This article explains the Health and Care Worker visa route under the UK’s Immigration Rules. It provides a detailed guide for UK employers, HR directors and business owners who are either considering applying for a sponsor licence to recruit from overseas or who already hold a licence and are looking to strengthen compliance. The route is designed to address shortages in the health and social care sectors by enabling qualified overseas workers to come to the UK to take up eligible roles.
What this article is about: This guide sets out the eligibility requirements for both employers and employees, the sponsorship process, the application procedure and the obligations that come with hiring under this visa category. It also covers costs, dependants and the settlement pathway. Employers will learn what is legally required of them as sponsors, how to manage compliance risk and how to use this visa strategically to support workforce planning.
The Health and Care Worker visa was introduced as part of the UK’s points-based immigration system to make it easier for overseas healthcare professionals to come to the UK. It is part of the Skilled Worker route but carries unique benefits, including reduced application fees, exemption from the Immigration Health Surcharge and lower salary thresholds to reflect skills shortages in the sector.
For employers, sponsoring Health and Care Workers is both a business opportunity and a legal responsibility. A sponsor licence must be obtained before overseas recruitment can begin, and once granted, it brings ongoing duties to monitor and report on sponsored employees. Non-compliance risks not only enforcement action but also the loss of the ability to sponsor staff in future.
This article will walk through the key aspects of the route in detail: what the Health and Care Worker visa is and how it compares to other visas; what employers need to do to sponsor workers; the process employees follow to apply; and how the visa leads to long-term settlement in the UK.
Section A: Understanding the Health and Care Worker Visa
The Health and Care Worker visa is a dedicated category within the UK’s points-based immigration system, introduced to meet critical workforce shortages in the health and social care sectors. It allows qualified overseas professionals to come to the UK to work in eligible roles across the NHS, adult social care and certain healthcare providers. The route has become an essential tool for UK employers who cannot fill vacancies domestically.
At its core, the visa operates under the Skilled Worker framework but with important differences tailored to the sector. While Skilled Worker visas apply broadly across many industries, the Health and Care Worker visa is limited to specific occupations such as nurses, care workers, senior care workers, health professionals and certain social care roles. These roles are set out in the Home Office’s Appendix Skilled Occupations and supported by the Immigration Salary List (ISL).
1. Which roles and sectors qualify
Eligible roles span a wide range of healthcare and care positions, including but not limited to:
- Adult social care workers, including care assistants and home carers
- Senior care workers in residential and nursing homes
- Registered nurses in multiple specialisms
- Paramedics
- Allied health professionals such as radiographers, social workers and occupational therapists
Employers should note that eligibility is determined not only by job title but also by the Standard Occupational Classification (SOC) code assigned to the role. Careful role-matching is critical to ensuring that a Certificate of Sponsorship can be issued lawfully.
2. Differences from the Skilled Worker visa
There are several key distinctions that make the Health and Care Worker visa more attractive than the general Skilled Worker route:
- Lower salary thresholds: The minimum salary requirement is reduced for qualifying roles, with care roles subject to the £25,000 discounted rate.
- Faster processing: Health and Care applications are prioritised, with a standard decision time of around three weeks.
- Exemption from the Immigration Health Surcharge: Applicants and their dependants are not required to pay this fee.
- Reduced visa fees: Government fees are lower compared with other Skilled Worker applications.
3. Key advantages for employers and employees
For employers, the Health and Care Worker visa reduces financial and administrative barriers to overseas recruitment. For employees, it provides a more affordable and streamlined route to live and work in the UK, with the added security of a path to settlement.
These unique features make the Health and Care Worker visa a cornerstone of UK immigration policy in supporting the NHS and the wider social care sector, where demand for qualified staff remains consistently high.
Section A Summary
The Health and Care Worker visa is a specialised sub-route of the Skilled Worker visa, designed to address shortages in health and social care. It offers lower salary thresholds, faster processing, reduced fees and exemption from the Immigration Health Surcharge. Employers must ensure that roles fall within the list of eligible occupations and that the correct SOC codes are applied. Understanding the scope and benefits of this visa is the first step in developing a compliant and effective overseas recruitment strategy.
Section B: Employer Sponsorship Duties
To recruit under the Health and Care Worker visa route, UK employers must hold a valid sponsor licence issued by the Home Office. This authorisation is the legal gateway through which businesses can hire overseas workers. Without a licence, employers cannot issue Certificates of Sponsorship (CoS), and candidates cannot apply for their visas.
1. Sponsor licence requirement for employers
A sponsor licence is not a one-off approval but an ongoing authorisation subject to strict compliance obligations. Employers must apply to the Home Office, provide evidence of their trading presence and demonstrate that they have the systems in place to manage sponsorship responsibly. For health and care employers, this often includes demonstrating regulatory registration, for example with the Care Quality Commission (CQC).
2. Eligible occupations and Immigration Salary List roles
The licence only permits employers to recruit into eligible roles that meet the Immigration Rules. These include adult social care workers, senior care workers, nurses, paramedics and other designated health professionals. Many of these positions are also included on the Immigration Salary List (ISL), which provides more favourable salary thresholds. Employers should check the ISL regularly, as it is updated to reflect changes in labour market demand.
3. Salary thresholds and July 2025 updates
The Home Office applies minimum salary thresholds to ensure roles are not undercutting the UK labour market. The current levels, as of 22 July 2025, are:
- General Skilled Worker threshold: £41,700
- Health and Care Worker discounted threshold: £25,000
- Transitional threshold (for Skilled Worker visa holders sponsored before April 2024): £31,300
Employers must ensure that the salaries offered meet or exceed these levels, unless an exception applies, such as NHS pay scales or where roles are on the ISL. Failure to meet salary rules will result in visa refusals and potential compliance scrutiny.
4. Compliance obligations under the sponsor licence regime
Holding a sponsor licence brings with it a series of statutory duties, including:
- Reporting changes to sponsored workers’ circumstances (e.g. changes in role, location or early termination of employment)
- Conducting and retaining prescribed right to work checks under the Immigration (Restrictions on Employment) Order 2007
- Maintaining accurate HR records, including absence monitoring
- Ensuring that recruitment is genuine and not primarily for the purpose of enabling immigration
The Home Office can audit employers at any time. Inspections may be unannounced, particularly in the care sector, where compliance is under close scrutiny.
5. Risks of non-compliance
If an employer fails to meet their sponsorship obligations, the Home Office may suspend or revoke their sponsor licence. This can result in sponsored workers losing their visas, leaving the business without key staff. Civil penalties may also be issued for breaches of right to work rules, with fines of up to £60,000 per illegal worker for repeat breaches. In serious cases, criminal liability may also arise.
Section B Summary
Employers must secure and maintain a sponsor licence to recruit Health and Care Workers from overseas. This involves meeting eligibility criteria, paying sponsored workers at or above the relevant thresholds and adhering to strict compliance obligations. Non-compliance risks severe sanctions, including financial penalties and the loss of the ability to recruit from overseas. Understanding and managing sponsorship duties effectively is therefore central to any employer’s recruitment strategy.
Section C: Application Process and Employee Considerations
Once an employer has secured a sponsor licence, they can begin the process of recruiting overseas workers under the Health and Care Worker visa route. For applicants, the process is structured but demands careful preparation to ensure that all requirements are satisfied.
1. Step-by-step application process for workers
The main stages of the application process are:
- Certificate of Sponsorship (CoS): The sponsoring employer issues a valid CoS to the applicant. This document confirms the role, salary, SOC code and employer details. It is an electronic record, not a physical certificate.
- Visa application: The applicant applies online for the Health and Care Worker visa, using the CoS reference number.
- Supporting documents: Applicants must submit proof of identity, qualifications (where relevant) and evidence of English language ability.
- Biometrics: Applicants usually attend a visa application centre to provide fingerprints and a photograph, unless using the UK Immigration: ID Check app.
- Decision: Most Health and Care Worker applications are processed within three weeks, reflecting the Home Office’s priority processing commitment.
2. Certificate of Sponsorship requirements
Employers must ensure the CoS is accurate and compliant. Errors, such as incorrect SOC codes or mismatched salary figures, can lead to refusals. Each CoS must be issued via the Sponsor Management System (SMS), and employers should only assign certificates when a genuine vacancy exists.
3. English language and financial maintenance requirements
Applicants must demonstrate English language ability through an approved test, a degree taught in English or nationality from an English-speaking country. Maintenance requirements are also in place, though many employers choose to certify maintenance on the CoS, relieving the applicant from providing financial evidence.
4. Application fees and Immigration Health Surcharge exemption
The Health and Care Worker visa carries reduced government fees compared with the general Skilled Worker visa. Crucially, applicants and their dependants are exempt from paying the Immigration Health Surcharge, which can otherwise add thousands of pounds in upfront costs. This exemption makes the visa highly attractive to overseas professionals.
5. Dependants: eligibility, rights and conditions
Visa holders may be joined by dependants, including partners and children under 18. Dependants enjoy full rights to work (except as professional sportspeople) and study in the UK. Employers should be aware that dependant applications are assessed alongside the main applicant, and changes to the main applicant’s visa status will impact dependants.
Note: Since 11 March 2024, overseas care workers and senior care workers sponsored under SOC codes 6145 and 6146 can no longer bring dependants to the UK. This restriction does not apply to other Health and Care Worker visa applicants, such as nurses and paramedics.
6. Right to work and switching visa categories
Successful applicants will be granted permission to live and work in the UK for up to five years, depending on the terms of sponsorship. Right to work checks must be carried out before employment begins in accordance with statutory Home Office guidance. Workers on other visas may be able to switch into the Health and Care Worker visa from within the UK, provided they meet eligibility requirements.
Section C Summary
The application process for the Health and Care Worker visa requires coordination between the sponsoring employer and the applicant. From issuing a valid Certificate of Sponsorship to ensuring English language and financial requirements are met, both parties play a role in securing approval. Reduced fees, faster processing and the Immigration Health Surcharge exemption make this visa one of the most accessible and cost-effective routes for overseas healthcare professionals. Employers must, however, remain vigilant in ensuring right to work compliance and accurate documentation throughout the process.
Section D: Settlement, ILR and Long-Term Planning
For many overseas professionals, the Health and Care Worker visa is not only a means to work in the UK but also a pathway to long-term settlement and, ultimately, British citizenship. For employers, understanding how the settlement rules apply is essential for workforce planning and for supporting employees through their immigration journey.
1. Eligibility for Indefinite Leave to Remain (ILR)
Health and Care Workers may apply for ILR once they have completed five years of continuous residence in the UK under this visa or a combination of eligible routes. ILR grants permanent status, removing restrictions on employment and residence. To qualify, the applicant must still be employed in a qualifying health or social care role at the time of application and must meet the relevant salary requirements.
2. Continuous residence requirements
The five-year residence period must generally be continuous, meaning the applicant cannot have been outside the UK for more than 180 days in any rolling 12-month period. Employers should be mindful of this when approving extended absences or overseas assignments, as excessive time outside the UK can jeopardise settlement eligibility.
3. Absences and breaks in employment
Breaks in employment or a change of sponsor can also affect continuous residence. If an employee switches employers, they must obtain a new visa sponsored by their new employer. As long as this is done lawfully, time accrued under the Health and Care Worker visa will still count towards ILR. However, gaps in lawful status or periods of unemployment may break continuity.
4. Pathway to British citizenship
Once ILR is granted, many employees will choose to apply for British citizenship after a qualifying period, usually one year. Citizenship offers additional benefits, including the right to a British passport and full civic rights. Employers should be aware that many employees see this as their long-term goal, and supporting them through the process can help with retention and engagement.
5. Employer planning for long-term workforce retention
From an HR perspective, the settlement pathway presents an opportunity to strengthen loyalty and reduce turnover. Employers who proactively assist employees in maintaining continuous residence, monitoring visa expiry dates and preparing for ILR can position themselves as supportive and attractive employers. This, in turn, can reduce recruitment costs and ensure stability in a sector often marked by high vacancy levels.
Section D Summary
The Health and Care Worker visa provides a clear path to ILR and British citizenship, making it an appealing option for overseas healthcare professionals. Employers who understand the settlement rules can better support their staff and plan for long-term workforce needs. By ensuring continuous residence, monitoring compliance and assisting with ILR applications, employers can foster loyalty and retain critical staff in an increasingly competitive labour market.
FAQs
1. How long does it take to process a Health and Care Worker visa?
Most applications are decided within three weeks of the applicant providing their biometrics. The route is classed as a priority by the Home Office, making it faster than many other visa categories.
2. Can dependants work in the UK on this visa?
Yes. Dependants, including a partner and children under 18, are permitted to work and study in the UK without restriction, except that they cannot work as professional sportspersons. However, since 11 March 2024, care workers and senior care workers sponsored under SOC codes 6145 and 6146 cannot bring dependants to the UK.
3. What happens if the employee changes employer?
If a sponsored worker changes jobs, they must apply for a new visa with a Certificate of Sponsorship from the new employer. Time spent on the Health and Care Worker visa with different employers can still count towards settlement, provided there are no gaps in lawful status.
4. Is the Immigration Health Surcharge waived for all applicants?
Yes. Both the main applicant and any dependants are exempt from the Immigration Health Surcharge under this route. This exemption applies for the entire period of the visa.
5. What if the sponsor licence is revoked?
If the sponsoring employer loses their licence, any visas linked to that licence will be curtailed. Employees will typically have 60 days (or until the visa expiry date if sooner) to secure a new sponsor and make a fresh application. Employers must therefore maintain compliance to protect their sponsored workforce.
Conclusion
The Health and Care Worker visa has become a cornerstone of the UK’s immigration system, addressing workforce shortages in health and social care while providing employers with an accessible route to recruit from overseas. For UK employers, the benefits of this visa route are significant: reduced salary thresholds, fast-tracked applications and exemption from the Immigration Health Surcharge all combine to make it one of the most cost-effective and practical solutions for filling critical vacancies.
However, with these opportunities come responsibilities. Employers must secure and maintain a sponsor licence, meet salary and eligibility requirements and remain vigilant in their compliance obligations. The risks of non-compliance are substantial, ranging from civil penalties of up to £60,000 per illegal worker to the loss of the ability to sponsor staff.
From an HR perspective, this visa route should not only be viewed as a recruitment tool but also as a long-term workforce planning strategy. Supporting employees through their visa applications, settlement and eventual path to citizenship can strengthen retention, reduce recruitment costs and position the employer as a responsible and attractive organisation to work for.
In summary, the Health and Care Worker visa offers a vital pathway for UK employers to address staffing shortages while also fostering long-term workforce stability. By understanding and embracing their obligations under the scheme, employers can make the most of this visa route to secure the skilled staff they need now and in the future.
Glossary
| Certificate of Sponsorship (CoS) | An electronic record assigned by a licensed sponsor to a migrant worker, enabling them to apply for a visa. |
| Indefinite Leave to Remain (ILR) | Immigration status granting permanent residence in the UK without time restrictions. |
| Sponsor Licence | Authorisation issued by the Home Office that permits UK employers to hire overseas nationals under specific visa routes. |
| Immigration Health Surcharge (IHS) | A fee usually paid by visa applicants for access to NHS services. Health and Care Worker visa applicants and their dependants are exempt. |
| Immigration Salary List (ISL) | A list of job roles identified by the Home Office as eligible for lower salary thresholds due to recruitment shortages. |
| Standard Occupational Classification (SOC) Code | A code used by the Home Office to classify job roles for visa eligibility and compliance purposes. |
Useful Links
| GOV.UK – Health and Care Worker visa guidance | https://www.gov.uk/health-care-worker-visa |
| GOV.UK – Register of licensed sponsors | https://www.gov.uk/government/publications/register-of-licensed-sponsors-workers |
| GOV.UK – Sponsor guidance for employers and educators | https://www.gov.uk/government/collections/sponsorship-information-for-employers-and-educators |
| DavidsonMorris – Health and Care Visa | https://www.davidsonmorris.com/health-and-care-visa/ |
| Xpats.io – Health and Care Visa | https://www.xpats.io/health-and-care-visa/ |
Author
Gill Laing is a qualified Legal Researcher & Analyst with niche specialisms in Law, Tax, Human Resources, Immigration & Employment Law.
Gill is a Multiple Business Owner and the Managing Director of Prof Services - a Marketing & Content Agency for the Professional Services Sector.
