Health and Care Worker Visa

What is the Health and Care Worker visa?

The Health and Care Worker visa lets qualified medical and care professionals live in the UK and work for the NHS, an NHS supplier or an adult social care provider. It opened in August 2020. In law it is a part of the Skilled Worker route, with lower fees and a faster decision.

The UK created it to make hiring health staff from abroad cheaper and quicker. Three features set it apart from the standard Skilled Worker visa:

•      A low fee. The application costs £324 for up to three years or £628 for longer, against £819 and £1,618 on the standard route.

•      No healthcare surcharge. Other workers pay £1,035 a year to use the NHS. Health and Care Worker visa holders and their families pay nothing.

•      A quick decision. Most applications are decided within three weeks, whether you apply from abroad or from inside the UK.

For a nurse coming for three years with a partner, the saving is more than £7,000.

The core idea is the same as any sponsored work visa. A UK employer with a Home Office licence offers you an eligible job and sponsors you. Your visa is tied to that employer and that job. You can stay up to five years at a time, extend as often as you qualify, and apply to settle after enough years.

The route has changed a great deal since 2024. Care workers lost the right to bring family in March 2024. Recruitment of care workers from abroad closed in July 2025. The English standard for new applicants rose in January 2026. Changes to settlement are planned.

Many guides online still describe the old rules. This one uses the rules in force in October 2026. It covers which jobs and employers qualify, the salary rules, professional registration, costs, the application steps, family, changing jobs, and the path to settlement and British citizenship.

The requirement summary

You need a job offer in an eligible health or care role from an approved UK health or care employer. The official overview is on the GOV.UK Health and Care Worker visa page.

Most people also need registration with a UK professional regulator before they can start work. That is separate from the visa, and it often takes longer.

Health and Care Worker or Skilled Worker?

Both visas sit under the same rules. You get the Health and Care Worker version, with its lower fee and no healthcare surcharge, only when all three of these are true:

1.     Your occupation code is on the Health and Care Worker list

2.     Your employer is one of the three eligible types

3.     Your employer confirms on your certificate of sponsorship that the role qualifies

If any one is missing, you apply for the standard Skilled Worker visa and pay the standard costs. A physiotherapist hired by a private sports clinic with no NHS work is one example. The job code qualifies, but the employer does not.

Your employer makes the call when it assigns your certificate. Ask which visa the certificate is for before you budget.

Eligible jobs and eligible employers

The visa covers 31 occupation codes for new applicants, from doctors and nurses to pharmacists and social workers. The full list is on the GOV.UK “Your job” page.

How occupation codes work

The Home Office sorts every job in the UK into a four digit occupation code. Your job title does not decide your eligibility. The code does.

Your employer picks the code and records it on your certificate of sponsorship. You can look up codes yourself with the CASCOT tool that GOV.UK links to. Match your real duties, not the title. Jobs in the same field can have different codes. Dentists and dental hygiene therapists are one example.

Jobs open to new applicants

The code for “other health professionals” (2259) covers roles such as audiologists, dietitians and operating department practitioners. The code for nursing auxiliaries and assistants (6131) covers healthcare assistants working in clinical settings.

Jobs open only to people already on the route

Some codes are closed to new applicants but stay open for people who already hold the visa.

Care workers (6135) and senior care workers (6136). You can extend, update or switch to the visa in these roles from inside the UK, under conditions. The next section explains them.

Six other medium skilled codes. These are health care practice managers (1231), dispensing opticians (3211), medical and dental technicians (3213), other health associate professionals (3219), ambulance staff other than paramedics (6132) and dental nurses (6133). You can extend or update your visa in these jobs only if you got your certificate of sponsorship before 22 July 2025 and have held a Health and Care Worker or Skilled Worker visa ever since.

Eligible employers

Your job offer must come from one of these:

•      The NHS

•      An organisation providing medical services to the NHS

•      An organisation providing adult social care

In practice, the Home Office guidance covers:

•      NHS trusts, health boards and other NHS bodies across England, Scotland, Wales and Northern Ireland

•      GP surgeries, and dental practices, pharmacies and opticians that hold NHS contracts

•      Private and charitable providers that the NHS pays to deliver health services

•      Adult social care providers registered with the care regulator for their part of the UK

•      Some professional regulators and related public bodies

GOV.UK links to the full list of eligible employers in its guidance for applicants.

The employer must also hold a sponsor licence. Check the register of licensed sponsors before you accept an offer. An employer without a licence can apply for one. The fee is £611 for small organisations and charities or £1,682 for larger ones, and a decision takes about eight weeks.

The certificate of sponsorship

When the employer is ready to hire you, it assigns a certificate of sponsorship. This is an electronic record with a reference number. It holds your personal details, job title, occupation code, salary, hours and dates. It also carries a short statement explaining why the role qualifies for the Health and Care Worker visa.

You must apply for the visa within three months of the date the certificate is assigned. Check every detail first. Only the employer can correct an error.

Care workers: what changed and who can still apply

Since 22 July 2025, employers can no longer sponsor care workers or senior care workers from outside the UK. Anyone abroad who is offered a sponsored care job today should treat the offer as a likely scam.

How the rules tightened

Care workers joined the route in 2022, and numbers grew fast. Reports of abuse followed. Some workers arrived to find little or no work, and some had paid large illegal fees to agents. The government then closed the route in stages.

Who can still use the route for care work

People already on the visa as care workers. You can extend your visa and you can move to another licensed care employer. You apply from inside the UK with a new certificate of sponsorship.

People in the UK on another visa who already work in care. You can switch to the Health and Care Worker visa as a care worker or senior care worker if you have been working legally for the sponsoring employer for at least three months. This option is temporary. It is due to close on 22 July 2028, and the government has said it will keep it under review.

A student who has worked part time for a care provider for several months, within the hours their visa allows, is a typical example of someone who could switch.

People outside the UK. You cannot apply as a care worker or senior care worker.

Conditions for care roles

•      In England, the employer must be registered with the Care Quality Commission, and the work must be a regulated care activity

•      The salary must be at least £25,000 a year, and must meet the hourly minimum in the going rates table

•      The employer must hold a sponsor licence in good standing

•      Most care workers cannot bring family members (see the family section)

Other routes into UK care and health work

The closure applies only to the two care worker codes. These jobs remain open to applicants from abroad:

•      Registered nurses working in care homes

•      Care home managers and domiciliary care managers (code 1232), if the role and salary qualify

•      Nursing auxiliaries and healthcare assistants in clinical settings (code 6131)

•      Social workers

•      Occupational therapists and physiotherapists working in social care

A care worker abroad with a nursing qualification should look at UK nurse registration. It is a longer path, but it leads to an open route with the right to bring family.

If your care employer loses its licence

The Home Office has taken away many care sector licences. If that happens to your employer, your visa is cut short, usually to 60 days. You then need a new sponsor.

You are not left alone in this. Regional partnerships funded by the government help displaced care workers find new licensed employers. Contact the partnership for your area as soon as you hear about the licence, and start applying to other providers at once.

Your rights at work

A sponsored care worker has the same employment rights as any UK worker. Your employer must:

•      Pay you at least the salary on your certificate of sponsorship

•      Give you the hours it promised

•      Pay you for travel time between home care visits where the law requires it

•      Give you payslips and a written contract

Your employer must not:

•      Charge you for your certificate of sponsorship, the sponsor licence or the Immigration Skills Charge

•      Hold your passport

•      Threaten to cancel your visa to stop you complaining

If any of this happens, you can get free advice from Acas on pay and contracts. You can report labour abuse to the Gangmasters and Labour Abuse Authority, and you can call the Modern Slavery Helpline. Reporting abuse does not by itself put your visa at risk.

Salary rules

Most Health and Care Worker applicants must be paid at least £25,000 a year, or the going rate for their job if that is higher. This is far below the £41,700 standard on the main Skilled Worker route.

There are two sets of rules. Which one applies depends on your occupation code.

Group 1: jobs on national pay scales

This group covers doctors, nurses, midwives, paramedics, pharmacists, therapists, radiographers, psychologists, social workers and most other clinical roles.

Your salary must be at least:

•      £25,000 a year, and

•      The national pay scale rate for your role, band and part of the UK

The Home Office publishes these rates in the table of national pay scales for eligible healthcare jobs. The table follows NHS pay bands. Most NHS staff are on a system called Agenda for Change, which runs from Band 2 to Band 9. Doctors and dentists have their own scales.

A newly registered nurse usually starts on Band 5, which pays well above the £25,000 floor. A nursing assistant on a lower band may sit close to the floor, so the exact band matters.

Two points to remember:

•      The pay scale rates apply to private employers too. A private care home hiring a nurse must pay at least the NHS rate for the equivalent band.

•      Rates differ between England, Scotland, Wales and Northern Ireland, and they rise when NHS pay awards are made. Check the table on the day your certificate is assigned.

Ask your employer which band your role is in. The band is on your offer letter for any NHS job.

Group 2: ten codes with different rules

The second group has no national pay scale. It covers these codes:

•      1171 health services and public health managers and directors

•      1231 health care practice managers

•      1232 residential, day and domiciliary care managers and proprietors

•      2113 biochemists and biomedical scientists

•      2114 physical scientists

•      3111 laboratory technicians

•      3211 dispensing opticians

•      3212 pharmaceutical technicians

•      6135 care workers and home carers

•      6136 senior care workers

For these jobs you must usually be paid at least £31,300 a year, or the “lower going rate” for the code, whichever is higher. The lower going rates are in the going rates table.

Suppose your offer is £32,000 and the lower going rate for your code is £33,000. You clear £31,300 but miss the going rate, so you do not qualify.

Some people in Group 2 can be paid less. The details are on the GOV.UK page on different salary requirements.

The new entrant and postdoctoral discounts are limited to four years in total. You cannot combine a discount with the immigration salary list.

What counts as salary

Only guaranteed basic pay before tax counts. Overtime that is not guaranteed, bonuses, and most allowances do not count. Benefits such as accommodation or pension contributions do not count either.

Going rates are set for a standard working week and are adjusted for the hours you work. The annual floor is not reduced for part time hours. A nurse working three days a week must still reach £25,000 in actual pay.

Your employer must also pay at least the national minimum wage for every hour and follow UK rules on working time. Applications are refused where the hours and pay on the certificate break those rules.

Pay during the visa

The salary on your certificate is a floor. Your employer cannot pay you less than the level that qualified you, apart from limited cases such as maternity leave or sick leave. Your pay is checked again when you extend and when you apply to settle.

Professional registration

Most health professionals must register with a UK regulator before they can practise, and this step usually takes longer than the visa. Start it before you look for a job.

Registration and the visa are separate processes run by separate bodies. The regulator decides whether you are fit to practise. The Home Office decides whether you can enter and work. You need both.

Doctors

You need GMC registration with a licence to practise. The steps for most doctors trained abroad are:

1.     Have your primary medical degree verified through the service the GMC uses.

2.     Prove your English with an accepted test, such as the academic version of IELTS or the medicine version of OET. The GMC's required scores are higher than the visa standard.

3.     Show your medical knowledge and skills. Most people do this through the PLAB tests. Part 1 is a written exam offered in many countries. Part 2 is a practical exam held in the UK.

4.     Apply for registration.

Doctors with certain postgraduate qualifications, such as membership exams of the UK royal colleges, can skip PLAB. PLAB 2 means a trip to the UK, usually on a visitor visa, before you have a job.

Nurses and midwives

You need NMC registration. The steps are:

1.     Apply to the NMC and have your qualification checked.

2.     Prove your English. The NMC accepts IELTS and OET at set scores. It also accepts some evidence of training or recent practice in English.

3.     Pass the computer based test. You can sit it at test centres in many countries.

4.     Pass the practical exam, called the OSCE. It is held only at approved centres in the UK.

Most overseas nurses are hired before the OSCE. The employer sponsors you, you travel to the UK, and you work in a supervised pre-registration role while you prepare. NHS trusts usually pay for OSCE training and the first attempt.

The sponsorship rules give a nurse or midwife in this position a limited time, normally eight months, to gain full registration. If you do not pass in time, your employer must stop sponsoring you. Ask your employer about its OSCE support and pass rates before you accept.

Allied health professionals

The HCPC regulates 15 professions. You apply with details of your training and experience, and assessors compare them with UK standards. They can accept you, ask for more information, or require a period of adaptation or a test. Processing can take several months, so apply early.

Care workers

Care workers in England do not register with a regulator, although the employer must be registered with the Care Quality Commission. In Scotland, Wales and Northern Ireland, care workers register with the national social care regulator, usually after they start work.

Timing

A realistic order for most people is:

1.     Check your profession's UK regulator and its route for overseas applicants

2.     Take the English test your regulator accepts

3.     Complete as much of the registration as you can from abroad

4.     Apply for jobs with licensed sponsors

5.     Get your certificate of sponsorship and apply for the visa

An English test accepted by your regulator also meets the visa's English rule for doctors, dentists, nurses and midwives. That saves you a second test.

English language

New applicants must prove English at level B2 in reading, writing, speaking and listening. The level rose from B1 on 8 January 2026. The rules are on the GOV.UK “Knowledge of English” page.

B2 is an upper intermediate level. A person at B2 can follow complex text, discuss matters in their own field in detail, and talk with native speakers without strain.

The easiest way for most clinicians

Doctors, dentists, nurses and midwives do not need separate proof for the visa if they have already passed an English assessment accepted by their UK regulator. The scores the GMC and NMC ask for are higher than B2. The test you take for registration therefore covers the visa as well.

Other professions are not covered by this shortcut. A physiotherapist or radiographer registered with the HCPC still needs to meet the visa rule in one of the four ways below.

Four ways to prove it

1.     A UK school qualification. A GCSE, A level, or Scottish National 4 or 5, Higher or Advanced Higher in English, from a course you began before you were 18.

2.     A degree from a UK institution. The degree must have been taught in English. It counts even if you studied outside the UK.

3.     A degree taught in English from outside the UK. You apply to Ecctis, which confirms that the degree equals a UK bachelor's degree or higher and was taught in English. Ecctis gives you a reference code for your application.

4.     An approved English test. You pass a Secure English Language Test with a provider and test centre on the Home Office list.

Check the test type before you book. The version of a test accepted by a regulator is not always the version on the Home Office list. One test can sometimes serve both purposes, but only if you book the right one.

Who is exempt

Citizens of these countries do not need to prove English: Antigua and Barbuda, Australia, the Bahamas, Barbados, Belize, Canada, Dominica, Grenada, Guyana, Jamaica, Malta, New Zealand, St Kitts and Nevis, St Lucia, St Vincent and the Grenadines, Trinidad and Tobago, and the USA. Citizens of the British overseas territories are also exempt.

The list depends on citizenship. Countries such as Nigeria, Ghana, India, the Philippines, Kenya and Zimbabwe are not on it, even though many of their health workers trained in English.

If you already hold the visa

•      If you held the visa before 8 January 2026 and are extending or updating it, level B1 applies and you do not need to prove English again

•      If you are switching from a Skilled Worker visa, you do not need new proof

•      If you are switching from any other visa, you need B2

This matters to care workers switching from a Student or Graduate visa. They need B2, usually shown through a degree with Ecctis or an approved test.

Money and documents

You need £1,270 in savings, or an employer who agrees to cover that amount, plus a short set of documents. Almost everyone applying from abroad also needs a criminal record certificate. The lists are on the GOV.UK documents page.

Money to support yourself

You must show at least £1,270 in your bank account, to prove you can manage until your first salary.

•      The money must stay in your account for at least 28 days in a row

•      The balance must not drop below £1,270 on any of those days

•      Day 28 must fall within the 31 days before you apply

You do not need to show savings if either of these applies:

•      Your employer certifies maintenance. It ticks the “sponsor certifies maintenance” box on your certificate of sponsorship, promising to cover your costs for the first month if needed. NHS trusts do this as standard. Ask any other employer to do the same.

•      You have lived in the UK on a valid visa for at least 12 months.

Documents everyone needs

•      Your certificate of sponsorship reference number

•      A valid passport or other travel document

•      Proof of your English, or of the assessment accepted by your regulator

•      Your job title, annual salary and occupation code

•      Your employer's name and sponsor licence number (both are on your certificate)

Documents some people need

Criminal record certificates

Because you will work with patients or vulnerable adults, the Home Office asks for a criminal record certificate from applicants outside the UK. The only exceptions are these codes:

•      2113 biochemists and biomedical scientists

•      2114 physical scientists

•      3111 laboratory technicians

•      6132 ambulance staff, other than paramedics

You get the certificate from the police or government of the country concerned. You may need more than one:

•      If you are under 28, you need a certificate from every country where you have stayed 12 months or more in total since you turned 18

•      If you are 28 or over, you need a certificate from every country where you have stayed 12 months or more in the last 10 years

Some countries take weeks or months to issue these. Apply as soon as you have a job offer.

This certificate is for the visa. Your UK employer will also run its own check through the Disclosure and Barring Service, or the equivalent in Scotland or Northern Ireland, before you start work.

Tuberculosis tests

If you have lived for six months or more in a country on the Home Office list, you need a test from a clinic the Home Office has approved. A test from any other clinic is not accepted. The certificate is valid for six months.

Documents your employer will ask for

These are not part of the visa application, but NHS and care employers need them before you start:

•      Proof of professional registration, or of your progress towards it

•      Your qualifications and training records

•      References covering recent employment

•      An occupational health check, including vaccination records

Collect them early, together with certified translations where needed. Missing employment paperwork delays more start dates than the visa does.

How much it costs

The application fee is £324 for a visa of up to three years and £628 for a longer one, and there is no healthcare surcharge. The fee is the same from inside or outside the UK. These figures are from the GOV.UK cost page.

Government charges

You can use the NHS from the day your visa starts. Like UK residents, you still pay for prescriptions in England, dental treatment and eye tests.

What you save

The standard visa figures combine the application fee with the healthcare surcharge of £1,035 a year for adults and £776 a year for children.

Other costs to plan for

The visa is cheap. Getting ready to practise in the UK is not. Budget for:

•      Professional registration. Application, assessment and exam fees with your regulator. For nurses this includes the computer based test and the OSCE. For doctors it includes both parts of PLAB.

•      English tests. One or more attempts at the test your regulator accepts.

•      A trip to the UK for exams. Doctors sitting PLAB 2 usually pay for travel and accommodation themselves.

•      Criminal record certificates and a tuberculosis test.

•      Translations of documents not in English.

•      Flights and your first weeks. A rental deposit and the first month's rent are often the largest single cost.

What employers usually pay

NHS trusts that recruit nurses from abroad commonly offer a package. It may cover the visa fee, the flight, the first weeks of accommodation, OSCE training and the exam fee. Packages differ a lot between employers, so compare them. Get the offer in writing.

Your employer must pay its own sponsorship costs. These are the sponsor licence fee, the £525 fee for your certificate of sponsorship, and the Immigration Skills Charge where it applies. It is not allowed to pass these on to you.

Repayment clauses

Some contracts say you must repay part of the recruitment costs if you leave within a set period, often two or three years. These clauses can be lawful for costs the employer really paid for you, such as flights or exam fees. The UK's code of practice for international recruitment says they should be fair, should reduce over time, and should be explained before you sign.

Read the clause closely. Ask for the total amount, how it reduces each month, and what happens if you leave for reasons such as illness or bullying. Very large fixed sums with no reduction are a warning sign.

Agencies

In the UK it is illegal for a recruitment agency to charge you a fee for finding you a job. Agencies are paid by the employer. Anyone who asks you for money in return for a UK health or care job, or for sponsorship, is breaking the rules.

Three years or five?

Your employer sets the length of the certificate, up to five years, and your visa matches it. Since there is no healthcare surcharge, a five year visa costs only £304 more than a three year one. It also takes you to the settlement point without a second application. Ask for five years where the contract allows it.

How to apply, step by step

The visa decision usually takes three weeks. The full journey, including professional registration and the job search, often takes six to twelve months for nurses and longer for doctors.

The steps

1.     Check your profession's UK regulator. Find out what it asks of people trained abroad.

2.     Pass the English test your regulator accepts.

3.     Start your registration. Complete every stage you can from your home country.

4.     Look for jobs. NHS Jobs lists vacancies across England and Wales, and Scotland and Northern Ireland have their own NHS job sites. Many adverts state whether sponsorship is offered. Some trusts also recruit through approved international agencies.

5.     Interview and accept an offer. Agree the start date, visa length, relocation support and any repayment terms in writing.

6.     Complete pre-employment checks. References, occupational health and identity checks.

7.     Order your criminal record certificates and book a tuberculosis test, if you need them.

8.     Receive your certificate of sponsorship. Check every detail, and confirm it is marked as eligible for the Health and Care Worker visa.

9.     Apply online. You fill in the Skilled Worker application on GOV.UK. The form asks whether you are applying for a Health and Care Worker visa. Answer yes. Pay the application fee.

10.  Prove your identity. Depending on your passport, you either scan it with the UK Immigration: ID Check app or give fingerprints and a photo at a visa application centre.

11.  Upload your documents.

12.  Receive your decision and your eVisa. Your immigration status is recorded online. You view it and share it with your employer through your UK Visas and Immigration account.

13.  Travel and start work. You can apply up to three months before the start date on your certificate.

Step 9 causes a common and costly mistake. If you answer no to the Health and Care Worker question, the form charges the standard fee and the healthcare surcharge. Check that the payment screen shows the lower fee and no surcharge before you pay.

How long it takes

The three week standard applies once you have applied, proved your identity and sent your documents. A decision takes longer if documents need checking, if you are called for an interview, or if you have a criminal conviction. A paid faster service is offered in some locations.

Ethical recruitment and the red list

The UK follows a code of practice for international health recruitment. Under it, UK employers and agencies must not actively recruit from countries with the most serious shortages of health workers. The list is based on a World Health Organization list and includes many countries in Africa and some in Asia.

This does not stop you from applying. A nurse or doctor in a listed country can apply directly to a UK vacancy, and a UK employer can hire them. The rule only bars employers and agencies from targeting those countries with recruitment campaigns. Be cautious of any agency that says it is actively recruiting in a listed country.

Applying from inside the UK (switching)

You can switch from most other visas without leaving. Apply before your current visa ends, and do not travel outside the UK, Ireland, the Channel Islands or the Isle of Man while you wait.

Student visa holders can switch only if one of these is true:

•      You have completed your course

•      Your job start date is after your course finishes

•      You are a full time PhD student and have studied for at least 24 months

This affects nursing and healthcare students. A student finishing a UK nursing degree can switch once the course is complete, and the time until NMC registration is confirmed needs planning with the employer.

Care workers and senior care workers switching in must have worked legally for the sponsoring employer for at least three months.

You cannot switch from inside the UK if you are here as a visitor, a short term student, the parent of a child student, a seasonal worker or a domestic worker in a private household. The same applies if you are on immigration bail or have permission given outside the Immigration Rules.

If your application is refused

You can ask for an administrative review if you believe the caseworker made an error. If the refusal was correct, fix the problem and apply again.

What you can and cannot do on the visa

You can work in your sponsored job, do overtime and bank shifts for your sponsor, take limited extra work, study and travel. You cannot change employer without a new application, and you cannot claim most benefits.

Extra work

The rules are on the GOV.UK additional work page.

You can work up to 20 hours a week in a second job, or for your own business, while you keep doing your sponsored job. The extra work must be one of these:

•      In an eligible occupation code listed as higher skilled

•      On the immigration salary list

•      In the same sector and at the same level as your main job

A nurse sponsored by one NHS trust can work agency shifts as a nurse elsewhere, up to 20 hours a week. Nursing is a higher skilled code, so the work qualifies.

Extra work in a medium skilled job is open only to people who got their first certificate of sponsorship before 22 July 2025 and have held the visa ever since. For newer visa holders, that rules out extra shifts as a care worker.

If you want to work more than 20 hours a week in a second job, that employer must sponsor you as well. You then apply to update your visa so that it covers both jobs.

Bank shifts

NHS staff often pick up extra shifts through their trust's staff bank. Bank shifts for the NHS body that sponsors you do not count towards the 20 hours and need no visa update.

Shifts through an outside agency, or for a different trust, are a second job. They count towards the 20 hours.

GPs after training

A doctor who completes GP training can do four months of additional paid work. This gives newly qualified GPs time to find a practice that holds a sponsor licence.

Things that break your visa conditions

•      Working for an employer who is not your sponsor, outside the extra work rules

•      Doing a different job from the one on your certificate

•      Working more than 20 hours a week in a second job without updating your visa

•      Taking extra work that does not qualify

•      Claiming benefits you are not entitled to

Breaking the conditions can lead to your visa being cancelled and can harm later applications, including settlement. Keep a record of your extra hours each week.

Bringing your family

Doctors, nurses and other workers in higher skilled jobs can bring a partner and children under 18, and each family member pays the same low fee with no healthcare surcharge. Care workers and people in medium skilled jobs mostly cannot. The rules are on the GOV.UK partner and children page.

Who counts as a dependant

•      Your husband, wife or civil partner

•      Your unmarried partner, if you have been in a relationship for at least two years

•      Your child under 18, including a child born in the UK during your stay

•      Your child over 18, only if they are already in the UK as your dependant

Parents, brothers, sisters and other relatives cannot come as dependants.

The limits for care workers

If you are a care worker or senior care worker, your partner and children can apply only if one of these is true:

•      You have been continuously employed in the UK as a care worker or senior care worker, on this visa or a Skilled Worker visa, since before 11 March 2024

•      The application is for your child who was born in the UK

•      You are the only living parent responsible for your child, and the child is applying to stay in the UK

•      Your child's other parent is also sponsored as a care worker or senior care worker, and the child is applying to stay in the UK

A care worker who switches into the route today cannot bring a partner, and can bring a child only in the narrow cases above.

The limits for other medium skilled jobs

The same kind of limit applies to other occupation codes listed as medium skilled. Check your code in the table of eligible occupations. On this route, the codes to check include laboratory technicians, pharmaceutical technicians and nursing auxiliaries and assistants.

For these jobs, family members can apply only if one of these is true:

•      You have been continuously employed in the UK in a medium skilled job, on this visa or a Skilled Worker visa, since before 22 July 2025

•      The application is for your child who was born in the UK

•      You are the only living parent responsible for your child, and the child is applying to stay in the UK

•      Your child's other parent is also sponsored in a medium skilled job, and the child is applying to stay in the UK

If your code is higher skilled, none of these limits apply. Confirm how your code is listed before you accept a job, because it decides whether your family can live with you.

Proving the relationship

Married couples and civil partners send their certificate. Unmarried partners must show a relationship of at least two years. Couples who do not live together must show an ongoing commitment, such as regular contact, shared finances or shared care of children.

A child must live with you, unless they are away at boarding school or university, and must not be married or in a civil partnership. Send a birth certificate naming you as a parent.

Fees and money

Each dependant pays £324 for up to three years or £628 for longer. They pay no healthcare surcharge.

On top of your own £1,270, your family needs:

The 28 day rule applies to this money too. It is not needed if your employer certifies maintenance for your family on your certificate of sponsorship, or if you have all lived in the UK for at least 12 months.

What dependants can do

Your partner can work in almost any job without a sponsor, be self-employed or study. Only professional sport and sports coaching are barred. Children can attend state schools without fees. Dependants cannot claim most benefits.

How they apply

Each family member makes a separate online application and needs your application number. If you apply first, you can get a family linking code to tie the applications together. They can apply with you or later.

Decisions usually take three weeks from outside the UK and up to eight weeks from inside. Their visas normally end on the same date as yours, and they must extend when you do.

Children born in the UK

A child born in the UK while you hold this visa is not automatically British. Apply for a dependant visa for the child if you want to travel abroad with them. You need a full UK birth certificate showing both parents. Once a parent becomes settled, a child born in the UK can usually be registered as a British citizen.

Changing employer, losing your job, and extending

You can move to a new employer, but only through a new application with a new certificate of sponsorship. Do not start the new job until the Home Office approves it.

When you need to update your visa

You must apply to update your visa if:

•      You move to a different employer, including a different NHS trust

•      Your job changes to a different occupation code, even with the same employer

You do not need to apply if:

•      You are promoted or change ward or department within the same occupation code and the same employer

•      You get a pay rise

•      You are a doctor in a training programme whose sponsor is the national training body, and you rotate between hospitals as part of that programme

A nurse who moves from a Band 5 post to a Band 6 post in the same trust stays in a nursing code and needs no new application. A healthcare assistant who qualifies and becomes a registered nurse changes code, and must apply.

How to change employer safely

1.     Get a written offer from an employer that holds a sponsor licence and is an eligible health or care employer.

2.     Check that the new job meets today's rules on occupation code and salary.

3.     Wait for the new certificate of sponsorship.

4.     Apply to update your visa. You can apply up to three months before the new start date.

5.     Keep working in your current job, or work your notice, while you wait.

6.     Start the new job only after approval.

The fee is £324 or £628, depending on the length of the new certificate. A decision usually takes about three weeks. Do not travel outside the UK and Ireland while the application is pending.

If your new employer is not an eligible health or care employer, the new visa is a standard Skilled Worker visa. You then pay the standard fee and the healthcare surcharge, and the standard salary rules apply. A nurse moving from the NHS to a private cosmetic clinic is a typical example. Check this before you resign.

If you lose your job

Redundancy, dismissal and resignation have the same effect on the visa. Your employer must tell the Home Office that your sponsorship has ended, normally within 10 working days.

The Home Office then shortens your visa and writes to you with a new end date. That date is usually 60 days from its letter. If your visa had less than 60 days left, the original date stays.

Before the new end date you must do one of these:

•      Find a new sponsor and apply to update your visa

•      Switch to another visa you qualify for

•      Leave the UK

A valid application made in time lets you stay lawfully while it is decided.

Health staff are in demand, so a new sponsor is often found within the 60 days. Start looking the day you are told. Keep your contact details current in your UK Visas and Immigration account so the letter reaches you.

If you do not gain registration in time

Nurses and midwives sponsored before full NMC registration have a set period to pass the OSCE. If you do not register in time, your employer has to end the sponsorship, and the 60 day rule above applies. Some employers will offer a different sponsored role if one fits the rules. Ask your employer early what happens after a failed attempt, and how many attempts it supports.

Extending your visa

You can extend as many times as you like. To extend, you must:

•      Still be in the same job, with the same occupation code

•      Still work for the employer that gave you your current certificate of sponsorship

•      Meet the salary rules that apply to you

•      Apply before your current visa ends

Your employer assigns a new certificate of sponsorship and you apply online from inside the UK. The fee is £324 for up to three years or £628 for longer. Your partner and children must apply to extend as well.

You do not need to prove English again. You do not need to show savings once you have lived in the UK for 12 months.

People in medium skilled codes who got their certificate before 22 July 2025 can keep extending in those jobs, provided they have held the visa without a break.

Settlement and citizenship

Under the rules in force in October 2026, a Health and Care Worker visa holder can apply to settle after five years. The government plans to change settlement periods, and the proposals treat health professionals and care workers very differently. None of that is law yet.

Settlement under the current rules

Settlement is also called indefinite leave to remain, or ILR. It lets you live and work in the UK with no time limit and no sponsor. You can then work for any employer, in any job.

The current requirements are:

1.     Five years in the UK on an eligible work route. Time on the Health and Care Worker visa and the Skilled Worker visa both count, and they can be combined.

2.     Limited absences. No more than 180 days outside the UK in any 12 month period.

3.     Your employer still needs you. Your sponsor confirms that it still employs you and will keep doing so.

4.     Salary. Your pay meets the level required for your occupation at the time you apply.

5.     Life in the UK test. A 45 minute test on British history, values and daily life, costing £50.

6.     English. Level B1 in speaking and listening, rising to B2 from 26 March 2027.

7.     The fee. £3,226 per person. There is no health worker discount on this fee.

Your partner can apply after five years of living in the UK as your dependant. Children can usually apply with you.

The fee is a heavy cost for a family, because the low visa fees stop at this point. A couple with two children pays £12,904 to settle. Start saving in year one.

The planned changes: earned settlement

In November 2025 the government proposed a system called earned settlement, and a consultation on it closed on 12 February 2026. The main ideas that matter to this route are:

•      A standard wait of 10 years for most migrants, up from five

•      A reduction of about five years for people who work for five years in certain health and education jobs on national pay scales, which would keep nurses, doctors and similar staff at around five years

•      Reductions for high earners: about five years off for taxable income of at least £50,270, and about seven years off for at least £125,140, measured over the three years before applying

•      A longer wait, possibly 15 years, for people in jobs below graduate level, which would include care workers

•      Tighter conditions on English, tax contributions and conduct

The consultation asked for views on how care workers and other lower paid health staff should be treated. Their final position is undecided.

Where things stand:

•      As of late September 2026, the government had not published its response and had not changed the rules on qualifying periods

•      The five year route is still open to everyone on this visa

•      The higher English level for settlement is confirmed and starts on 26 March 2027

What to do about it:

•      If you reach five years soon, apply as soon as you are eligible. You can apply up to 28 days before the five year date.

•      Pass the Life in the UK test now. The pass does not expire.

•      If you are a care worker, improve your English towards B2 and keep full records of your pay and tax.

•      Keep a list of every trip abroad, with dates.

•      Check the GOV.UK settlement pages each month. New rules can take effect a few weeks after they are announced.

British citizenship

After settlement, you can apply to naturalise as a British citizen. The main requirements are:

•      At least 12 months with settled status, unless you are married to a British citizen

•      At least five years of living in the UK

•      No more than 450 days outside the UK in the last five years, and no more than 90 days in the last 12 months

•      Good character, which covers criminal record, tax and immigration history

•      The Life in the UK test and the English requirement, both already met for settlement

The fee is £1,709, plus £130 for the ceremony.

On the current rules, the usual timeline is settlement at year five and citizenship at year six. The UK allows dual citizenship, so check whether your home country does.

Why applications are refused, and how to spot a scam

Most refusals on this route come from the job or employer not qualifying, missing certificates, or doubts that the job is genuine. Fraud has also been a serious problem on this route, especially in care work.

Common reasons for refusal

1. The employer or job does not qualify. The occupation code is not on the health list, or the employer is not an NHS body, an NHS supplier or an adult social care provider. How to avoid it: check your code against the GOV.UK list, and ask the employer to confirm in writing that your certificate is for the Health and Care Worker visa.

2. A care worker application from abroad. These have been closed since 22 July 2025. How to avoid it: do not apply, and do not pay anyone who says they can arrange it.

3. The salary is too low. The pay is below the national pay scale rate for the band, below the going rate, or made up with allowances that do not count. How to avoid it: compare your guaranteed basic pay with the published table for your role and area.

4. No criminal record certificate. Or a certificate from only one of the countries you have lived in. How to avoid it: list every country where you have spent 12 months or more and order each certificate early.

5. No tuberculosis certificate, or one from the wrong clinic. How to avoid it: use only a clinic on the Home Office list.

6. English proof not accepted. The test was the wrong type or from a centre that is not approved, and you are not in a profession covered by the regulator shortcut. How to avoid it: confirm which rule you are relying on before you apply.

7. The money rule is missed. The balance fell below £1,270 during the 28 days. How to avoid it: ask your employer to certify maintenance.

8. A certificate of sponsorship problem. It has expired, has an error, or was withdrawn because the employer lost its licence. How to avoid it: apply within three months, check each field, and check the employer is still on the register on the day you apply.

9. Doubts that the job is genuine. This is most common with small care providers. The Home Office may doubt that the employer has enough work for you. How to avoid it: know your employer, your duties, your hours and your pay, and keep your interview and offer records.

10. False documents or untrue answers. Fake qualifications, fake English certificates and forged employment letters lead to refusal and a ban of up to 10 years. How to avoid it: submit only real documents, and declare past refusals and immigration problems.

Job offer scams

Many people have lost money to fake or abusive sponsorship in UK care work. Know the signs.

How to check an offer

1.     Find the employer on the register of licensed sponsors. Check the name and location match.

2.     For a care provider in England, find it on the Care Quality Commission website and read its latest inspection report.

3.     For an NHS job, find the vacancy on the official NHS jobs site for that part of the UK.

4.     Search for the employer's name with words such as “licence revoked” or “scam”.

5.     Call the employer on a phone number from its official website, not one from the agent.

6.     Ask for the certificate of sponsorship number, then check that the details match your offer letter.

If you paid for a certificate and arrive to find no job, you are a victim of fraud, and the visa can still be cancelled. Report it to Action Fraud in the UK and to the police in your own country. Seek advice from a regulated immigration adviser quickly, because your time to find a new sponsor is short.

Getting advice

In the UK, only regulated people can give immigration advice. That means solicitors, barristers and advisers registered with the Immigration Advice Authority. Check the register before you pay anyone. NHS employers usually guide recruits through the visa at no charge.

Frequently asked questions

Can I apply without a job offer? No. You need a confirmed offer and a certificate of sponsorship from a licensed, eligible employer.

Can I come to the UK as a care worker from abroad? No. That option closed on 22 July 2025. Only people already in the UK can still use the route for care work, under set conditions.

Do I really pay no healthcare surcharge? Yes. You and your dependants are exempt, and you can use the NHS from the day your visa starts.

I paid the surcharge by mistake. Can I get it back? Yes. Eligible health and care workers who paid it can claim a refund. GOV.UK has a refund process for this.

Is there an age limit? You must be at least 18. There is no upper limit.

Do I need UK registration before I apply for the visa? It depends on your profession. Doctors normally need GMC registration first. Nurses are often sponsored before full NMC registration and complete the OSCE in the UK. Ask your employer what it requires.

Can I work for a private hospital or care home? Yes, if it is an eligible employer: it provides services to the NHS or provides adult social care. Otherwise you need the standard Skilled Worker visa.

Can I do agency or bank shifts? Bank shifts for your NHS sponsor are allowed without limit. Agency work for others is allowed up to 20 hours a week if the work qualifies.

Can I work part time? Yes, if your actual pay still meets the salary floor and the pay scale rate for your hours.

Can I bring my family? Yes, if your job is higher skilled, such as doctor, nurse, midwife, pharmacist or therapist. Care workers and most people in medium skilled jobs cannot.

Can I switch from a Student visa? Yes, once you have finished your course, or if your job starts after it finishes. Care workers must also have worked legally for the sponsor for three months.

Do I need an Electronic Travel Authorisation (ETA)? No. An ETA is for visitors who do not need a visa. You travel on your eVisa.

What if my employer treats me badly? You have full UK employment rights. Get advice from Acas or a union, and look for a new sponsor. Reporting abuse does not by itself end your visa.

Can I leave the NHS for a non-health job? Only with a new Skilled Worker visa for that job, at the standard cost and salary rules. After settlement you can work anywhere.

Will the planned settlement changes affect me? Possibly. The proposals are kinder to pay scale health professionals than to care workers, but nothing is law as of late September 2026.

Before you apply: a short checklist

•      ☐ My occupation code is on the Health and Care Worker list

•      ☐ My employer is an eligible health or care employer and is on the register of licensed sponsors

•      ☐ My salary meets the floor and the pay scale rate or going rate for my role

•      ☐ I know whether my job lets me bring my family

•      ☐ My professional registration is complete, or my employer has confirmed the plan to complete it

•      ☐ My English proof is ready, through my regulator, a degree with Ecctis, or an approved test

•      ☐ I have criminal record certificates for every country that applies

•      ☐ I have a tuberculosis certificate from an approved clinic, if I need one

•      ☐ My employer has certified maintenance, or I have held £1,270 for 28 days

•      ☐ My certificate of sponsorship is correct and marked for the Health and Care Worker visa

•      ☐ The payment screen shows £324 or £628 and no healthcare surcharge

•      ☐ I have paid no one for the job offer or the certificate

Sources

•      GOV.UK: Health and Care Worker visa overview

•      GOV.UK: Your job (eligible codes, employers, salary floor)

•      GOV.UK: If you'll need to meet different salary requirements

•      GOV.UK: Knowledge of English

•      GOV.UK: How much it costs

•      GOV.UK: Documents you'll need to apply

•      GOV.UK: Your partner and children

•      GOV.UK: Switch to this visa

•      GOV.UK: Taking on additional work

•      GOV.UK: Health and Care visa guidance for applicants (eligible employers)

•      GOV.UK: National pay scales for eligible healthcare jobs

•      GOV.UK: Skilled Worker visa, how much it costs (standard fees used in the comparison)

•      GOV.UK: Earned settlement consultation

•      BritPass: What is earned settlement? (status of the settlement proposals, English level from March 2027)

•      Jobbatical: Health and Care Worker visa eligible roles (care worker switching window to 22 July 2028)