The Health and Care Worker visa changed drastically in 2025, altering how healthcare and social care employers can recruit international workers. If you’re a care worker, healthcare professional, or employer in the sector, these changes directly affect your immigration options.
The most impactful change came on July 22, 2025, when the UK government closed overseas recruitment for care workers and senior care workers under occupation codes 6135 and 6136. This was a major shift in immigration policy, ending a route that had issued over 100,000 visas in 2023/24 alone.
This guide explains exactly what changed, who’s affected, what the transitional provisions mean in practice, and what alternatives exist for both workers and employers navigating these restrictions.
What Changed on July 22, 2025?
The July 2025 reforms came after a series of restrictions that began in early 2024. Understanding what actually happened helps clarify your options going forward.
Overseas Recruitment Closed for Care Workers
New applications from outside the UK are no longer accepted for care workers (SOC 6135) and senior care workers (SOC 6136). Care employers cannot sponsor new international recruits for these roles. The route is completely closed to overseas applicants in these occupation codes.
The closure affects domiciliary care agencies, residential care homes, and nursing homes that previously relied on international recruitment to fill vacancies. Employers who submitted Certificates of Sponsorship before July 22, 2025 can still honour those commitments, but no new overseas applications will be processed.
In-Country Switching Still Possible Until 2028
There’s a critical distinction here that many articles miss. While overseas recruitment has ended, workers already in the UK can still apply under specific conditions until July 22, 2028.
You can still apply if you’re already legally working for the sponsoring employer in the UK and have been on their payroll for at least three months. This applies when you’re switching from another visa route to the Health and Care Worker visa, provided your employer is CQC-registered in England. The three-month employment requirement means you must have worked legally for the specific employer who will sponsor your visa, not just any UK employer.
Overseas applications are no longer accepted, and you won’t qualify if you’ve worked for less than three months or your employer lacks CQC registration. This transitional provision gives some breathing room for workers already established in the UK, but it won’t help employers looking to recruit from overseas.
Six Healthcare Roles Removed
Beyond care workers, six other roles lost eligibility because they don’t meet the new skill threshold:
- SOC 6131: Nursing auxiliaries and assistants (with specific restrictions)
- SOC 6133: Dental nurses
- SOC 6132: Ambulance staff (excluding paramedics)
- SOC 3219: Health associate professionals
- SOC 6139: Care escorts and therapy support staff
Workers in these roles who already had visas or Certificates of Sponsorship before July 22, 2025 can continue under transitional arrangements, but employers can’t recruit new international workers for these positions.
Timeline of Changes
To understand where we are now, you need to see how we got here. The restrictions didn’t happen overnight; they developed through a series of policy announcements between March 2024 and July 2025.
March 11, 2024: Dependent Ban
The first major blow came in early 2024 when care workers and senior care workers lost the right to bring family members to the UK. New care worker visa holders from this date onwards could not sponsor partners (including spouses, civil partners, or unmarried partners) or children.
This created real emotional and financial hardship for many workers who had planned to reunite with their families. Some workers chose to return home rather than accept indefinite family separation. Others remained in the UK but faced the difficult reality of supporting families abroad while working in demanding care roles.
The rule didn’t apply retroactively, which meant care workers who already had visas before March 11, 2024 retained their right to bring dependents. This created a two-tier system within the care worker population: those with family rights and those without.
April 2025: Salary Threshold Increase
The minimum salary for Health and Care Worker visa holders jumped from £23,200 to £25,000 per year in April 2025. This affected care workers on the Immigration Salary List and those paid according to national pay scales.
For many care workers already earning around £23,000-£24,000, this created immediate compliance issues when extending their visas. Employers had to either increase wages or risk losing workers when their visas came up for renewal. The timing proved particularly challenging because it came just three months before the complete closure of overseas recruitment.
The increase brought the Health and Care Worker visa closer to other immigration routes, though it remained well below the general Skilled Worker visa threshold of £41,700.
July 22, 2025: Skill Level Increase
The general Skilled Worker visa skill requirement jumped from RQF Level 3 (A-level equivalent) to RQF Level 6 (degree level). While the Health and Care Worker visa retained some medium-skilled roles, the overall policy direction was clear: the UK wants higher-skilled migration.
This change removed roughly 180 occupations from sponsorship eligibility across all visa routes. The impact extended far beyond healthcare, affecting construction, hospitality, and administrative roles across the economy.
For the care sector specifically, this meant that roles without degree-level requirements (which includes most frontline care work) could no longer be filled through international recruitment.
Who Can Still Use the Health and Care Worker Visa?
Despite the restrictions, the Health and Care Worker visa remains open for most healthcare professionals. Eligibility continues for registered professions and roles that meet the degree-level skill requirement.
Eligible Healthcare Professions
The visa remains available for registered healthcare professionals who meet the degree-level skill requirement. Eligible occupations include:
Doctors and Medical Professionals:
- SOC 2211: General practitioners
- SOC 2212-2217: Hospital doctors and specialists
- SOC 2217: Medical radiographers
Nursing Professionals:
- SOC 2231: Registered nurses
- SOC 2232: Midwives
- SOC 2233: Specialist nurses
Allied Health Professionals:
- SOC 2221: Physiotherapists
- SOC 2222: Occupational therapists
- SOC 2223: Speech and language therapists
- SOC 2216: Pharmacists
- SOC 2234: Paramedics
Management and Technical Roles:
- SOC 1232: Residential, day and domiciliary care managers
- SOC 3111: Laboratory technicians (with 3+ years experience)
- SOC 3217: Radiography and medical equipment technicians
All these roles require either professional registration with the relevant UK body (such as GMC, NMC, or HCPC) or meet the RQF 6 threshold through qualification and experience requirements.
What About Existing Care Workers?
If you’re already in the UK on a Health and Care Worker visa as a care worker, your situation depends on when you entered and your current circumstances.
You can extend your visa until July 22, 2028 and switch employers if you’ve worked for them for three or more months. The requirement to work for an employer before switching protects against exploitative quick turnover while giving workers some mobility. You can also apply for settlement (ILR) after five years if you meet the continuous residence and other requirements.
You cannot bring new dependents unless you held your visa before March 11, 2024. The dependent ban remains in force even for extensions. You also cannot apply from outside the UK if you’ve left. The transitional provisions only protect those already in the country.
The key point: you’re protected by transitional arrangements if you’re already in the UK and working in the role, but your options are more limited than they were a year ago.
Salary Requirements After the 2025 Changes
Understanding salary thresholds is crucial because getting this wrong means visa refusal. The requirements vary depending on your occupation and when you entered the UK.
For Health and Care Worker Visa Holders
Most healthcare professionals on national pay scales need to earn £25,000 per year minimum, or the going rate for their job, whichever is higher. This dual requirement means that even if £25,000 is the base threshold, you must still meet the occupation-specific salary that the Home Office sets for your role.
For example, a Band 5 nurse’s starting salary of £28,407 (2025/26 pay scale) comfortably meets both the £25,000 minimum and the going rate for registered nurses. Band 6 senior nurses earning between £33,384 and £41,787 similarly exceed all requirements. Band 3 healthcare assistants earning roughly £23,615 fall below the threshold and can no longer be sponsored for new visas.
This creates a clear line between roles that can and cannot access the Health and Care Worker visa. The threshold is notably lower than the general Skilled Worker visa requirement of £41,700, which is why the Health and Care route remains attractive for eligible professions.
Immigration Salary List Considerations
Some roles remain on the Immigration Salary List (ISL) with specific thresholds. The ISL will phase out by December 2026, but for now, it provides some flexibility for shortage occupations.
Roles on the ISL can be paid at the higher of either £25,000 or their specific occupation threshold. This benefits employers filling shortage roles where the going rate might otherwise be higher. Workers in ISL roles at RQF 3-5 (below degree level) cannot bring dependents, which limits the appeal of these positions for international workers with families.
The temporary nature of the ISL means employers should plan for the eventual removal of these concessions. After December 2026, all roles will need to meet standard salary thresholds regardless of shortage status.
Salary Assessment and Deductions
Employers who recoup business costs, immigration costs, or business investments through repayment clauses must count these deductions against the salary stated on the Certificate of Sponsorship. If these deductions take the salary below the relevant eligibility requirements, the individual cannot apply for a visa.
This rule prevents employers from offering artificially high salaries that are then reduced through mandatory deductions. For example, if you sponsor someone at £26,000 but require them to repay £3,000 in recruitment fees, their effective salary is £23,000 (which falls below the threshold). This application would be refused.
The same principle applies to accommodation costs deducted from wages, unless the deductions are truly voluntary and not guaranteed through contractual terms.
Dependent Restrictions: Who Can Bring Family?
The dependent restrictions introduced in 2024 and 2025 are among the harshest changes for affected workers. Understanding these rules is essential for anyone considering or already on the Health and Care Worker visa.
Current Dependant Rules
Workers sponsored for RQF level 6 roles (degree level and above) can still bring dependents to the UK. This includes registered nurses, doctors, allied health professionals, and other graduate-level healthcare positions. These workers can bring their partner and children under 18, or children over 18 if they’re currently in the UK as dependents.
Anyone sponsored for an RQF level 3-5 role (below degree level) after July 22, 2025 cannot bring dependents. This applies whether you’re applying for a new visa or switching from another route. The restriction extends to care workers, senior care workers, and the other roles that remain on the Immigration Salary List but fall below degree level.
Existing Visa Holders and Dependants
If you already had dependents in the UK before these rules changed, they can remain. Your family isn’t forced to leave just because new applicants can’t bring dependents. When you extend your visa, your dependents can extend theirs too.
Care workers and senior care workers who held visas before March 11, 2024 retain the right to bring dependents even if they haven’t done so yet. This transitional protection recognises that some workers may have been planning family reunification but hadn’t completed the process before the ban took effect.
Switching Routes and Dependant Loss
This is where it gets particularly harsh. If you’re in the UK on another route that permits dependents (such as a Graduate visa), and you switch into a below-degree-level health and care role after July 22, 2025, you lose the right to keep your dependents with you.
This creates a difficult choice for Graduate visa holders working in care: continue in the role without family, or leave care work to preserve family unity. The policy doesn’t grandfather in existing family situations when workers change visa categories.
The same rule applies to those switching from Skilled Worker visas in other sectors. Your existing dependents must either leave the UK, switch to a different visa route that allows them to stay independently, or you must change to an occupation that permits family sponsorship.
Application Process and Fees
The application process remains largely the same as before the 2025 changes, but the costs have increased and eligibility has narrowed.
How to Apply
The application process begins when your employer issues your Certificate of Sponsorship (CoS). This certificate contains a unique reference number and details about your job, salary, and occupation code. Your employer must submit this through their sponsorship management system before you can apply.
You then complete the online application form on the gov.uk website. The form requires detailed information about your employment history, qualifications, and personal circumstances. You’ll need to provide supporting documents including your passport, evidence of your professional qualifications, and proof of your English language ability.
After completing the online form and paying the fees, you’ll attend a biometric appointment at a visa application centre. This involves providing your fingerprints and photograph. You must also submit any required supporting documents at this stage.
Most applications receive a decision within three weeks, though this can vary. The fast-track nature of Health and Care Worker visa applications means they’re prioritised over general Skilled Worker applications.
Current Fees and Costs
The costs for Health and Care Worker visa applications in 2025/26 are:
- Certificate of Sponsorship: £525 (paid by employer, cannot be passed to worker)
- Visa application fee: £590 (same rate for in-country and overseas applications for visas sponsored for more than 3 years)
- Immigration Health Surcharge: £0 (Health and Care Worker visa holders remain exempt)
- Immigration Skills Charge: £1,320 per person per year (paid by employer, some NHS roles exempt)
For comparison, the standard Skilled Worker visa costs £1,519 for the application fee plus £1,035 per year for the IHS. The Health and Care Worker route offers real savings, particularly due to the IHS exemption.
English Language Requirements
English language requirements remain at CEFR Level B1 (intermediate) for most Health and Care Worker visa applications. This is equivalent to IELTS 4.0 in each skill (reading, writing, listening, speaking).
From January 8, 2026, new Skilled Worker visa applications require B2 level English (upper intermediate). This change doesn’t directly affect Health and Care Worker visas, but it’s worth noting if you’re considering switching routes.
Healthcare professionals registered with UK professional bodies (like doctors registered with the GMC or nurses registered with the NMC) usually meet the English requirement through their registration, as these bodies verify English proficiency during the registration process.
Employer Requirements and CQC Registration
For care employers specifically, the CQC registration requirement has become increasingly important under the new rules.
What CQC Registration Means
Only CQC-registered providers in England can sponsor care workers or senior care workers. This means your organisation must be registered with the Care Quality Commission and maintain an adequate or better rating.
The CQC registration requirement exists to ensure that workers are sponsored by legitimate, regulated care providers rather than unregulated employers. It also gives the Home Office confidence that workers will be in safe working environments.
Care providers who were sponsoring workers in exclusively non-regulated activities before April 2024 can continue to sponsor these workers, including for visa extensions, but cannot hire new international workers for these roles. This grandfather clause protects existing arrangements while closing the loophole going forward.
Sponsor License Requirements
Beyond CQC registration, employers need a valid sponsor license from the Home Office. This involves showing that your organisation is genuine, can fulfil sponsorship duties, and has appropriate HR systems in place.
The sponsor license application costs £1,476 for large sponsors and £536 for small sponsors and charities. Once granted, the license requires annual renewal and ongoing compliance monitoring.
Sponsors must maintain accurate records of sponsored workers, report certain changes to the Home Office, and ensure workers are paid at least the required salary. Failure to comply can result in license suspension or revocation, which would affect all sponsored workers at that organisation.
Alternatives for Affected Workers
If you’re a care worker affected by the July 2025 closure, several alternative routes might be available depending on your circumstances and qualifications.
Skilled Worker Visa for Other Roles
If you can qualify for a degree-level role in healthcare, you could apply for a Health and Care Worker visa in that capacity. For example, completing nursing qualifications and registering with the NMC would open the registered nurse route (SOC 2231).
Alternatively, you could pursue roles in other sectors through the standard Skilled Worker visa. This route requires meeting the higher salary threshold of £41,700 (or £33,400 if on the Immigration Salary List), which is a big jump from care work salaries.
The standard Skilled Worker visa also doesn’t offer the IHS exemption, meaning you’d pay the full immigration health surcharge. For a five-year period, this adds over £5,000 to your costs.
Graduate Visa Route
If you’re an international student in the UK who has completed a degree, the Graduate visa offers two years of unrestricted work rights. You can work in care during this period without needing sponsorship.
From January 1, 2027, the Graduate visa duration will reduce from two years to 18 months for bachelor’s and master’s degree holders. PhD graduates will still get three years.
The Graduate visa can’t be extended. After it expires, you must either qualify for another route or leave the UK. This makes it a temporary solution rather than a long-term pathway.
Family Route
If you have a British citizen or settled person partner, you might qualify for a family visa. This requires your sponsor (the British citizen or settled person) to meet the minimum income requirement of £29,000 per year.
The family visa leads to settlement after five years and doesn’t restrict which occupation you can work in. This makes it attractive for those with British partners, though meeting the income requirement can be challenging.
Impact on Different Sectors
The 2025 changes affect different parts of the health and care sector in distinct ways.
NHS Trusts and Foundation Trusts
NHS employers are largely unaffected by the care worker restrictions because they primarily recruit registered healthcare professionals (roles that remain fully available under the Health and Care Worker visa).
The salary threshold increase to £25,000 did affect Band 3 healthcare assistants, but most NHS trusts already pay above this level, particularly in high-cost areas. Band 5 nurses and above comfortably exceed the threshold.
NHS employers continue to benefit from the IHS exemption and lower visa fees, making international recruitment financially viable compared to other sectors.
Private Healthcare Providers
Private hospitals and clinics face similar circumstances to NHS trusts. As long as they’re recruiting registered professionals, the Health and Care Worker visa remains accessible.
Private providers don’t benefit from NHS pay scales, which means they must carefully verify that salaries meet going rates and thresholds. The Home Office regularly updates going rates based on the latest salary data.
Social Care Sector
This is where the impact hits hardest. Residential care homes, nursing homes, and domiciliary care agencies can no longer recruit care workers from overseas.
Care homes that relied heavily on international recruitment now face real staffing challenges. The transitional provisions until 2028 provide some relief for workers already in the country, but no new pipeline exists for overseas recruitment.
Employers are now focusing on domestic recruitment, offering higher wages to attract workers, and investing in retention strategies. Some are reducing capacity due to staffing shortages.
Domiciliary Care Agencies
Home care providers face perhaps the most acute challenges. These agencies typically employ care workers (SOC 6135) and senior care workers (SOC 6136) almost exclusively (the exact roles that lost overseas recruitment).
Many domiciliary care agencies operate in regions with severe domestic labour shortages. Without access to international recruitment, some providers report turning away clients because they can’t staff the visits.
The sector is exploring alternatives, including recruitment from the European settled population, partnerships with local communities, and career change programs targeting people from other industries.
Common Mistakes to Avoid
Understanding what not to do is as important as knowing what to do. These are the errors we see most often.
Attempting Overseas Applications for Closed Roles
Some workers continue to submit applications for care worker positions from overseas, not realising the route is completely closed. These applications are automatically refused regardless of qualifications or experience.
The refusal not only wastes the application fee but can also create complications for future visa applications, as you must declare previous refusals.
Underestimating the Three-Month Employment Requirement
Workers sometimes try to switch into care worker roles after only one or two months with an employer. The three-month requirement is strict (you must have been on the payroll for a full three months before you can apply).
Misunderstanding Dependant Rights
We frequently see applications from workers who assume they can bring dependents because they’re switching from a route that previously allowed it. The dependent restrictions apply based on your new visa category, not your old one.
If you’re switching into a below-degree-level care role after July 22, 2025, your dependents cannot continue under your sponsorship, even if they’ve been in the UK with you for years on a previous visa.
Not Meeting CQC Registration Requirements
Care employers sometimes apply for sponsor licenses or attempt to sponsor care workers without proper CQC registration. These applications are systematically refused.
The CQC registration must be current and in good standing. If your registration is suspended or you’re rated inadequate, you cannot sponsor care workers.
Salary Calculation Errors
Employers occasionally include overtime, bonuses, or allowances that aren’t guaranteed in the salary figure on the Certificate of Sponsorship. The Home Office only counts guaranteed basic salary plus certain guaranteed allowances.
If the actual guaranteed salary falls below the threshold, the application will be refused even if the worker typically earns above it with overtime.
What to Do Now: Practical Steps
Your next steps depend on whether you’re a worker, employer, or both.
For Current Care Workers
If you’re already working as a care worker in the UK on a Health and Care Worker visa, these are your priorities:
Actions Required:
- Verify your visa expiry date (transitional provisions end July 22, 2028)
- Plan extension applications at least 3 months before expiry
- Confirm you’ve been with your current employer for 3+ months if considering switching
- Review settlement (ILR) eligibility if you’ve been in the UK for 5 years
Consider whether you want to pursue alternative qualifications that would open other visa routes. Some care workers are completing nursing degrees or health and social care management qualifications to access roles with longer-term visa availability.
If you’ve been with your current employer for three months or more, you have the flexibility to switch employers. Don’t feel trapped in poor working conditions. Your transitional rights include employer mobility.
For Prospective Care Workers Overseas
If you’re outside the UK and considering care work, understand that the route is closed. Don’t pay agents or recruiters who claim they can still get you a care worker visa (this is a scam).
Explore alternative routes, such as completing nursing qualifications and applying as a registered nurse, or investigating other occupation codes that remain open. The social care manager route (SOC 1232) remains available for those with appropriate management qualifications.
For Healthcare Professionals
If you’re a registered nurse, doctor, allied health professional, or other eligible healthcare worker, the Health and Care Worker visa remains fully available. Focus on meeting the salary threshold (£25,000 minimum or going rate) and ensuring you have acceptable proof of professional qualifications and registration.
Verify that your occupation code is still on the eligible list. While most registered professions remain available, it’s worth checking before committing to recruitment expenses.
For Care Employers
If you’re a care employer affected by the changes, develop domestic recruitment strategies immediately. Waiting for policy reversal is unlikely to succeed. The direction of travel is clear toward higher-skilled migration.
Consider training existing staff to progress into senior positions, partnering with local colleges on health and social care programs, and offering competitive packages to attract workers from other sectors.
For workers already sponsored, ensure you’re meeting salary requirements and can support visa extensions until 2028. Your existing workers are valuable continuity that shouldn’t be lost through administrative errors.
Looking Ahead: After 2028
The government has been clear that the transitional provisions for in-country switching end on July 22, 2028. What happens after that date remains uncertain.
Possible Scenarios
The most likely scenario is that care worker and senior care worker codes will be completely removed from all visa routes. Workers in these roles should still be able to apply for extensions or indefinite leave to remain if they meet the requirements at the time.
Some speculation exists that the government might introduce a new, more restrictive care worker route with stricter conditions. No concrete proposals have been published though.
Alternatively, if severe care workforce shortages continue, there might be pressure to partially reopen recruitment. The Migration Advisory Committee’s reviews will likely influence any future policy changes.
What This Means for Planning
Workers should assume the 2028 deadline is firm and plan accordingly. If you want to stay in the UK long-term, consider training for roles that will remain eligible or qualifying for settlement before 2028.
Employers should similarly plan for a future without new international care worker recruitment. Building sustainable domestic recruitment pipelines takes years, not months.
Key Takeaways
The 2025 changes to the Health and Care Worker visa narrowed access for care workers while leaving most registered healthcare professions unaffected.
Care workers (SOC 6135) and senior care workers (SOC 6136) can no longer apply from overseas. Workers already in the UK can continue until July 2028 under transitional provisions if they meet the three-month employment requirement. The £25,000 minimum salary threshold applies to all Health and Care Worker visa holders.
Most healthcare professionals including nurses, doctors, and allied health professionals retain full access to the visa. The IHS exemption and lower fees remain for all Health and Care Worker visa applicants.
Dependent restrictions prevent workers in below-degree-level roles from bringing family members. Care employers must be CQC-registered to sponsor workers.
The implications are most severe for the social care sector, which must now rely entirely on domestic recruitment. For individual workers, the changes mean fewer pathways to UK work in care roles, though options remain for those willing to gain additional qualifications.
Planning ahead is essential. Whether you’re a worker considering your long-term options or an employer rethinking your recruitment strategy, the July 2028 end of transitional provisions should feature prominently in your planning.
This guidance is current as of February 2026. Immigration rules change frequently. Always verify current requirements on gov.uk or consult a qualified immigration advisor before making decisions based on this information.
