Certificate of Sponsorship, Explained for NHS Candidates

What a CoS actually is

A Certificate of Sponsorship is not a paper certificate — it is an electronic record with a reference number, assigned by a licensed sponsor (for the NHS, usually the trust employing you). It confirms to the Home Office that a genuine employer is sponsoring you for a specific role. You need it to apply for a Health and Care Worker or Skilled Worker visa.

Who needs one — and who doesn't

• You need a CoS if you are not a British or Irish citizen and don't already hold UK status that allows work (such as settlement, EU pre-settled/settled status, or a dependant visa with work rights).
• You do NOT need one if you already have the right to work in the UK — say so clearly in applications, because it makes you easier to hire.
• Students switching from a Student visa and people already on a Skilled Worker visa moving trusts still need a new CoS for the new role.

The process, from offer to visa

• 1. Conditional offer — you pass the interview and accept the role.
• 2. Pre-employment checks — references, occupational health, DBS, professional registration.
• 3. The trust assigns your CoS — you receive the reference number by email.
• 4. You apply for the visa online using that number, pay the fee (the IHS is waived on the Health and Care Worker visa), and book biometrics.
• 5. Decision — often within about three weeks outside the UK; then you travel and start.

Realistic expectations

• The employer assigns the CoS — you cannot buy one, and you cannot apply for one yourself. Anyone selling a CoS is committing fraud.
• A CoS is tied to one role at one sponsor. Changing employers means a new CoS and usually a new visa application.
• Timelines vary: pre-employment checks are usually the slowest part, not the visa itself.
• Ask the trust's recruitment team — not agents — about where your CoS is in the process. It's a normal question; they answer it every day.

The scams to avoid

• Anyone charging you money 'for a CoS' or 'to guarantee sponsorship'. Real sponsors never sell certificates.
• 'Agents' who ask for your passport or registration documents before you have a real, named job offer.
• Job adverts that promise visas before interviews. Real NHS recruitment interviews first, sponsors after.
• Pressure to pay 'processing fees' to individuals. Official fees are paid to gov.uk, on gov.uk.