Health and Care Worker visa changes: impact on employers  

In July 2025, important and consequential changes to the UK’s immigration system came into effect with direct implications for international workers on UK work visas and the organisations that employ them.  For NHS bodies, social care providers and independent health and care services, these changes have fundamentally altered how workforce planning, recruitment and retention must be approached.

At a time when health and care services are already under sustained pressure, employers are now navigating tighter eligibility rules, higher thresholds and increased compliance risks. Access to clear, accurate immigration advice has become essential.

This article outlines the key changes affecting the health and care sector, explains what they mean in practice for employers, and draws on our legal work to highlight where risks most commonly arise. 

The minimum skill level for sponsorship on a UK work visa has increased from RQF Level 3 (A-level) to RQF Level 6 (degree-level). As a result, several roles found across health and care settings are no longer eligible for sponsorship unless the worker was already sponsored before 22 July 2025. This includes Medical and dental technicians (3213), Ambulance staff (excluding paramedics) (6132) and Dental nurses (6133). 

This change narrows the range of roles that can be filled through sponsorship and makes retaining existing sponsored staff increasingly important.

Workers already in the UK under SOC codes 6135 and 6136 can continue to be sponsored until 22 July 2028, but only if From 22 July 2025, employers can no longer recruit care workers and senior care workers under SOC codes 6135 and 6136 from overseas.

For many adult social care and health providers, this represents a major shift. International recruitment has long been a critical response to chronic workforce shortages, and this route is now closed to new overseas hires.

However employers can still recruit and sponsor care workers and senior care workers inside of the UK until 22 July 2028 (kept under review), provided that the worker has been legally employed by the sponsor for at least three months before the Certificate of Sponsorship is issued. Therefore switching to the Health and Care Worker visa as a care worker from other routes is still possible.

Sponsored care workers already in the UK under SOC codes 6135 and 6136 can continue to extend their permission to stay until 22 July 2028, provided they meet the criteria including the relevant salary requirements. After July 2028 (date kept under review), these roles will no longer be eligible for sponsorship.

Workers sponsored under SOC codes 6135 and 6136 are unable to bring dependants to the UK. This rule was introduced on 11 March 2024, however this continues to affect recruitment and retention across the sector. This rule does not apply to those who have held permission on their Health and Care Worker (or Skilled Worker) visas since before 11 March 2024. Therefore, importantly this will apply to those applicants now looking to switch to the Health and Care Worker visa as a care worker or senior care worker from different immigration routes.

As of the July 2025 changes, the minimum salary threshold for sponsorship of national pay scale occupations such as health care workers has increased from £23,200 to £25,000. Similarly, the minimum salary threshold for roles on the Immigration Salary List (such as care worker and senior care worker) also increased from £23,200 to £25,000.

Aside from the threshold the employer must also check the going rate for the role and will need to offer the higher of the two.This could be particularly challenging for employers such as NHS trusts operating with fixed pay bands where there may be little flexibility to adjust salaries.

There are different going rates depending on the employee’s circumstances, including whether they were already on the Skilled Worker or Health and Care Worker routes before 4 April 2024. It is therefore recommended that you seek advice on your particular situation. Even small discrepancies can result in refusals, placing both the worker’s immigration status and the organisation’s application at risk.

One of the most common risks we see in our work with health and care employers is the confusion around role duties, SOC codes and salary thresholds. This is rarely due to employer error. Rather, it reflects the increasing complexity of the sponsorship system and the speed at which rules are changing.

Through our legal work supporting NHS organisations and other health and care providers, including advice we’ve delivered as part of Scotland’s Migration Service, we regularly assist employers who are:

• Unsure which SOC code best reflects a role’s actual duties
• Managing sponsored roles that could be affected by salary thresholds following recent changes
• Operating within national or sector-wide pay frameworks that do not align neatly with immigration salary rules
• Supporting sponsored staff whose roles or pay have evolved over time

Selecting the correct SOC code is critical. It determines both whether the role is eligible for sponsorship and which salary threshold applies. An incorrect code can result in the application being refused, but even if granted it could still present a problem at extension or settlement stage and could create issues in compliance during Home Office audits. 

Since the July 2025 changes were announced, we have advised several employers where SOC code identification was a key point of confusion. In many cases, the code initially selected appears to no longer qualify, however it is common that employers judged the role based on the title rather than the core duties. Therefore, on closer assessment, the role may still be eligible either looking at the job description or other exceptions which still operate. In other cases, the correct role may have been removed from sponsorship or requiring a higher skill level.

In one case, an employer approached us unsure which SOC code applied to a healthcare role and, as a result, what salary they were required to offer. Our analysis identified that the role fell within a specific exception, allowing sponsorship at a lower skill level even after the July 2025 changes. The role was also on the Immigration Salary List, meaning the applicable salary threshold was the minimum £25,000.

Correctly identifying the SOC code, understanding the relevant exception, and applying the appropriate salary threshold enabled the employer to make a compliant Certificate of Sponsorship application and proceed with confidence.

For employers across these sectors, these changes affect workforce planning, sponsorship costs and retention. There is an increased risk of losing experienced staff, particularly where salary thresholds rise faster than sector pay structures.

At the same time, many internationally recruited workers, who have built lives in the UK while working in a sector that relies heavily on them, now face uncertainty. In recent months, some NHS staff have been unable to renew their visasthrough no fault of their own, simply because their salary falls below £25,000, even where it aligns with national pay scales.

Taken together, these changes create a more complex and restrictive landscape for international workers and their employers, widening the gap between workforce reality and immigration policy.

The recent changes to the Health and Care Worker and Skilled Worker routes represent a significant shift for health and care employers. While policy objectives focus on reducing net migration, the impact for both employers and workers is already being felt across the sector. 

Our experience supporting employers shows that many of the risks, particularly around SOC codes and salary thresholds, can be managed with access to the right information and timely advice.

Taking steps to prepare, employers should consider: 

• Comparing sponsored roles against updated salary and skills thresholds
• Identifying staff likely to be affected in relation to visa extensions and settlement
• Engaging with affected employees early on
• Seeking specialist immigration advice if there is any uncertainty

If your organisation would benefit from tailored advice on sponsoring health and care roles or sponsorship compliance, our team of experienced immigration lawyers can support you.