Health and Care Worker Visa: A Complete Guide for UK Care Providers
The Health and Care Worker visa is the part of the Skilled Worker route for eligible doctors, nurses, health professionals and adult social care roles. It offers lower visa fees and no Immigration Health Surcharge. Since 22 July 2025, care workers and senior care workers can only be sponsored if they are already in the UK, and that option closes on 22 July 2028.
Overseas recruitment of care workers closed on 22 July 2025. In-country switching runs until 22 July 2028.
This guide covers eligibility, how sponsorship works now, salary and English rules, dependants, settlement and your duties as a sponsor. Last reviewed September 2026.
Update: overseas recruitment of care workers ended on 22 July 2025
Since 22 July 2025, new visa applications from outside the UK for care worker and senior care worker roles have been closed. People already working legally in the UK can still switch into these roles until 22 July 2028, provided they have worked for their sponsor for at least three months before they apply, and existing visa holders can continue to extend.
Parts of this guide were written before that change. Check the current rules on GOV.UK before you assign a Certificate of Sponsorship.
What Is the Health and Care Worker Visa?
The Health and Care Worker visa is part of the Skilled Worker route. It is for people with a job offer from a licensed sponsor in an eligible health or adult social care role, such as doctors, nurses, allied health professionals and some care roles.
It was introduced in 2020 to make it quicker and cheaper for the NHS and the care sector to recruit. The main advantages over a standard Skilled Worker visa are lower fees and no Immigration Health Surcharge.
Key features of the Health and Care Worker visa include:
Lower visa application fees than the standard Skilled Worker visa
No Immigration Health Surcharge for the worker or their eligible dependants
Decisions usually within 3 weeks from outside the UK, or 8 weeks from inside
Care workers (SOC 6135) and senior care workers (SOC 6136) limited to in-country applications since 22 July 2025
A route to settlement, currently after five years for eligible workers
The visa operates under the skilled worker visa framework, so care providers must hold a Home Office sponsor licence and meet every sponsor duty, including right to work checks, record keeping and reporting.
Who Is Eligible: Occupations, English, Salary and Sponsorship
Eligible Occupation Codes (SOC Codes)
The Health and Care Worker visa is available for specific occupations defined by Standard Occupational Classification (SOC) codes.
The eligible occupations include:
- Care workers and home carers (SOC 6135), in-country applications only
- Senior care workers (SOC 6136), in-country applications only
- Registered nurses and midwives
- Doctors and other regulated health professionals
- Allied health professionals, such as physiotherapists and occupational therapists
For the most current list of eligible occupations, refer to the GOV.UK Health and Care Worker visa page and the current list of eligible occupations.
English Language Requirements
Applicants must prove they can read, write, speak and understand English to the required level.
What is required:
- CEFR level B2 for most applications made from 8 January 2026
- B1 still applies to workers extending or updating a Health and Care Worker visa they held before 8 January 2026
- Evidence can be an approved Secure English Language Test, a degree taught in English, or nationality of a majority English-speaking country
Workers switching from a Skilled Worker visa do not need to prove their English again.
Minimum Salary Thresholds
Salary rules depend on the occupation code for the role.
The current rules are:
- Care workers and senior care workers: at least £25,000 a year and £12.82 an hour, or the going rate if higher
- Most other eligible roles: the higher of the general salary threshold and the going rate for the occupation
- Many NHS roles: the national pay scale rate is used as the going rate
Only guaranteed basic pay counts, and it must match the certificate for the whole period of sponsorship. Going rates are usually updated in April, so check GOV.UK each time.
Certificate of Sponsorship (CoS)
A certificate of sponsorship is an electronic record assigned by a licensed sponsor. It confirms the job, SOC code, salary and hours. The worker needs its reference number to apply, and every detail must match the contract and payroll.
Health and Care Worker Visa vs Skilled Worker Visa
Whilst the Health and Care Worker visa operates within the skilled worker framework, there are important differences between the two routes:
Visa Fee:
Health and Care Worker visa applicants pay a lower application fee than standard Skilled Worker applicants. Fees usually change each April, so check the current amounts on GOV.UK.
Immigration Health Surcharge (IHS):
Health and Care Worker visa holders and their eligible dependants do not pay the Immigration Health Surcharge. Standard Skilled Worker applicants pay it for each year of their visa, which is a significant saving on a five year visa.
Eligible Roles:
The Health and Care Worker visa covers eligible health and adult social care roles only. Care workers and senior care workers can apply only from inside the UK, until 22 July 2028. The Skilled Worker visa covers a much wider range of occupations.
Processing Time:
Decision times are similar for both routes: usually within 3 weeks for applications made outside the UK and 8 weeks for applications made inside the UK.
Settlement Pathway:
Both routes currently lead to settlement after five years, subject to the salary and other rules at the time of application. The government has proposed longer qualifying periods under an earned settlement model, which were not in force when this guide was last reviewed in September 2026.
Care Worker Visa Sponsorship: In-Country Rules to 2028
Who you can still sponsor for care roles, the three month rule, salary and English requirements, and how to plan beyond July 2028.
How to Get a Sponsor Licence
To sponsor anyone on the Health and Care Worker visa, including a care worker switching in-country, you must first hold a Home Office sponsor licence.
The Sponsor Licence Application Process
- Show that your organisation is genuine and operating lawfully in the UK
- In England, be registered with CQC and carrying on a regulated activity if you will sponsor care workers or senior care workers
- Apply online and send your supporting documents, usually within five working days
- Appoint an Authorising Officer, a Key Contact and at least one Level 1 User
- Have HR systems that track immigration status, right to work checks and attendance
- Pay the licence fee: £611 for small or charitable sponsors, £1,682 for medium or large sponsors
- Expect a decision within 8 weeks in most cases, or 10 working days with the £750 priority service
Costs and Compliance Duties
Your licence usually stays valid as long as you keep meeting the requirements. Each certificate of sponsorship carries a fee, and the Immigration Skills Charge may also apply. Once licensed, you must:
- Complete right to work checks before employment starts
- Keep the records listed in Appendix D of the sponsor guidance
- Report a worker who does not start, leaves or is absent without permission, usually within 10 working days
- Pay at least the salary stated on the certificate
- Make sure each worker does the job described on their certificate
- Co-operate with Home Office compliance visits
Appendix D Documents
Appendix D of the sponsor guidance lists the records you must keep for each sponsored worker, such as right to work evidence, contact details and pay records. Missing or incomplete records are a frequent finding at compliance visits and can lead to your licence being downgraded or suspended.
Skills for Care sets the benchmark for workforce development in adult social care.
Our guide covers the Workforce Development Fund, qualification frameworks, workforce planning, and how to access funded training.
How the Application Process Works in 2026
For Workers
Check eligibility: occupation code, salary and English, which is CEFR B2 for most new applicants
For care workers and senior care workers, be in the UK and have worked for the sponsor legally in the role for at least three months
Get the certificate of sponsorship reference number from the employer
Apply online and pay the visa fee; there is no Immigration Health Surcharge on this route
Prove identity, usually through the UK Immigration: ID Check app or at an appointment
Wait for a decision, usually within 3 weeks outside the UK or 8 weeks inside
Receive an eVisa, which has replaced the Biometric Residence Permit
For Care Providers (Employers)
Hold a sponsor licence and, in England, CQC registration if you will sponsor care roles
Confirm the role, SOC code and salary meet the current rules
For care workers, confirm the three month in-country employment rule is met
Assign a certificate of sponsorship through the sponsor management system
Complete right to work checks, keep the records and diary the visa expiry date
Health and Care Worker Visa Salary Requirements
Understanding current salary requirements is critical, as thresholds have been subject to significant change in recent years.
Current Salary Thresholds (2026)
- Care workers (SOC 6135) and senior care workers (SOC 6136): at least £25,000 a year and £12.82 an hour, or the going rate if higher
- Other eligible roles: the higher of the general salary threshold and the going rate for the occupation
- Many NHS roles: the national pay scale rate is used as the going rate
- Care roles no longer receive a discount through the Immigration Salary List
What Counts Towards Salary
- Guaranteed basic gross pay
- Hours worked, up to a maximum of 48 a week
- Pay stated on the certificate and paid through payroll
Overtime, bonuses, commission, accommodation and one-off payments do not count towards the salary threshold.
Dependants, Extensions and Settlement
Most Health and Care Worker visa holders can bring a partner and children under 18. Care workers and senior care workers are the exception: since 11 March 2024 they cannot bring dependants, except in limited cases.
Who Can Bring Dependants
- Doctors, nurses and other eligible health professionals can usually bring a partner and children under 18
- Care workers and senior care workers can only do so if they have been continuously employed and sponsored in the role since before 11 March 2024
- Limited exceptions apply, including a child born in the UK and some cases of sole parental responsibility
Dependants of Health and Care Worker visa holders do not pay the Immigration Health Surcharge, but they usually need to show they can support themselves unless the sponsor certifies maintenance.
Key Dates for Care Providers
The dates that changed sponsorship of care roles:
- 11 March 2024: care workers and senior care workers can no longer bring new dependants
- 11 March 2024: providers in England must be registered with CQC to sponsor care roles
- 22 July 2025: overseas recruitment of care workers and senior care workers closes
- 8 January 2026: English rises to CEFR B2 for most new applicants
Visa Extensions and Settlement
Extending Your Health and Care Worker Visa
A Health and Care Worker visa can be granted for up to five years at a time. To extend, the worker must:
- Apply before their current visa expires
- Have a new certificate of sponsorship from their current or new sponsor
- Still be in an eligible job and meet the salary rules
- For care roles, meet the conditions for workers already on the route
Applications made inside the UK are usually decided within 8 weeks.
Path to Indefinite Leave to Remain (ILR) and Settlement
Under the current rules, Health and Care Worker visa holders can usually apply for settlement (Indefinite Leave to Remain) after:
- Five years of continuous residence on the Health and Care Worker or Skilled Worker route
- Meeting the knowledge of English requirement (currently CEFR level B1)
- Passing the Life in the UK test
- Still being sponsored and paid at least the required salary when they apply
The government has consulted on an earned settlement model that would lengthen the qualifying period for many workers. When this guide was last reviewed in September 2026 these changes were not in force, so check GOV.UK before advising staff.
Continuous Residence Requirements
To count towards settlement, residence must be continuous. As a general rule, absences from the UK should not exceed 180 days in any 12 month period during the qualifying period.
Recent Changes to the Route (2024 to 2026)
The rules for care roles have changed several times since 2024. These are the changes with the biggest impact on care providers.
Overseas Recruitment Closed
From 22 July 2025, care workers (SOC 6135) and senior care workers (SOC 6136) can no longer be sponsored from outside the UK. In-country switching is allowed until 22 July 2028 after three months of lawful work for the sponsor.
Salary and English Rules
Care roles now need at least £25,000 a year and £12.82 an hour, or the going rate if higher. From 8 January 2026, most new applicants must prove English at CEFR level B2 rather than B1.
Dependants and Enforcement
Care workers have been unable to bring new dependants since 11 March 2024, when providers in England also had to be CQC registered to sponsor. The Home Office continues to revoke licences where sponsors breach their duties.
Compliance and Home Office Audits
As a licensed sponsor, you are subject to Home Office compliance checks and must keep strong records at all times.
Record Keeping Requirements
Keep the documents listed in Appendix D for every sponsored worker, for the period the sponsor guidance requires
Keep right to work check evidence, certificate records and employment contracts
Record changes to hours, pay, job duties and work location
Keep attendance records and up to date contact details for each worker
Reporting Duties
Report within 10 working days if a worker does not start, stops working for you, or is absent without permission for more than 10 consecutive working days
Report significant changes to your organisation within 20 working days
Report changes to a worker's job, salary or location where the guidance requires it
Respond promptly to Home Office requests for information
Home Office Audits
The Home Office carries out pre-arranged and unannounced compliance visits. Breaches can lead to:
Civil penalties of up to £60,000 per worker for employing someone without the right to work
Your licence being downgraded, suspended or revoked
A cooling-off period before you can apply for a new licence
Sponsored staff losing their permission to work for you
Right to Work Check
Carry out right to work checks before employment starts. For most sponsored workers this is now an online check using their eVisa share code, and you must keep a record of the result.
How Care Sync Experts Can Help
Care Sync Experts supports care providers with sponsor compliance and the wider workforce and regulatory picture. For advice on an individual worker's immigration application, we recommend an OISC-regulated immigration adviser or a solicitor. Our support includes:
Guidance through the application process, compliance management, and audit preparation
Health and Care Worker visa guidance:
Clear, up to date guidance on the rules, salary thresholds and sponsor duties that affect your service
For new providers planning their workforce from the start
Support with induction and the Care Certificate for new staff
Compliance audit support
Regular audits and documentation reviews to ensure Home Office compliance
Right to work training:
Staff training on conducting proper right to work checks and maintaining compliance records
For comprehensive support with Health and Care Worker visa sponsorship or to discuss your organisation's immigration and recruitment needs, contact Care Sync Experts today.
Frequently asked questions
Still have questions?
Can't find the answer you're looking for? Please chat to our friendly team.
Book a Free Consultation
Ready to take the next step? Speak to one of our care registration experts today. We will assess your situation, answer your questions, and give you a clear plan of action.
Book your free consultationLearn how we can support your success
Email: hello@caresyncexperts.co.uk
Phone: 0333 577 0877