What international medical recruitment actually costs in the UK
Hiring an internationally-qualified doctor into the UK has fixed government and Home Office charges that apply regardless of how you source the candidate, plus variable costs — an agency fee if you use one, and relocation support. Government fees are revised periodically; every figure below carries a named, linked source so you can confirm the current rate before budgeting against it.
Quick answer
- Sponsor licence
- A one-off cost to become a licensed sponsor (amortised across all hires for an existing sponsor) — see GOV.UK for current small vs medium/large sponsor rates.
- Certificate of Sponsorship
- A fixed per-worker fee, currently £525 as of an April 2026 Home Office fee update — confirm the current rate on GOV.UK.
- Immigration Skills Charge
- Per sponsored worker, per year of visa — rate depends on sponsor size and whether the specific occupation code is exempt; check GOV.UK before assuming exemption.
- Immigration Health Surcharge
- Paid by the applicant, but Health and Care Worker visa holders are exempt entirely, per NHS Employers.
The fixed, government-side costs
| Cost | Who pays | Notes |
|---|---|---|
| Sponsor licence | Employer | One-off (with renewal cycles); most established NHS trusts already hold one, so this is not usually a per-hire cost for them. |
| Certificate of Sponsorship | Employer | Fixed fee per sponsored worker, same across the standard and Health and Care routes. |
| Immigration Skills Charge | Employer | Per worker, per year sponsored; depends on sponsor size and the specific occupation code’s exemption status — verify before budgeting. |
| Visa application fee | Applicant (often reimbursed) | Lower under the Health and Care Worker sub-category than the standard Skilled Worker route. |
| Immigration Health Surcharge | Applicant | Health and Care Worker visa holders are exempt entirely. |
Figures change with Home Office fee reviews. Confirm current amounts on GOV.UK before quoting them internally — see Sources below.
The variable costs
- Recruitment agency fee, if used — always payable by the employer under the Code of Practice, never the doctor. Structures vary (per-placement flat fee, retained search fee, or a pipeline/subscription arrangement) and are commercially negotiated rather than fixed by regulation.
- Relocation and settling-in support — flights, temporary accommodation, and orientation. No single reliable published average exists; treat it as a distinct budget line based on distance and the support package you offer.
- Time cost of clinical and HR staff running screening, interviews and induction — real, but rarely itemised separately in published cost research.
Independent and press coverage of NHS international-recruitment spend has reported widely varying per-hire totals between trusts and cohorts — driven mainly by whether expenses-paid overseas recruitment trips were used and by agency-fee structure. Treat any single reported average as illustrative of that specific cohort, not a universal benchmark for your own hire.
Frequently asked questions
What is the single biggest fixed cost of sponsoring a doctor on a visa?
For most Skilled Worker sponsorships it is the Immigration Skills Charge, currently charged per sponsored worker per year of the visa at a materially higher rate for medium/large sponsors than small ones (see GOV.UK for the current figures). Whether it applies to a given doctor’s role depends on the specific occupation code — the Health and Care Worker route does not automatically exempt every role from it, so check the current occupation-code list rather than assuming.
Is the Immigration Health Surcharge paid by the employer or the doctor?
It is a visa-application cost paid by the applicant, but Health and Care Worker visa holders are exempt from it entirely, per NHS Employers’ own guidance. Some employers choose to reimburse visa-related costs as part of a relocation package even where they are not legally required to pay them directly.
Does the Certificate of Sponsorship fee change by visa route?
No — the standard Worker Certificate of Sponsorship fee applies per sponsored worker regardless of whether the sponsorship is under the standard Skilled Worker route or the Health and Care Worker sub-category. Check GOV.UK for the current fee, as Home Office fees are revised periodically.
Are agency fees on top of, or instead of, these government charges?
On top. Government and Home Office charges (sponsor licence, CoS, ISC where it applies) are fixed regardless of recruitment method; an external recruitment agency fee is a separate, negotiated cost for sourcing and screening candidates, and varies by agency and contract structure. Under the Code of Practice, this fee is always paid by the employer, never the doctor.
What does relocation typically add?
Flights, initial accommodation, and settling-in support are real, employer-side costs that vary widely by trust and by how far the doctor is relocating from — there is no single reliable published average, so budget it as a distinct line item rather than folding it into visa costs.
Sources & further reading
These are the primary, official sources for everything on this page. Where figures appear, confirm the current value at the source before relying on it.
- GOV.UK — Get a licence to sponsor a worker visa
How an employer applies for and holds a sponsor licence, including current sponsor-licence fees by organisation size.
- GOV.UK — Immigration Skills Charge guidance for employers
Which occupation codes are exempt from the Immigration Skills Charge and the current per-worker, per-year rates.
- GOV.UK — Pay for UK healthcare as part of your immigration application
The current Immigration Health Surcharge rate and which visa routes are exempt.
- NHS Employers — Skilled Worker: Health and Care Visa
Employer-facing guidance confirming the Health and Care Worker visa’s exemption from the Immigration Health Surcharge, and its other cost differences from the standard Skilled Worker route.
- NHS Employers — International Recruitment Toolkit
Practical guidance for NHS organisations recruiting overseas: ethical sourcing, pastoral support, onboarding.