The Health and Care Worker visa has been at the centre of some of the most significant changes to UK immigration in recent years, and both care providers and overseas workers in this sector are still feeling the impact. From restrictions on dependants to the end of new overseas recruitment for care workers and senior care workers, the landscape has changed considerably since 2024.
If you run a care business that sponsors overseas workers, or if you are currently working in the UK on a Health and Care Worker visa, this guide sets out where things stand and what you need to do.
Getting advice from experienced immigration lawyers uk at the right time can make a very significant difference to how these changes affect you, whether you are an employer trying to protect your licence or a worker planning your future in the UK.
What the Health and Care Worker Visa Is
The Health and Care Worker visa is a sub-route of the Skilled Worker visa. It was introduced to make it easier and more affordable for the NHS, NHS suppliers and eligible adult social care providers to recruit qualified staff from overseas.
The route carries important advantages compared with the standard Skilled Worker route. Eligible applicants benefit from reduced visa application fees and exemption from the Immigration Health Surcharge. Employers sponsoring eligible Health and Care Worker visa applicants are also exempt from the Immigration Skills Charge, which can otherwise cost up to £1,320 per year per worker for medium and large sponsors after the increase introduced in December 2025.
The roles that qualify for the Health and Care Worker visa are defined by occupation code and employer type. Eligible roles include doctors, nurses, allied health professionals, social workers, nursing auxiliaries and assistants, and some adult social care roles. However, not every role in a care or NHS setting qualifies.
The job must appear on the eligible occupation list and be offered by an eligible employer. This usually means the NHS, an organisation providing medical services to the NHS, or an organisation providing adult social care. In England, care workers and senior care workers must be sponsored by a provider registered with the Care Quality Commission and currently carrying on regulated activity, unless a narrow transitional exception applies.
Understanding SOC codes and job descriptions is the first step for any care provider considering sponsorship, because the wrong occupation code can create serious compliance problems.
What Has Changed Since 2024
The changes introduced from 2024 onwards have reshaped international recruitment in the care sector.
From 11 March 2024, care workers and senior care workers were restricted from bringing dependants to the UK, unless they fell within specific transitional or limited exception rules. This had a major impact on recruitment pipelines from countries where many applicants had previously relocated with family members.
From 22 July 2025, new overseas recruitment for care workers and senior care workers ended. This means new applicants outside the UK can no longer use the Health and Care Worker visa route to come to the UK for care worker or senior care worker roles. Some people already in the UK can still extend, update or switch into these roles if they meet the transitional requirements.
From 22 July 2025, the general Skilled Worker salary threshold increased from £38,700 to £41,700. The Health and Care Worker route has separate salary rules. Most Health and Care Worker roles must meet the relevant minimum threshold and the applicable going rate, which may be based on either national pay scales or specific occupation-code rates. If you have not reviewed the skilled worker sponsorship salary rules that apply to your workers’ occupation codes since these changes, you should do so now.
The Home Office has also significantly tightened its scrutiny of care providers holding sponsor licences. The care sector saw rapid growth in sponsor licence activity between 2021 and 2023, followed by serious concerns about worker exploitation, false vacancies, underpayment and poor sponsor compliance. Since then, the Home Office has increased enforcement action, including sponsor licence suspensions and revocations.
Official data for the year ending April 2026 shows Health and Care Worker visa applications from main applicants fell sharply compared with the previous year and were far below the 2023 peak. The fall reflects a combination of tougher policy rules, greater scrutiny of sponsors and enforcement action against non-compliant employers.
The Dependant Restriction for Care Workers
One of the most significant and most talked-about changes was the restriction on dependants for care workers and senior care workers.
From 11 March 2024, new care workers and senior care workers were no longer generally allowed to bring partners or children as dependants under the Health and Care Worker visa route.
There are limited exceptions. Dependants may still be able to apply where the main applicant has been continuously employed in the UK as a care worker or senior care worker and has held a Health and Care Worker visa or Skilled Worker visa since before 11 March 2024. There are also specific provisions for some children born in the UK, sole responsibility situations and cases where both parents are sponsored in relevant care roles and the child is applying to stay in the UK.
This is more limited than the dependant rules for many other Skilled Worker roles. It has had a significant practical impact on overseas applicants and on care providers’ ability to recruit internationally.
For workers currently in the UK without their family, it is worth getting advice on whether there are other immigration routes under which dependants may be able to join them. The skilled worker visa dependants guide covers how the dependant rules work more broadly, and where the boundaries of the care worker restriction sit.
Salary Requirements for Health and Care Roles in 2026
Salary requirements depend on the occupation code, the type of role, whether the role is linked to national pay scales, and whether any transitional rules apply. Always check the current going rate for the specific occupation code against the latest Home Office guidance before assigning a Certificate of Sponsorship.
The table below gives a general overview of commonly sponsored health and care roles.
| Role | SOC 2020 Code | Salary Basis | Eligible for Health and Care Worker Visa |
|---|---|---|---|
| Generalist medical practitioners | 2211 | National pay scale or relevant going rate | Yes |
| Specialist medical practitioners | 2212 | National pay scale or relevant going rate | Yes |
| Registered nurses and midwives | 2231 to 2237 | National pay scale or relevant going rate | Yes |
| Physiotherapists | 2221 | National pay scale or relevant going rate | Yes |
| Occupational therapists | 2222 | National pay scale or relevant going rate | Yes |
| Social workers | 2461 | National pay scale or relevant going rate | Yes |
| Nursing auxiliaries and assistants, including eligible healthcare assistant roles | 6131 | National pay scale, subject to role and setting | Yes |
| Care workers and home carers | 6135 | Specific transitional salary rules and going rates | No new overseas recruitment from 22 July 2025; limited in-country applications only |
| Senior care workers | 6136 | Specific transitional salary rules and going rates | No new overseas recruitment from 22 July 2025; limited in-country applications only |
Care workers and senior care workers were previously listed under SOC 2010 codes 6145 and 6146 for Certificates of Sponsorship assigned before 4 April 2024. Under the current SOC 2020 structure, the relevant codes are 6135 and 6136.
The immigration salary list may also be relevant in some cases, although the July 2025 changes significantly narrowed the availability of lower-skilled roles and introduced the Temporary Shortage List for certain transitional purposes.
What Care Providers Must Have in Place as Sponsors
If you run a care business and hold a sponsor licence, your compliance obligations under the skilled worker visa uk solicitors framework are the same core obligations that apply to other sponsors. However, the enforcement environment for care providers is much more intense.
The guide to running a sponsor licence for care providers sets out the specific considerations that apply to the care sector. At a minimum, you should have the following in place.
- Robust right to work checks carried out before every worker starts, with records kept in a format the Home Office can inspect
- Accurate and up-to-date records for every sponsored worker, including contracts, payslips, contact details, working hours and work locations
- Named key personnel on your sponsor licence who are actively involved in the business and understand their responsibilities
- A clear process for reporting changes to the Home Office, including absences, changes in role, changes in working hours and changes in work location
- An understanding of what business changes trigger sponsor reporting, including changes in ownership, CQC registration, trading status or business structure
Every Certificate of Sponsorship you assign must be accurate. The occupation code, salary, working hours, job description and work location must all reflect the actual role the worker will be doing.
If a worker ends up doing duties that do not match the role described on their Certificate of Sponsorship, this can become a compliance issue even if the salary is being paid correctly.
The Home Office Compliance Crackdown on Care Providers
The care sector has been a major focus of Home Office compliance enforcement activity. Sponsor licence compliance visits in this sector can result in suspension, downgrade or revocation where the Home Office finds serious failings.
Common findings during compliance visits to care providers include the following.
- Workers doing jobs that do not match the description on their Certificate of Sponsorship
- Workers being paid below the amount stated on the Certificate of Sponsorship
- Unlawful deductions, repayment clauses or arrangements that reduce actual pay below the required level
- Key personnel named on the licence who are no longer involved in the business
- Key personnel who do not understand sponsor duties
- Missing contracts, payslips, absence records or work location records
- Failure to report extended absences or changes in a worker’s role, hours or location
- Sponsored workers being sent to locations not properly reflected in the sponsor’s records
- Care providers operating in England without the required active CQC registration for the sponsored care role
The rules around workers operating across multiple sites are particularly relevant for domiciliary care providers. The multi-site and hybrid working guide covers what you need to have in place if your workers deliver care across different addresses.
What Happens If Your Licence Is Suspended or Revoked
If the Home Office suspends your licence, you cannot assign new Certificates of Sponsorship while the suspension is in place. Your current sponsored workers usually keep their visa status during the suspension, but the uncertainty creates obvious operational difficulties.
If your licence is sponsor licence revoked, the consequences are far more serious. Sponsored workers can have their permission curtailed, usually to 60 days or to the end of their visa if less than 60 days remains. They must then find a new sponsor, make a different immigration application, or leave the UK.
For a care business that relies on overseas staff to maintain safe staffing levels, revocation can be operationally catastrophic.
If you receive a suspension notice or revocation warning, you have a limited window to respond. Working quickly with an employer sponsor license solicitor gives you the best chance of putting together a response that addresses the Home Office’s concerns credibly. In some cases, sponsor licence reinstatement after suspension may be possible, but this depends heavily on the nature of the failings and the strength of the evidence you can produce.
The detail of what the sponsor licence renewals and extensions process involves is also worth understanding, particularly for care providers whose licences are coming up for renewal at the same time as facing heightened scrutiny.
For Workers: Your Route to Settlement and Citizenship
If you are currently working in the UK on a Health and Care Worker visa, the recent changes do not remove the route to settlement if you continue to meet the requirements.
After 5 years of continuous residence on the Skilled Worker route, including time spent on the Health and Care Worker sub-route, you may be eligible to apply for Indefinite Leave to Remain. The full eligibility criteria and what you need to demonstrate are covered in the guide to ILR settlement for skilled workers.
You will need to meet the relevant salary requirement, absences requirement, English language requirement, Life in the UK Test requirement and suitability criteria. If your sponsor has had compliance issues, or if your role has changed, it is sensible to take advice before making your settlement application.
After receiving Indefinite Leave to Remain, many applicants can apply to naturalise as a British citizen after holding ILR for at least 12 months, provided they meet the other eligibility criteria. Different timing can apply if you are married to or in a civil partnership with a British citizen. The guide to British citizenship after ILR walks through what is involved.
Other Routes Worth Knowing About
If you are a care business owner rather than an employed worker, it is worth knowing that other immigration routes may be relevant depending on your circumstances.
The self sponsorship visa uk model, where a business owner sets up a UK company that then sponsors them for a Skilled Worker visa, is not typically straightforward in the care sector. Care worker and senior care worker roles are now heavily restricted, and in England the sponsor must be a CQC-registered provider currently carrying on regulated activity. For senior management, director-level or operational roles within a qualifying care business, however, the position may be different and should be assessed carefully against the current occupation-code and salary rules.
For overseas care companies looking to establish a UK branch, the uk expansion worker visa route may allow senior personnel to come to the UK to set up the new entity before it has begun trading. However, this route is temporary and does not lead directly to settlement, so it should be treated as part of a wider immigration strategy rather than a long-term solution.
Managing Unpaid Leave and Absences
The care sector has a higher-than-average level of shift changes, sickness absence and temporary changes in working patterns. How you manage and report these issues is an area of specific compliance focus for the Home Office.
Workers who are off sick, on unpaid leave, or temporarily unavailable need to be managed carefully within the rules. The guide to managing unpaid leave for sponsored workers covers when reporting is required, what records you need to keep, and how extended absences affect a worker’s visa status and your obligations as their sponsor.
Frequently Asked Questions
Can a care worker on the Health and Care Worker visa change employers?
Yes, but the worker must obtain a new Certificate of Sponsorship from the new employer and apply to update their visa before starting the new role. For care workers and senior care workers, current rules are restrictive. In-country switching can only happen where the applicant meets the relevant conditions, including the requirement to have been legally working for the sponsor in the relevant care role for at least 3 months before the Certificate of Sponsorship is assigned, unless they are covered by another transitional provision.
The guide to switching to a Skilled Worker visa covers the process in detail.
Does the Immigration Skills Charge apply to Health and Care Worker visa applications?
No. This is one of the key benefits of the Health and Care Worker route for employers. The Immigration Skills Charge does not apply to roles that qualify under the Health and Care Worker sub-route.
Can a care provider apply for a sponsor licence if it is a new business?
Yes, but the Home Office will look carefully at whether the business is genuine, properly set up and capable of meeting sponsor duties. In England, a care provider sponsoring care workers or senior care workers must also be registered with the Care Quality Commission and currently carrying on regulated activity, unless a specific transitional exemption applies.
A newly registered care provider with minimal trading history, weak HR systems or unclear staffing needs will face a more difficult application than an established provider. The full process for making a sponsor licence application in 2026 is covered in the blog.
What happens to my sponsored workers if I sell my care business?
A change of ownership can trigger a requirement for the acquiring entity to apply for a new sponsor licence. This is one of the most commonly missed reporting obligations in the care sector. The sponsor duties and compliance guide covers what is required when business ownership changes.
If my sponsor licence is revoked, how long do my workers have to find a new employer?
Workers whose permission is curtailed after sponsor licence revocation are usually given 60 days, or until their visa expiry date if sooner, to find a new sponsor, make another valid immigration application, or leave the UK. This is a very tight timeframe, particularly in a sector where many providers are under licence-related pressure.
Are senior care workers and care workers treated differently under the current rules?
Care workers and senior care workers are different occupation codes, and the duties and salary requirements are not identical. However, both are subject to major restrictions introduced since 2024. Both are affected by the dependant restriction for new applicants from 11 March 2024, and both are closed to new overseas recruitment from 22 July 2025. Limited in-country extensions, updates and switching may still be possible where the transitional requirements are met.
Can overseas applicants still apply for UK care worker jobs?
Not for care worker or senior care worker roles under the current Health and Care Worker visa rules. From 22 July 2025, new overseas recruitment for those roles ended. Overseas applicants may still be eligible for other Health and Care Worker roles if the occupation code, employer and salary requirements are met.
We Are Here to Help
Whether you run a care business that needs to protect its sponsor licence, or you are a health or care worker building your life in the UK, the immigration rules in this sector are genuinely complex and the stakes are high.
Garth Coates Solicitors works with care providers and individual workers across the full range of Health and Care Worker visa issues, from initial licence applications to compliance audits, enforcement responses and long-term settlement planning.
Call us on +44 (0)20 7799 1600 or get in touch to request a consultation and we will be happy to talk through your situation.
