Questions and answers

COVID-19 sources of external staffing

These frequently asked questions are updated regularly, in response to ongoing changes to government advice and national and/or local restrictions.

Visas and extensions

1. What is the current situation around free visa extensions? 

All regulated professionals across the NHS who have a visa expiring before 01 October 2021 are eligible for a one-year visa extension. The extension also applies to immediate family members.

If there are any concerns about an individual's right to work at this time due to previous delays in processing their Biometric Residence Permit (BRP) for the first of visa extensions, organisations should read these FAQs in the first instance and contact if needed. Employers are encouraged not to email colleagues at the Home Office repeatedly as this slows down response times. Our understanding is that right to work is not affected at this time due to administration delays.

If organisations are having issues confirming extensions or are unsure about elements of the process, please contact for additional support.

2. Will individuals be given evidence of their visa extension?

Yes. Individuals should have been sent a letter that will arrive either to their home address or to the HR department within the trust. We have had queries from NHS organisations about delays to processing these visa extensions, UKVI has confirmed that it is continuing to process all applications and updates will be given as soon as a worker's visa is extended. Demand is high and the department has had to adapt to working restrictions, however UKVI have confirmed that there is no risk to yourselves or your employees of enforcement action during this time. If you haven't received a copy of the letter, please email

3. Why does the visa extension not apply to other healthcare staff from overseas who are here in the UK?

The government prioritised measures based on immediate COVID-19 supply needs and capacity. More information is available on the website and we will update this FAQ if the situation changes.

4. Will overseas workers offered visa extensions have to pay the immigration health surcharge?

No, those eligible for a visa extension will not have to pay the Immigration Health Surcharge. The IHS also no longer applies to registered health and care professionals coming to the UK on a skilled worker health and care visa. 

5. Is there functionality within the Electronic Staff Record (ESR) to record these temporary measures such as visa extensions?

UKVI is asking trusts to send them a spreadsheet of those staff who have applied for a free extension. This includes information on dependents. Please ensure to keep these details up to date with UKVI. 

6. What about health and care professionals who have visas due to expire after 01 October 2021? 

If their visa is due to expire after 01 October 2021, individuals will need to apply to extend their stay as usual via the Health and Care Visa route.

They will be able to apply from within the UK where they would usually need to return to their home country, and the terms of their leave will remain the same until their application is decided (providing they applied before their current visa's expiry date). The government has also stated that a decision should be made within three weeks of biometric information being provided.

Individuals can apply to extend their visa for a maximum of five years, as long as their total stay does not exceed six years.

Details on how staff can extend their visa, including full eligibility detail, are available on

7. Can an employee start employment with a trust if they have not yet arranged a biometric appointment? 

Yes, the concession under the Health and Care Visa enables staff to start working with for the sponsor even if they have not been able to obtain an appointment to submit their biometrics.

8. What is exceptional assurance and what happens to staff who cannot leave the country? 

If staff had intended to leave the UK, but were not able to do so and have a visa or leave that expires between 1 January 2021 and 28 February 2021, they may have been able/be able to request additional time to stay, known as exceptional assurance.

UKVI has now extended the Exceptional Assurance concession so that those individuals who have a visa, or leave, that expires by 30 June 2021, and who intend to leave the UK but have not been able to do so, can request additional time to stay.

Requests for Exceptional Assurance should continue to be submitted by emailing with the subject header “Request for an assurance”. Details on the additional information required in support of Exceptional Assurance requests can be found on the Gov.UK website.

The Exceptional Assurance concession will continue to be reviewed on regular basis. Any further updates will provided on Gov.UK

If an individual's previous visa allowed them to work, they will continue to be able to do so. More information, including an application form, is available on

9. I have a member of staff who has applied for indefinite leave to remain (ILR). Will they now extend their visa, or do they wait for their ILR?

ILR applications which have been made will be honoured and processed as quickly as possible.

10. Are visa centres open?

Details of which visa centres are open can be found on A number of UK-based Visa and Citizenship Application Centres (UKVCAS) are also open. More detail is available on the UKVCAS page on



11. How does the mandatory COVID-19 entry tests, 10-day quarantine and Test to Release work and what does it mean for healthcare professionals?

All new arrivals into the UK must present a negative COVID-19 test taken no longer than 72 hours prior to departure. The travel corridor list has been temporarily suspended, therefore all international passengers arriving to England, including British and Irish nationals, will still have to isolate for ten days. Find out more from or read our latest news story to find out more about updated NHS Staff Council quarantine guidance.  

From December 2020, under the government's Test to Release scheme, individuals entering the UK have been able to obtain a private test five days post-arrival into the UK, and if negative can begin in post. Health and care overseas recruits and staff can use Test to Release, however, tests must be carried out privately. NHS COVID-19 testing is not permitted to be used for this purpose. A list of the private test providers can be accessed from the website.

Guidance on quarantine and self isolation was been produced by a joint working group of the NHS Staff Council Executive. Please refer to this dedicated page for further details.

11. Will NHSE/I cover the £1750 for all staff groups or is it just Nursing? 

Currently, the reimbursement offer only applies to nursing, given the relative volume of nurses who are coming from ‘red list travel ban’ countries. We NHSE/I will continue to keep the number of people from other professional groups coming from ‘red list travel ban’ countries under review to better understand likely demand.

12. How do Trusts pay for the COVID hotel quarantine packages? 

As the payment for the hotel needs to be made up-front, NHSE/I ask that the Trust arranges to pay this on behalf of the nurses following your current local arrangements, e.g. Trust credit card, but this process is up to the individual trusts. Please note the reimbursement of the cost will be paid by NHSE/I directly to the Trust.

13. How do trusts know what hotel their nurses are quarantining in? 

Nurses will not know what hotel they are going to until they arrive. They will need to let trusts know where they are. There is free WIFI available at the hotel for the nurses to contact you. Please make sure you provide them with the relevant contact details before they depart.

14. We have recruited and issued a sponsorship visa for someone from a country where entry to the UK is banned except for residents. They are due to arrive next week. Does this individual fall under the criteria of being classed as having residence rights in the UK due to their visa? 

International arrivals from countries that have been banned entry to the UK (red countries) will only be permitted entry if they use an alternative route and are British or Irish citizens, or are third country nationals with residence rights in the UK. Those with residence rights include: 
  • holders of Indefinite Leave to Remain
  • holders of existing leave to enter or remain (ie those with biometric Residence permits) or an entry clearance/visa that grants such leave e.g. students, workers, etc (but excluding visit visas)
  • holders of EU Settlement Scheme (EUSS) leave
  • those who have rights of entry under the Withdrawal Agreements (including returning residents with a right of residence under the EEA Regulations and EEA frontier workers)
  • family members of EEA nationals with rights under the Withdrawal Agreement.

For the NHS this means that international recruits can still enter the UK from restricted countries with their entry clearance / workers visa or their pre or settled status. However they will still need to self-isolate for a period of 10 days and cannot use the Test to Release Scheme

15. I have a member of staff from overseas who is currently stuck in their home country or elsewhere outside of the UK. What are the arrangements for their travel back to the UK?

The Foreign and Commonwealth Development Office (FCDO) has information on its website for individuals who need to return to the UK. 

16. What is the Home Office bereavement scheme and do employers need to do anything to ensure families and dependants have the support they need?

The bereavement scheme which was launched in April 2020 continues to offer indefinite leave to remain for the families and dependents of health workers in the NHS, the independent health and care sector. The scheme was extended in May 2020 to cover NHS support staff and social care workers.

Employers of those eligible for the scheme will be contacted by UK Visas and Immigration in the first instance, who will then arrange for those affected to be issued with indefinite leave to remain. If further information is required or relatives believe they are eligible but have not yet heard anything, enquiries in the first instance should be shared with

You can find more information about the bereavement scheme on the website.

17. I work within HR in a trust – is there anything I should be doing or preparing to support our affected migrant workforce?

Individuals may have questions, so it will be worth developing some local Q&As and placing these on your staff intranet to help manage flow. Overseas nurses will be directed to local HR and nursing teams for further information, so try to be prepared for any questions or concerns they may have. 

18. The restriction on the number of hours student doctors and nurses has been lifted, but is there a cap in place to ensure health and safety?

Working hours and patterns are to be determined locally. Please visit our COVID-19 working hours and working time regulation section for detailed information. 


OSCE, English language and professional registration 

19. There have been individuals awaiting OET exams which have been cancelled and rescheduled. Is there anything that can be done to allow the OET to happen during these restrictions? 

Following a successful pilot from OET, the NMC will be accepting the OET@Home test as evidence of English language competency on the NMC temporary register. The OET@Home test allows candidates to take the OET on their computer at home instead of having to travel to a test centre. It uses the same test material, format, tasks and activities as the test venue centres. Tthe NMC will also accepts the new OET on computer test, which allows candidates to take the OET on a computer at a test centre instead of a paper test. 

For more information, please visit the OET website or NMC website.

20. Will computer-based testing (CBT) and English Language expiry dates be extended? 

The NMC have automatically extended the validity of CBT results due to expire between March 1st and August 31st by six months. This is automatic. 

The NMC have agreed to a further extension to the temporary language measures. This will cover people whose language evidence expires between 21 Jan 2021 - 21 August 2021. The NMC will grant candidates a six-month period whereby if they are working in a healthcare role in the UK or another English-speaking majority country, their employer can provide a supporting reference that states their English language is being used and maintained. In that six-month period, they would be expected to take the OSCE and submit all relevant papers for their application to NHSE/I. 

Please continue to check the NMC website for further updates.

21. OSCE capacity and availability remains a central challenge to successful international recruitment across the system. What steps have been taken to address this?

The NMC is working with all OSCE delivery partners to help ensure candidates are able to book their OSCE without being delayed. Test centres are busy; however they continue to increase capacity by opening weekends and offering later test slots during the week to help accommodate those needing to sit the test.

The NMC recommend proactively organising tests for international nurses at the earliest opportunity and using all test sites for those that you know will be in the UK and prepared. Group bookings are possible but the NMC require as much notice as possible and it may be necessary at times to reduce the size of your group booking. 

All three sites (Ulster University, Oxford Brookes and Northampton University) offer the Mental Health OSCE. 

In the meantime, it is possible to add eligible nurses to the temporary register.

22. Would it be possible to book OSCEs without names and candidate numbers? 

Currently, test centres do allow organisations to provisionally book places in advance, but candidate detail confirmation needs to take place at least 3-4 weeks before candidate takes the OSCE. 

Candidates must be in receipt of their test of competence invitation email from the NMC to confirm their eligibility to sit the OSCE. 

23. Can overseas doctors who haven’t yet passed both PLAB 1 and 2 join the General Medical Council’s register on a temporary basis?  

As things stand, the GMC is not giving temporary registration to overseas-qualified doctors who are yet to pass both parts of the PLAB test. The statutory requirements for registration remain at the same high standard to protect patients and ensure registrants have the necessary medical knowledge and skills to practise safely in the UK.

Overseas doctors who cannot be given temporary registration who wish to contribute to the COVID-19 response are able to volunteer for suitable roles in the NHS where opportunities exist. They must not undertake duties of a doctor until they are GMC registered with a licence to practise. 

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