What to Expect After Receiving an NHS Offer Letter

8 Minutes

Have you recently received an offer letter from the NHS offering you a medical role in the UK? If so – congratulations! Working for the NHS comes with plenty of excellent benefits, and with the right planning and support, you are sure to enjoy your new life in the UK before too long.

Of course, after receiving the letter, there are a handful of responsibilities you must deal with first. Luckily, we have broken down the process to make the journey from receiving an NHS offer letter to starting your first day on the job as straightforward as possible. As a general rule, this process should take between three and four months.

Step One: Checking the Offer Letter and Acceptance

The first step is refreshingly simple: check the offer letter, ensuring that every detail is correct, and then accept it if everything is in good order. Make sure you are fully happy with the letter and the move before confirming. You can do this within a day.

Step Two: Collating Documents for Your CoS

International medical graduates need a certificate of good standing to prove to your NHS trust that they have the experience and skills necessary to work for the NHS. This part should take between two and three weeks.

To obtain your CoS, you will need your passport, two references, a police clearance certificate, and GMC registration evidence. The references should be from previous employers – you can either obtain two reference letters with hospital stamps or allow the NHS trust’s HR department to contact them for confirmation. You’ll also need to prove your English language knowledge.

Remember to keep all of these documents organised at every step of the relocation journey. Ideally, keep a digital and physical copy of each document to ensure you always have one on hand.

Step Three: Getting Your Visa, Travel Vignette, and BRP

For step three, you’ll need to acquire your visa, travel vignetter, and BRP.

Start with the Visa. You’ll be applying for the health and care skilled worker visa, which allows you three years of stay (although you can apply for one that lasts longer, which costs more). To obtain this visa, you will need the following:


You should already have your CoS on hand after step two.

Police Clearance Certificate

Again, you’ll need to show your police clearance certificate, showing your criminal history for anywhere you’ve lived in the past ten years for more than twelve months.

Tuberculosis Test Clearance Certificate

You’ll need a tuberculosis test clearance certificate if you travel from certain countries. These countries include Angola, Belarus, Iraq, India, South Africa, and many more – it’s important to check whether you’ll need it.


Some IMGs need to prove that they have at least £945 in their account 90 days before the application, with dependents needing £630. You don’t need this if the hospital has ticked the ‘yes’ box on your CoS.

Proof of English Knowledge

Lastly, you’ll need to prove your English knowledge to obtain your health and care skilled worker visa.

Once you have applied for the visa and received confirmation, you will need to attend a biometrics appointment. This appointment involves taking your fingerprints, and you’ll need to bring your verified documentation and passport along with you.  

Step Four: Prepare to Travel

At this stage, you need to organise transportation and short-term accommodation. That includes booking flights, organising airport transfers, booking short-term accommodation, and packing everything you need. Don’t forget to collate all your documents. Ideally, keep them all in a single place, so you always have them on hand!

Step Five: Arriving in the UK

The last step involves arriving in the UK. Once you’ve landed, you need to complete a couple of tasks before starting your first day on the job as an NHS doctor. They include the following:

  • Collect BRP
  • Visit the Police Station
  • Attend an Occupational Health Appointment
  • Attend a GMC ID Check
  • Get your ID Checked at the HR Department
  • Set Up a Bank Account
  • Research the UK and the Cost of Living

All of this should take around two weeks.

Living in the UK might be a culture shock for you in many ways, so it helps to embark on research before you land there. Remember that the UK is made up of many different cities – living in one area might be vastly different from living somewhere else in the UK, so research exactly where you’ll be staying, whether that’s London, Cardiff, or Leeds. Also, keep in mind that the NHS offers relocation packages to some candidates, which can help with the initial cost of living.

Step Six: Attending Your Induction and First Day

After all of this, you’re ready to start your new NHS job in the UK! Your induction day is to show you how things work – during this day, you’ll learn your responsibilities, the colleagues you’ll be working with, and anything else relevant to your role. Remember to ask questions.

Following your induction, it will be your first day on the job. Even at this stage, you’re still on a journey, and it might take a while to settle into your role. If you have any questions or want to join a community of IMGs similar to you, we have plenty of resources for IMGs at any stage of their journey.

Let BDI Resourcing Guide You Through Your Relocation

The journey from accepting your NHS offer letter and starting your first day on the job is a long and sometimes complicated one. It helps to have someone on your side during this time – someone who can help you navigate the responsibilities so that you don’t miss anything. That’s what we offer. If you need assistance, you can speak to one of our expert advisors, who are always happy to help! We also have plenty of resources for international medical graduates relocating to the UK, including blogs on the UK cost of living, relocation packages, post-offer acceptance checklists, and more.