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Shortage Occupation List review – what the health sector needs to know

The Migration Advisory Committee (MAC) has published its long-awaited, full review of the Shortage Occupation List (SoL). We consider the recommendations made by the MAC and highlight those of particular relevance to your sector.

Shortage Occupation List

The SoL is a list of occupations that do not have enough settled workers in the UK to fill available jobs in particular sectors. It is a way of prioritising jobs where shortages are most severe and where the consequences of not filling the vacancies are most serious. These jobs are then given preferential treatment when a UK company is trying to sponsor a non-EEA migrant to fill the vacancy.

The last review of the SoL was conducted by MAC in 2013, since then there have been a number of developments to the UK labour market – unemployment is lower, vacancies are higher but free movement is no longer plugging the gap that it once did.

There are a number of benefits to occupations being placed on the SoL list, both for migrants and for employers:

1.    Resident Labour Market Test

A Resident Labour Market Test does not need to be carried out before filling a job shortage that is included on the SoL. This means employers do not need to demonstrate that they have attempted to recruit the position domestically before hiring a migrant – saving time and money on recruitment processes. However, to fill a vacancy for a nurse, even though it is on the SoL, employers must still carry out a Resident Labour Market Test.

2.    Salary Threshold

Occupations on the SoL do not need to meet the minimum £35,800 salary threshold required for settlement in the UK after five years. This requirement is also waived if the job has been on the SoL in the previous 5 years. Jobs on the SoL do still have to meet the same salary thresholds as Tier 2 (General) applicants. The current threshold is £30,000 for experienced workers and can be as low as £20,800 for new entrants in certain occupations. The salary thresholds for applicants in the health and education sector are based on the national pay scales.

3.    Priority

Roles on the SoL are prioritised if the limit of new entrants under Tier 2 (General) of 20,700 is reached. Occupations on the SoL are automatically granted 320 points out of a maximum 480, which is a higher level than could possibly be achieved by occupations not on the SoL such that these roles are prioritised for recruitment by the Home Office.

4.    Fees

Applicants and their families will pay lower visa application fees if their occupation is on the SoL.

The MAC report highlights the widely reported struggles that the healthcare sector iscurrently facing. Despite increasing employment, vacancy rates continue to rise due to the increasing demand for healthcare as a result of a growing and ageing population in the UK. The report reaffirms that migration has made an important contribution to the sector workforce and will continue to do so.

The most common responses to recruitment issues was a low level of applications, a lack of the required skills, too much competition from other employers and the undesirable nature of shift work and unsociable hours. In addition, long-term concerns relate to a shortage of medical school places. Given it can take 10 years from starting a medicine degree to get to a specialist post, increased University applicants is unlikely to solve the labour shortage in the short-term.


The MAC report makes the following recommendations:

  • Medical practitioners – recommend expanding to include the entire occupation and not just limited roles relating to emergency medicine and psychiatry as is largely the current position;
  • Psychologists –which is not currently on the SoL;
  • Medical radiographers – recommend expanding to include the entire occupation;
  • Occupational therapists – recommend adding the entire occupation to the SoL;
  • Speech and language therapists – adding the entire occupation to the SoL (this was removed from the list in 2011);
  • Nurses – recommend no change to the existing SoL eligibility, therefore employers must still carry out a RLMT; and
  • Social workers – recommend expanding to include entire occupation to the SoL and not just social workers working in children’s and family services.

The MAC report also proposes the removal of ‘health professionals not elsewhere classified’ of which, the most common job titles in this occupation code are orthotists/prosthetists and dieticians.

On the whole, the recommendations serve to broaden the range of roles in the sector on the SoL in an effort to bring the UK’s skilled immigration system in line with the struggles faced by employers in the healthcare sector.


These recommendations put forward by the MAC will be considered by UK Visas and Immigration. It is expected that these will be accepted and an updated SoL implemented in the near future making it easier to recruit from overseas into a wider range of hard to fill roles.

If you require further information regarding sponsorship of non-EEA nationals or other visa matters, please get in touch.

Please note that this briefing is designed to be informative, not advisory and represents our understanding of English law and practice as at the date indicated. We would always recommend that you should seek specific guidance on any particular legal issue.

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