Initially it was thought that December and January were just blips. Now it’s starting to feel like this could be a long-term issue.”

She said employers were increasingly seeking to sponsor skilled workers because they needed certainty in their recruitment plans.

“The government has to step in now and either change the points or the criteria or create exemptions. Calls for NHS workers to be removed have already been made.”

Carter added that she had seen two applications refused for clients last week: a software developer and a designer for a bespoke luxury goods manufacturer.

All jobs offered to skilled workers from outside the EU that are not on the official shortage occupation lists have to be advertised in Britain first for a set period unless the salary will be at least £159,600.

“I know of employers who are now willing to pay £65,000 for a job they were previously offering a salary of £35,000 for just to make sure they get a visa in the next round of allocations,” Carter added.

The immigration law firm Fragomen confirmed that the cap had been reached for the third time. “Since the quota has been exceeded three times consecutively it is highly likely to be exceeded again next month due to the volume of reapplications. Applicants can reapply next month provided the job advertisement is still valid. There is no right of appeal following refusal.”

Danny Mortimer, the chief executive of NHS Employers, has pressed the Home Office to exempt medical staff from the quota, saying NHS organisations were “increasingly concerned at their inability to obtain permits for essential medical colleagues”.

A doctor on an NHS ward


More than a third of tier-2 work visas issued by the Home Office go to medical and other staff recruited by the NHS. Photograph: Peter Byrne/PA

A Home Office spokesperson said: “It is important that our immigration system works in the national interest, ensuring that employers look first to the UK resident labour market before recruiting from overseas.

“The tier 2 visa route is intended to fill gaps in the labour market. 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.”

UK hits visa cap on skilled workers for third month in row

NHS and other key employers face staffing crisis as Home Office refuses visa applications

Home Office UK visas & immigration building in Croydon


The cap on skilled worker numbers operates on an annual quota of 20,700 with a fixed number of spaces available each month. Photograph: Alamy Stock Photo

Britain has hit its cap on visas for skilled non-European workers for an unprecedented third month in a row, deepening the staffing crisis facing the NHS and other key employers.

When the monthly quota was reached in December and January for the first time in seven years immigration lawyers had expected it would prove to be a blip, but they now fear it is turning into a long-term problem.

More than a third of the tier-2 work visas issued by the Home Office go to medical and other staff recruited to work in the NHS. Migration experts expect that among the first group to be turned away will be doctors and other healthcare staff, software developers and scientists.

The next set of quarterly immigration figures will be published on Thursday. They are expected to show increasing evidence of a “Brexodus” over the past year, with an accelerating decline in the numbers of EU nationals coming to work in Britain while increasing numbers return home.

The Home Office sent out hundreds of emails to UK employers and businesses last week telling them that their applications for the certificates of sponsorship required to recruit mostly highly skilled workers from outside the EU had been refused because they did not meet the minimum points score set for the February quota.

The cap on skilled worker numbers operates on an annual quota of 20,700 with a fixed number of spaces available each month. Until last December the monthly quota had only been exceeded in one month since the cap was introduced by Theresa May as home secretary in 2011.

The Home Office confirmed that the minimum salary for a job to qualify for a skilled work visa was normally £30,000, or £20,800 for a graduate recruit. However, in December it was set at £55,000 and in January tier-2 visa applications for jobs paying less than £46,000 a year were refused unless they were PhD-level roles or were for jobs on the official shortage occupation lists.

The points-based immigration system prioritises applicants according to their advertised salary, with the minimum annual pay changing according to the number of applicants above the quota and their points rating. This hits the NHS particularly hard.

Q&A

Does the UK have enough doctors and nurses?

The UK has fewer doctors and nurses than many other comparable countries both in Europe and worldwide. According to the Organisation for Economic Co-operation and Development (OECD), Britain comes 24th in a league table of 34 member countries in terms of the number of doctors per capita. Greece, Austria and Norway have the most; the three countries with the fewest are Turkey, Chile and Mexico. Jeremy Hunt, the health secretary, regularly points out that the NHS in England has more doctors and nurses than when the Conservatives came to power in 2010. That is true, although there are now fewer district nurses, mental health nurses and other types of health professionals.

NHS unions and health thinktanks point out that rises in NHS staff’s workloads have outstripped the increases in overall staff numbers. Hospital bosses say understaffing is now their number one problem, even ahead of lack of money and pressure to meet exacting NHS-wide performance targets. Hunt has recently acknowledged that, and Health Education England, the NHS’s staffing and training agency, last month published a workforce strategy intended to tackle the problem.

Read a full Q&A on the NHS winter crisis

Nichola Carter, an immigration specialist at Carter Thomas solicitors, said: “From the information I’m receiving it is starting to look like the threshold for rejection in February could be around the £50k mark. Initially it was thought that December and January were just blips. Now it’s starting to feel like this could be a long-term issue.”

She said employers were increasingly seeking to sponsor skilled workers because they needed certainty in their recruitment plans.

“The government has to step in now and either change the points or the criteria or create exemptions. Calls for NHS workers to be removed have already been made.”

Carter added that she had seen two applications refused for clients last week: a software developer and a designer for a bespoke luxury goods manufacturer.

All jobs offered to skilled workers from outside the EU that are not on the official shortage occupation lists have to be advertised in Britain first for a set period unless the salary will be at least £159,600.

“I know of employers who are now willing to pay £65,000 for a job they were previously offering a salary of £35,000 for just to make sure they get a visa in the next round of allocations,” Carter added.

The immigration law firm Fragomen confirmed that the cap had been reached for the third time. “Since the quota has been exceeded three times consecutively it is highly likely to be exceeded again next month due to the volume of reapplications. Applicants can reapply next month provided the job advertisement is still valid. There is no right of appeal following refusal.”

Danny Mortimer, the chief executive of NHS Employers, has pressed the Home Office to exempt medical staff from the quota, saying NHS organisations were “increasingly concerned at their inability to obtain permits for essential medical colleagues”.

A doctor on an NHS ward


More than a third of tier-2 work visas issued by the Home Office go to medical and other staff recruited by the NHS. Photograph: Peter Byrne/PA

A Home Office spokesperson said: “It is important that our immigration system works in the national interest, ensuring that employers look first to the UK resident labour market before recruiting from overseas.

“The tier 2 visa route is intended to fill gaps in the labour market. 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.”

UK hits visa cap on skilled workers for third month in row

NHS and other key employers face staffing crisis as Home Office refuses visa applications

Home Office UK visas & immigration building in Croydon


The cap on skilled worker numbers operates on an annual quota of 20,700 with a fixed number of spaces available each month. Photograph: Alamy Stock Photo

Britain has hit its cap on visas for skilled non-European workers for an unprecedented third month in a row, deepening the staffing crisis facing the NHS and other key employers.

When the monthly quota was reached in December and January for the first time in seven years immigration lawyers had expected it would prove to be a blip, but they now fear it is turning into a long-term problem.

More than a third of the tier 2 work visas issued by the Home Office go to medical and other staff recruited to work in the NHS. Migration experts expect that among the first group to be turned away will be doctors and other healthcare staff, software developers and scientists.

The next set of quarterly immigration figures will be published on Thursday. They are expected to show increasing evidence of a “Brexodus” over the past year, with an accelerating decline in the numbers of EU nationals coming to work in Britain while increasing numbers return home.

The Home Office sent out hundreds of emails to UK employers and businesses last week telling them that their applications for the certificates of sponsorship required to recruit mostly highly skilled workers from outside the EU had been refused because they did not meet the minimum points score set for the February quota.

The cap on skilled worker numbers operates on an annual quota of 20,700 with a fixed number of spaces available each month. Until last December the monthly quota had only been exceeded in one month since the cap was introduced by Theresa May as home secretary in 2011.

The Home Office confirmed that the minimum salary for a job to qualify for a skilled work visa was normally £30,000, or £20,800 for a graduate recruit. However, in December it was set at £55,000 and in January tier 2 visa applications for jobs paying less than £46,000 a year were refused unless they were PhD-level roles or were for jobs on the official shortage occupation lists.

The points-based immigration system prioritises applicants according to their advertised salary, with the minimum annual pay changing according to the number of applicants above the quota and their points rating. This hits the NHS particularly hard.

Q&A

Does the UK have enough doctors and nurses?

The UK has fewer doctors and nurses than many other comparable countries both in Europe and worldwide. According to the Organisation for Economic Co-operation and Development (OECD), Britain comes 24th in a league table of 34 member countries in terms of the number of doctors per capita. Greece, Austria and Norway have the most; the three countries with the fewest are Turkey, Chile and Mexico. Jeremy Hunt, the health secretary, regularly points out that the NHS in England has more doctors and nurses than when the Conservatives came to power in 2010. That is true, although there are now fewer district nurses, mental health nurses and other types of health professionals.

NHS unions and health thinktanks point out that rises in NHS staff’s workloads have outstripped the increases in overall staff numbers. Hospital bosses say understaffing is now their number one problem, even ahead of lack of money and pressure to meet exacting NHS-wide performance targets. Hunt has recently acknowledged that, and Health Education England, the NHS’s staffing and training agency, last month published a workforce strategy intended to tackle the problem.

Read a full Q&A on the NHS winter crisis

Nichola Carter, an immigration specialist at Carter Thomas solicitors, said: “From the information I’m receiving it is starting to look like the threshold for rejection in February could be around the £50k mark. Initially it was thought that December and January were just blips. Now it’s starting to feel like this could be a long-term issue.”

She said employers were increasingly seeking to sponsor skilled workers because they needed certainty in their recruitment plans.

“The government has to step in now and either change the points or the criteria or create exemptions. Calls for NHS workers to be removed have already been made.”

Carter added that she had seen two applications refused for clients last week: a software developer and a designer for a bespoke luxury goods manufacturer.

All jobs offered to skilled workers from outside the EU that are not on the official shortage occupation lists have to be advertised in Britain first for a set period unless the salary will be at least £159,600.

“I know of employers who are now willing to pay £65,000 for a job they were previously offering a salary of £35,000 for just to make sure they get a visa in the next round of allocations,” Carter added.

The immigration lawyers Fragomen confirmed that the cap had been reached for the third time. “Since the quota has been exceeded three times consecutively it is highly likely to be exceeded again next month due to the volume of reapplications. Applicants can reapply next month provided the job advertisement is still valid. There is no right of appeal following refusal.”

Danny Mortimer, the chief executive of NHS Employers, has pressed the Home Office to exempt medical staff from the quota, saying NHS organisations were “increasingly concerned at their inability to obtain permits for essential medial colleagues”.

A doctor on an NHS ward


More than a third of tier 2 work visas issued by the Home Office go to medical and other staff recruited to work in the NHS. Photograph: Peter Byrne/PA

A Home Office spokesperson said: “It is important that our immigration system works in the national interest, ensuring that employers look first to the UK resident labour market before recruiting from overseas.

“The tier 2 visa route is intended to fill gaps in the labour market. 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.”

193,000 NHS patients a month waiting beyond target time for surgery

An increasing number of patients are having to endure long waits for operations, according to a study that provides the latest evidence of the NHS’s failure to meet waiting time targets because hospitals are so busy.

Analysis by the Royal College of Surgeons found that over the past year an average of 193,406 people a month did not get surgery within 18 weeks of being referred.

The figure compares with 139,240 the previous year and 105,427 four years ago, and is the NHS’s worst performance by this measure since 2008. It covers patients waiting for operations including for broken limbs, traumatic injuries, brain conditions and eye problems.

Ian Eardley, the college’s vice-president, said: “We are now struggling to meet the standards and timeliness of care that the public rightly expect. Waiting longer creates prolonged pain, uncertainty and immobility for patients and is stressful for them and their families, especially those who may be very ill or in significant pain.

“Many of these patients are older and in the most serious cases, such as heart or cancer surgery, waiting longer could have a big effect on the quality of someone’s life and their eventual recovery from surgery.”

He said the sharp rise in the number of patients waiting longer than 18 weeks suggested the NHS had passed a tipping point.

In October 2016, for example, patients who had been on the waiting list for more than 18 weeks included 52,816 who needed trauma and orthopaedic surgery, 33,547 classified under general surgery, and 24,578 who needed a procedure to improve their eyesight.

The increases were most pronounced in ear, nose and throat surgery, up 124% since 2012-13, to 23,454 a month in 2015-16, and neurosurgery, up 109%, to 5,004.

The number of women who did not receive gynaecological surgery within the target time rose by 102% in the same period, to 14,795 a month..

Some NHS hospital trusts are leaving notably large proportions of patients waiting longer than 18 weeks for certain forms of surgery. For example, of the 717 patients who were waiting for neurosurgery at Plymouth Hospitals NHS trust last October, 59% had been waiting longer than 18 weeks.

The same applied to 48% of the 1,359 people awaiting oral surgery at Walsall Healthcare NHS trust and 44% of the 655 patients awaiting oral surgery at the University of South Manchester NHS foundation trust.

The shadow health secretary, Jon Ashworth, said he hoped hospitals’ poor performance against surgery waiting time standards would not prompt the government to soften the targets.

“We already know ministers want to water down the A&E target. Given this more widespread deterioration in waiting times, I hope this won’t lead to ministers abandoning others standards too,” he said.

Eardley said the delays in accessing surgery were likely to get worse given the intense pressure on hospitals and widespread bed shortages. “There is no sign of waiting times reducing any time soon and they are very likely to have become worse this winter. The key question is: how much longer will patients have to wait before the government steps in to relieve the pressure?”

On Friday, Theresa May seemed to edge closer to acknowledging the seriousness of the crisis confronting the NHS. “I recognise, and we have acknowledged, that the NHS is under pressure,” she said at a Downing Street press conference. She stressed the NHS had put £400m into preparations for coping with winter pressures.

She had said on Thursday there had been a “small number” of incidents of unacceptable practice in NHS trusts, and the health secretary, Jeremy Hunt, said there were problems in “one or two” areas.

Earlier on Friday, NHS England revealed that 65 out of its 152 acute trusts had had to declare an alert during the first week of January.

UK already celebrates LGBT History Month | Brief letters

“Asked … whether he thought there should be a gay history month along the lines of black history month, Corbyn said: ‘There could be that…’ ” (Report, theguardian.com, 27 October). Lesbian, Gay, Bisexual, Trans History Month has existed in the UK since 2005 and has a major impact on schools throughout the country. We still celebrate it every February. I should know because I am the CEO of the charity that runs it.
Tony Fenwick
CEO, Schools Out UK/LGBT History Month

I am grateful to Mr Fox for explaining that the EU is putting politics over prosperity (Fox warns on tariffs, 27 October) as I was assuming that they were putting principles over profit.
Steve Shearsmith
Cottingham, East Yorkshire

Surely, with the active use of stents and microchip implants, the medical profession can invent some non-invasive valve procedure that can switch on and off the effect of a vasectomy (Letters, 27 October)? I freely offer this idea to the world as long as it is for ever known as a stop-cock.
Stephen Andrews
(Happily had the snip 30 years ago)
Charlbury, Oxfordshire

With Bake Off the nation’s favourite programme, and 10 million watching the final episode (Royal picnic wins Bake Off crown for teacher, 27 October), is it just a coincidence that, in the same week, Public Health England issue dire warnings about a major increase in Type 2 diabetes?
Peter Davis
Dovercourt, Essex

Bob Dylan did not “change rock from teenage to adult music” (Notes & queries, 27 October). His fans simply got older.
Michael Short
St Leonards-on-Sea, East Sussex

You picture Christ’s tomb (Jesus Christ’s tomb uncovered, Eyewitness, 28 October). No mention of any bones. That would be an atheist’s dream, surely!
Jerry Stuart
London

Join the debate – email guardian.letters@theguardian.com

Almost half of young Australian adults binge-drink every month, report says

Almost half of young Australian adults engage in binge-drinking on at least a monthly basis, a new report shows – but across the board rates of alcohol consumption are falling.

Findings from the Australian Institute of Health and Welfare on trends in alcohol availability, use and treatment show that 18- to 24-year-olds are most likely to report risky drinking behaviour.

The report says 47% reported drinking more than four standard drinks on a single occasion on at least a monthly basis, 33% consumed 11 or more standard drinks on a single occasion at least yearly, and 18% at least monthly.

But older Australians were more likely to have more than an average of two standard drinks a day, with 23% of respondents aged from 40 to 49 reporting what was defined as a “lifetime” risk.

Similarly, nearly half (49%) of respondents receiving treatment were aged in their forties. Overall, treatment for alcohol had increased by 20% from a decade ago, with patients in 2014-15 most likely to be males aged over 40 and living in major cities.

Researchers said it was possible that problems related to drinking did not develop until later in life or that people simply did not seek treatment for them until then.

The report, released on Friday, assessed trends in alcohol availability, use and treatment.

Volume of alcohol consumed per capita

Tim Beard, a spokesman for the AIHW, said binge-drinking – particularly among younger Australians and those living in rural or very remote areas – was at odds with the downward trend of consumption rates overall.

“That contrast really jumped out at us.”

He said drinking alcohol in significant quantities became less socially acceptable as people aged, and those who reported receiving treatment was “an ageing cohort”, seeking help for “habits they formed sometimes 20, 30 years ago”.

“They might have been receiving treatment for years.”

In 2013, just over 15 million Australians, about 78% of the population, had consumed alcohol in the past year – but the apparent consumption of alcohol as determined through sales and taxation data has decreased nationally from 2003-04 to 2013-14.

The proportion of people abstaining – who had never consumed a full serving of alcohol – had risen from 17% in 2004 to 22% in 2013; the rate of ex-drinkers had also increased.

Alcohol consumption per person had also fallen to 9.7 litres in 2013-14 from 10.8l in 2008-9.

The increasing price of alcohol, restrictions on trading hours, and fewer outlets were understood to be effective in reducing harms.

“I think there’s a lot more public awareness of the impact of all sorts of behaviours on health,” said Beard, noting the National Drug Strategy aimed to reduce rates of smoking, drinking and drug abuse across the board through prevention.

“It’s not just younger people who aren’t taking it up – it’s a lot of people who are giving it up.”

But despite some emerging positive patterns, risky drinking and alcohol dependence continued to be significant issues in Australia, particularly among some groups.

Remote and very remote areas were more likely to engage in risky drinking than people living in major cities, said Beard.

Interactive

“They’re sort of bucking the trend, unfortunately, when you look at them as a group. It’s a small pocket but a notable one.”

The report found 15% of people who identified as lesbian, gay or bisexual reported drinking at very high levels each month, compared to 7% of people who identified as heterosexual.

Indigenous Australians were more likely than non-Indigenous Australians to report risky drinking on single occasions, and more than three times as likely to drink at very high levels every week – though the gap was decreasing over time.

Alcohol was the leading cause of burden of disease for Australians under the age of 45 in 2011; alcohol-use disorders were responsible for 1.5% of the total burden of disease.

Research published by the University of Adelaide last week highlighted the difficulties experienced by Australians to cut back on their alcohol intake or quit altogether.

Ashlea Bartram, a PhD researcher at the university’s School of Public Health, found that people routinely made excuses to remove themselves from situations where others were drinking, or provided accepted excuses for abstaining such as being unwell or needing to drive.

She said it was “quite clear there is a stigma attached” to people attempting to change their drinking habits. “It’s as though some kind of social code has been violated.”

People tended to make excuses not to attend social gatherings, and instead found “new ways to spend time with their peers that weren’t focused on alcohol,” Bartram said.

How Obamacare Adds $a hundred A Month To Your Spouse’s Coverage

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To steer clear of the Inexpensive Care Act&rsquos so-named &ldquoCadillac tax&rdquo on rich benefit programs, companies are incorporating surcharges of $ 100 a month or much more to wives and husbands of staff, hoping spouses will seek coverage elsewhere, new employer information demonstrates. The Cadillac tax was developed as element of the Cost-effective Care Act [...]