Episode 4: Navigating the Sponsorship Process for International Healthcare Recruitment

In this week’s video series, Claire Donoghue sits down with Mathew James to dive deep into one of the most pressing concerns for both NHS employers and private healthcare providers—how to correctly sponsor international healthcare professionals.

At Nursingjobsuk, we’ve worked closely with organisations across the healthcare sector to support their Certificate of Sponsorship (CoS) applications. In this blog, we break down the key topics discussed in our conversation and provide practical guidance to help employers attract, hire, and retain international talent efficiently and compliantly.

Why Sponsorship is a Key Concern for Employers

When recruiting internationally, one of the first questions employers ask is: “How do we get the sponsorship process right?” Sponsorship is a legal requirement for hiring most healthcare professionals from overseas, and getting it wrong can result in delays, compliance issues, or even legal penalties.

Step 1: Obtaining a Sponsorship Licence

Before an employer can issue a CoS, they must first apply for a Sponsorship Licence via the UK Home Office. This licence allows organisations to sponsor overseas candidates under the Skilled Worker route.

To apply, employers must:

• Demonstrate they are a genuine organisation operating lawfully in the UK.

• Prove they have appropriate HR systems in place to monitor sponsored staff.

• Ensure they understand their ongoing compliance responsibilities.

You cannot move forward with sponsorship until this licence is approved—planning ahead is crucial.

Step 2: Candidate Selection and Background Checks

Before issuing a CoS, employers must identify and select a suitable candidate. This step goes beyond reviewing CVs; employers need to:

• Verify healthcare experience thoroughly.

• Check registration status for regulated roles (e.g., nurses must have started their registration process with the Nursing and Midwifery Council (NMC)—this can be confirmed via the NMC website).

• Conduct background checks and assess the candidate’s suitability to work in a UK healthcare setting.

Step 3: Understanding Defined vs Undefined CoS

There are two types of Certificates of Sponsorship:

• Defined CoS: For candidates applying from outside the UK. These require approval from the Home Office for each individual before being assigned.

• Undefined CoS: For candidates already in the UK or switching from another visa category. Employers are allocated a yearly quota of undefined CoS when they get their sponsorship licence.

Employers must know the difference to avoid delays or misapplications.

Step 4: Resident Labour Market Test – What Is It?

While no longer a formal requirement under the new Skilled Worker route, employers should still demonstrate that there is a genuine need to recruit from abroad, especially in roles not listed on the Shortage Occupation List.

This can include:

• Documenting unsuccessful efforts to hire locally.

• Demonstrating skill shortages in your region or department.

• This type of planning and evidence is still encouraged and often required by internal HR or compliance teams.

Step 5: Cost Implications and Planning Ahead

There are significant costs associated with issuing a CoS, including:

• Sponsor licence fees

• Immigration Skills Charge

• CoS assignment fee

However, these costs are often outweighed by the long-term savings of employing permanent international staff compared to ongoing reliance on agency workers.

Importantly, the CoS process typically takes 1–3 months, so structured workforce planning is essential. Waiting until the last minute can result in staffing gaps and increased costs.

How Nursingjobsuk Can Help

At Nursingjobsuk, we have extensive experience supporting NHS Trusts and private healthcare employers through:

• Sponsorship licence applications

• Candidate screening

• CoS compliance

• End-to-end international recruitment

We ensure all documentation is correct and submissions are compliant—saving you time, money, and stress.