Ethics and regulation
Taking on non-UK dentists and staff members
The UK has historically been a country that has attracted dentists from all over the world to work here. Practice owners need to be aware of the rules and regulations governing the work of non-UK-qualified dentists in the UK. There are different systems for the recognition of professional qualifications and the permission to work from an immigration point of view. These, for many years, have depended on whether a dentist is a national of an EU/EEA country or not, and where they obtained their qualification.
As of 2021, immigration requirements for dentists from the EU/EEA and from other parts of the world are expected to be mostly the same. The UK government is introducing a new ‘points-based’ immigration system based on level of qualification, level of salary, English language requirements and job offer.
This article focuses on immigration arrangements for dentists and staff from abroad, not on the recognition of professional qualifications. The arrangements are still subject to change.
The BDA cannot advise its members on immigration matters. Immigration advisers must be registered with the Office of the Immigration Services Commissioner, which the BDA is not. We can therefore only signpost members to relevant information. Below is a general overview of immigration requirements, but further advice on individual situations needs to be sought from other sources.
Dentists with EU/EEA nationality have to date been able to work in any sphere of practice without a visa, subject to GDC registration and inclusion in NHS lists as applicable. At the time of writing (November 2020), there is only one month left until the Brexit transition period will end, which will end the free movement for EU/EEA nationals to the UK and UK nationals to the EU/EEA. This will result in changes to the requirements for recruitment.
If you currently have staff members (dentists or DCPs) who are nationals of an EU/EEA country, you should encourage them to apply to the EU Settlement Scheme. The scheme provides EU citizens who have been in the UK for five years or more with settled status, and those who have been here for a shorter time with pre-settled status, with a view to obtaining settled status later. The deadline for applications is June 2021, but individuals are advised to apply sooner rather than later as processing times might be longer than usual due to work arrangements under the pandemic. All EU/EEA nationals must apply by the deadline no matter how long they have been in the UK.
Dentists and other staff members who are nationals from outside the EU/EEA currently usually need a work visa unless they have the right to work here through family circumstances. The majority of overseas dentists are likely to require a Tier 2 visa, with the need for a sponsor, which will usually be the dental practice.
In the course of 2020, the government introduced a new Health and Care visa, for which dentists from overseas are eligible. This is part of the Skilled Worker Route but benefits from fast-track assessment and an exemption from having to pay the healthcare surcharge.
From 2021, visa requirements also apply to EU/EEA citizens.
Overseas students who have qualified in the UK with a dental degree do not currently have an automatic right to work in the UK, in terms of immigration. Dentists are usually able to undertake dental foundation training, with the visa for that year supported by Health Education England or other related authorities. If they intend to remain in the UK thereafter, they will then have to change to a sponsored Tier 2 visa.
Under the proposed arrangements from 2021, a new graduate immigration route will be available to international students who have completed a degree in the UK from summer 2021. They will be able to work, or look for work, in the UK at any skill level for up to 2 years, or 3 years if they are a PhD graduate.
Becoming a sponsor
Sponsorship involves applying to the Home Office for a sponsorship licence and making certain commitments with regard to supporting the overseas dentist as well as monitoring their compliance with their visa conditions.
At the moment, a practice intending to sponsor an overseas dentist needs to demonstrate that no other applicant who already has the right to work in the UK was suitable for the job (‘resident labour market test’). It is expected that the RLMT will no longer be required from 2021.
There is also a minimum salary requirement linked to obtaining a Tier 2 visa. The Home Office will wish to see information about salary arrangements.
The proposed changed immigration rules suggest a £26,500 minimum salary for all skilled workers; in dentistry there is also a professional pay scale which defines minimum salaries for a number of roles within dentistry. The expected minimum salary levels should not usually be an issue for dentists, but for dental practices struggling to find, for example, dental nurses, this requirement may be difficult to meet.
Dentists and other staff members who are on a Tier 2 visa should ideally have an employment contract rather than working on a self-employed basis, although this may be possible under certain circumstances; sponsors should take further advice.
Usually after five years, dentists who hold Tier 2 visa can apply for indefinite leave to remain (ILR) and the need for a visa will then cease.
Other things to consider
If you take on a dentist to work in NHS general dental practice, they will need further training – performer list validation by experience (PLVE) in England and Wales, or working as an assistant in Scotland and Northern Ireland until they can show VT equivalence. Even if a dentist does not need a visa, these arrangements usually necessitate an employment contract.