The Health and Care visa is a UK immigration route designed for overseas medical and health professionals coming to work in eligible roles within the NHS, NHS suppliers, and the adult social care sector.
What this article is about: This guide explains the current rules governing the Health and Care visa as of 2025. It covers the professions that remain eligible, the impact of recent restrictions on care worker roles, the requirements for applicants and sponsoring employers, the risks of refusal, and the position of dependants. Employers will also find guidance on compliance duties when hiring under this route.
The visa has undergone significant reform, particularly in 2024, when eligibility was substantially narrowed. Care worker and home carer roles are now closed to new applicants, with only narrow transitional concessions in place until July 2028 for certain workers already sponsored in these roles. Employers and applicants must pay close attention to these changes, as errors or misunderstandings can lead to visa refusals, wasted fees, and long-term impacts on immigration history.
Section A: What is the Health and Care Visa?
The Health and Care visa was introduced in August 2020 as a subcategory of the Skilled Worker route. Its purpose was to make it easier and faster for qualified health professionals to come to the UK to work in shortage roles within health and adult social care. The visa was designed to address workforce shortages, reduce costs for applicants, and support employers with recruitment.
1. Definition and purpose of the route
The Health and Care visa provides overseas professionals with the right to work in qualifying healthcare roles in the UK. It was created to streamline recruitment by:
- Offering lower visa fees compared with the Skilled Worker visa.
- Exempting applicants and their dependants from the Immigration Health Surcharge.
- Providing quicker processing times.
The scheme remains employer-led, meaning applicants must have a confirmed job offer from a Home Office-approved sponsor in an eligible role.
2. Eligible professions and exclusion of new care worker roles
Eligibility for the Health and Care visa is strictly limited to qualifying roles listed under the Immigration Rules. These include doctors, nurses, and allied health professionals such as paramedics and midwives.
Until March 2024, the route was also open to care workers and home carers under SOC codes 6145 and 6146. However, due to policy reform aimed at reducing overall migration levels, these roles are now closed to new visa applicants. This means individuals who have not previously held leave in these roles cannot apply under the Health and Care visa from abroad or by switching in-country.
3. Transitional concessions for care workers until July 2028
For existing care workers and home carers sponsored before the closure, limited transitional provisions are in place. These allow them to extend their visas or change employers within the sector until July 2028. However, no new entrants are permitted, and employers cannot newly sponsor overseas applicants for these roles.
This concession provides stability for workers already in the UK but signals the government’s intent to reduce reliance on overseas care recruitment in the long term. Employers seeking to plan workforce needs must prepare for the expiry of these concessions.
4. Key advantages compared with the Skilled Worker visa
Despite the recent restrictions, the Health and Care visa retains several advantages over the broader Skilled Worker route:
- Significantly lower visa application fees.
- Exemption from the Immigration Health Surcharge, saving applicants and their families thousands of pounds.
- Faster processing, with many applications decided in around three weeks.
These benefits remain available only to those in eligible health roles. For care sector employers, the withdrawal of access to new overseas care workers removes one of the route’s most relied-upon features, with long-term implications for staffing.
Section A Summary
The Health and Care visa was established to attract overseas professionals into shortage roles across the UK health sector. It remains open to medical and allied health professionals, but since 2024 is closed to new care worker and home carer applications, with transitional arrangements running until July 2028 for those already sponsored. The visa continues to offer reduced costs and quicker processing compared with the Skilled Worker visa, though its scope has narrowed considerably.
Section B: Eligibility Requirements
The Health and Care visa route has strict eligibility criteria, and both the applicant and the sponsoring employer must meet the requirements set out under the Immigration Rules. Employers must hold a valid sponsor licence, while applicants must demonstrate suitability for the role through qualifications, salary, and personal requirements such as language proficiency and good character.
1. Employer sponsorship and compliance obligations
Applicants cannot apply for the Health and Care visa without sponsorship. The prospective employer must be a UK-based organisation approved by the Home Office as a Skilled Worker sponsor and specifically authorised to sponsor Health and Care roles. This includes NHS trusts, NHS suppliers, and certain registered care sector providers.
Employers must assign a valid Certificate of Sponsorship (CoS) to the applicant, confirming that the job offered is genuine, eligible, and meets minimum salary and skill levels.
Compliance is critical. The Home Office monitors sponsors closely and can take enforcement action, including suspension or revocation of a sponsor licence, if employers fail to meet their duties. Sponsorship rules for the Health and Care visa are tightly enforced, meaning organisations must maintain accurate records, track sponsored workers, and report changes through the Sponsor Management System. Sponsors are required to report events such as non-attendance, termination of employment, or changes to the job role within 10 working days.
2. Salary thresholds, exemptions and frequent changes
Salary rules under the Health and Care visa follow the Skilled Worker framework but with important exemptions. From July 2025, the general Skilled Worker salary threshold is £41,700 per year. For Health and Care roles, the following apply:
- £25,000 threshold for qualifying health roles, including nurses, paramedics, midwives, and certain other allied health professionals.
- £33,400 threshold for new entrants to the labour market.
- £31,300 transitional threshold for individuals sponsored before April 2024.
These thresholds are subject to frequent policy changes, and employers must always check the latest Home Office guidance when planning recruitment. If the salary offered falls below the required level, the application will be refused.
For roles covered by national pay scales, such as NHS doctors and nurses, the Home Office accepts these pay scales as evidence of meeting salary requirements.
3. English language, financial and tuberculosis requirements
Applicants must meet the English language requirement, usually by:
- Passing a recognised English language test (speaking, listening, reading and writing).
- Having a degree taught in English.
- Being a national of a majority English-speaking country.
Financial maintenance rules apply unless the sponsoring employer certifies maintenance on the CoS. This means applicants must show they have sufficient funds to support themselves and any dependants upon arrival.
Applicants from listed countries must also undergo tuberculosis (TB) testing before applying for a visa.
4. Criminal record checks and occupation-specific rules
For certain roles, particularly those involving regulated activity with vulnerable adults or children, applicants must provide a criminal record certificate from any country they have lived in for 12 months or more over the past 10 years.
Errors or omissions in providing criminal record checks can lead to refusal. Occupation codes also matter, especially since dependant rights now vary depending on the specific SOC code of the sponsored role. Misunderstandings here have already caused family applications to be refused.
Section B Summary
Eligibility for the Health and Care visa is based on sponsorship by an approved employer, compliance with minimum salary levels, and meeting individual applicant requirements such as English language proficiency, financial maintenance, and good character. The rules are complex and subject to regular change. Employers and applicants must take care to comply fully, as mistakes can lead to refusals, the loss of application fees, and negative marks on immigration records.
Section C: Application Process
Applying for a Health and Care visa is a multi-stage process requiring careful preparation by both the sponsoring employer and the applicant. The Home Office applies strict rules to documentation, fees, and timing. Any mistakes risk refusal, loss of fees, and negative entries on the applicant’s immigration history.
1. Certificates of Sponsorship and required documentation
The application begins with the sponsoring employer assigning a Certificate of Sponsorship (CoS) to the applicant. This is an electronic document issued via the Sponsor Management System confirming:
- The applicant’s personal details.
- The job title, occupation code, and employer information.
- Salary details and whether maintenance is certified.
Once assigned, the CoS must be used within three months.
In addition to the CoS, applicants must provide supporting documents, which may include:
- A valid passport or travel document.
- Proof of English language ability.
- Evidence of personal savings (if maintenance not certified).
- Tuberculosis test results (if required).
- Criminal record certificate (for certain roles).
Failure to include all required documents, or discrepancies between documents and CoS details, are common reasons for refusal.
2. Application forms, biometrics and processing times
Applications are completed online through the Home Office portal. Applicants outside the UK must apply from their country of residence, while those switching or extending from within the UK must hold valid leave that allows them to do so.
After submitting the form, applicants are usually required to attend a visa application centre to provide biometrics (fingerprints and a photograph). Certain applicants may be eligible for the UK Immigration: ID Check app instead.
Processing times are generally quicker than standard visas. Most Health and Care visa applications are decided within three weeks of attending a biometric appointment, although delays can occur during periods of high demand. Priority services may be available for an additional fee, but availability depends on the local visa application centre and may not always be offered outside the UK.
3. Visa fees, refusal risks and impact on immigration history
The Health and Care visa offers lower application fees than the main Skilled Worker route. Current fees are:
- £284 for up to three years.
- £551 for more than three years.
Dependants pay the same application fee as the main applicant but remain exempt from the Immigration Health Surcharge (IHS).
However, fees are non-refundable if the application is refused. A refusal is also recorded on the applicant’s immigration history, which can make future applications more difficult. Grounds for refusal include:
- Ineligibility of the role or employer.
- Salary falling below the minimum threshold.
- Missing or incorrect documents.
- Previous immigration breaches.
Given the financial and reputational risks, employers and applicants are strongly advised to ensure compliance before applying.
4. Immigration Health Surcharge exemptions
A key benefit of the Health and Care visa is exemption from the Immigration Health Surcharge. This applies to the main applicant and all eligible dependants. The exemption can save a family thousands of pounds over the course of a visa.
Instead of paying the surcharge, visa holders have free access to the NHS during their stay, subject to the same charges as UK residents for services such as prescriptions and dental care.
Section C Summary
The Health and Care visa application process involves obtaining a Certificate of Sponsorship, preparing supporting documents, submitting an online application, and attending biometrics. While the visa is cheaper and faster to process than most other routes, refusal risks remain high, particularly where documentation or salary requirements are not met. Applicants and employers must prepare thoroughly to avoid losing fees and damaging immigration records.
Section D: Family Members and Settlement
The Health and Care visa allows certain family members to accompany or join the main applicant in the UK, but rights and eligibility vary depending on the role and occupation code. Recent reforms have also restricted dependant rights, making this a complex and high-risk area of immigration compliance for employers and families alike.
1. Rules for dependants by occupation code
The Home Office defines dependants as a partner (spouse, civil partner, or unmarried partner) and children under the age of 18. In the past, most Health and Care visa holders could bring dependants. However, following the closure of care worker and home carer roles to new applicants in 2024, the right to sponsor dependants has been restricted further.
- Care workers and home carers (SOC 6145 & 6146): New applicants cannot apply under these roles. For those benefiting from transitional concessions, dependants are no longer permitted for new extensions or change-of-employer applications.
- Other eligible roles (e.g. doctors, nurses, midwives, paramedics): Dependants remain eligible to apply, provided the main applicant continues to meet visa conditions.
Employers and applicants must carefully check occupation codes, as applying incorrectly for dependants can lead to refusal of family applications.
2. Common pitfalls in dependant applications
Dependants must provide evidence of their relationship to the main visa holder. This may include:
- Marriage or civil partnership certificates.
- Evidence of durable relationships for unmarried partners.
- Birth certificates for children.
Errors in documentation are a common cause of refusals. Another frequent mistake is failing to meet financial maintenance rules for dependants, where the sponsor has not certified maintenance on the CoS.
Dependants must also pay the visa fee and meet suitability requirements, such as providing tuberculosis test results (if applicable) and criminal record certificates where required.
Children born in the UK to Health and Care visa holders are not automatically British citizens. They will only be eligible for registration as British once a parent obtains Indefinite Leave to Remain (ILR) or British citizenship.
3. Indefinite Leave to Remain and citizenship pathways
The Health and Care visa can provide a route to Indefinite Leave to Remain (ILR) after five years of continuous residence, provided:
- The visa holder has spent five years in eligible sponsored employment.
- They meet the applicable settlement salary threshold (currently £25,000 for qualifying health roles).
- They continue to meet English language and Life in the UK test requirements.
- They have not breached immigration laws.
- They have not exceeded the 180-day absence limit in any 12-month period under Appendix Continuous Residence.
Dependants may also qualify for ILR after five years if they have lived in the UK continuously and lawfully during that period.
Following ILR, applicants and dependants may be eligible to apply for British citizenship after a further 12 months (or immediately if married to a British citizen), subject to meeting residence and good character requirements.
Section D Summary
Family members of Health and Care visa holders may be eligible to apply as dependants, but rights now vary significantly depending on the occupation code. Care workers and home carers face restrictions, with transitional arrangements excluding new dependant applications. Other eligible health professionals retain dependant rights. Both the main applicant and dependants can eventually qualify for Indefinite Leave to Remain and citizenship, but the rules are tightly enforced, and errors carry serious consequences.
FAQs
Is the Health and Care visa still open to care workers?
No. Since 2024, care worker and home carer roles (SOC codes 6145 and 6146) are closed to new applicants. Only workers already sponsored in these roles before the closure may continue under transitional concessions until July 2028, but they cannot bring new dependants.
Which jobs qualify for sponsorship under the Health and Care visa?
Eligible roles are set out under the Immigration Rules and include doctors, nurses, midwives, paramedics, and other allied health professionals. Employers must be on the list of approved sponsors and authorised to issue Certificates of Sponsorship for these roles.
What happens if my visa application is refused?
A refusal means the application fee is lost, and the refusal is recorded on your immigration history. This can complicate future UK visa applications. Refusals often result from incorrect documentation, salary levels below thresholds, or applications under ineligible roles.
Can dependants still join Health and Care visa holders?
Yes, but dependant rights vary by occupation code. For doctors, nurses, and other eligible health professionals, dependants may apply. For care workers and home carers, new dependant applications are no longer permitted, even under transitional concessions.
How long is the Health and Care visa valid for?
The visa can be granted for up to five years, depending on the length of sponsorship stated on the Certificate of Sponsorship. It can be extended if the applicant continues to meet the requirements. After five years, the main applicant may be eligible to apply for Indefinite Leave to Remain.
Can Health and Care visa holders change employers?
Yes, but only if the new employer is also an approved sponsor authorised for Health and Care roles. A new Certificate of Sponsorship must be issued, and a new visa application submitted. Transitional care workers changing employers must do so before July 2028.
Are Health and Care visa holders exempt from the Immigration Health Surcharge?
Yes. One of the key benefits of this route is exemption from the IHS, which saves visa holders and their families significant costs compared with most other work visa categories.
Conclusion
The Health and Care visa remains a vital route for overseas medical professionals to live and work in the UK. It continues to benefit NHS trusts, healthcare providers, and patients by addressing staffing needs in critical roles such as doctors, nurses, midwives, and paramedics.
However, the visa has been significantly restricted since 2024. Care worker and home carer roles are now closed to new applicants, with transitional concessions for existing workers only running until July 2028. Employers and applicants must therefore keep pace with the latest eligibility rules and policy updates, as the Home Office frequently revises salary thresholds, dependant rights, and compliance obligations.
For applicants, the visa provides advantages such as lower fees, exemption from the Immigration Health Surcharge, and faster processing compared with the Skilled Worker visa. But refusals are costly and leave a mark on immigration history, making careful preparation essential.
For employers, sponsoring under the Health and Care route carries strict compliance duties. Non-compliance risks not only the loss of the sponsor licence but also disruption to the workforce. HR teams and managers must ensure accurate use of the Sponsor Management System, timely reporting of changes, and close adherence to sponsor guidance.
In summary, the Health and Care visa continues to provide opportunities for overseas healthcare professionals and their families, but only within a narrower scope than before. Success depends on careful compliance with evolving rules, accurate applications, and forward planning for long-term settlement.
Glossary
| Term | Definition |
|---|---|
| Certificate of Sponsorship (CoS) | An electronic record issued by a licensed sponsor confirming details of the job and worker, required for all Skilled Worker and Health and Care visa applications. |
| Sponsor Licence | Permission granted by the Home Office to an employer, allowing them to recruit and sponsor overseas workers in eligible roles. |
| SOC Code | Standard Occupational Classification code used by the Home Office to identify eligible roles for sponsorship. |
| Immigration Health Surcharge (IHS) | A fee normally payable by visa applicants to access NHS services; Health and Care visa holders and their dependants are exempt. |
| Indefinite Leave to Remain (ILR) | Permanent settlement status allowing individuals to live and work in the UK without time restrictions, available after five years of lawful residence under the Health and Care visa. |
| Transitional Concessions | Temporary rules allowing certain care workers already sponsored before closure of the route to extend their visas or change employers until July 2028. |
| Home Office Compliance | The system of duties and monitoring imposed on licensed sponsors, including reporting worker changes and record-keeping requirements. |
Useful Links
| Resource | Link |
|---|---|
| GOV.UK: Health and Care Worker visa guidance | Visit GOV.UK |
| GOV.UK: List of eligible health and care occupations | Visit GOV.UK |
| DavidsonMorris: Health and Care Visa Guide | Visit DavidsonMorris |
| Xpats.io: Health and Care Visa Guide | Visit Xpats.io |
