Health & Care Worker ILR: Salary, the 5-Year Rule & the Closure

Researched and maintained by the ILR Calculator UK editorial team · Reviewed against Appendix Skilled Worker and the Immigration Rules in force on 24 June 2026 · General information about UK settlement, not regulated immigration advice. For advice on your own case, use an adviser regulated by the Immigration Advice Authority (IAA) or a solicitor.

Health and Care Worker visa holders can apply for Indefinite Leave to Remain after 5 years of continuous residence, on a much lower salary floor than the main Skilled Worker route — usually £25,000 or the going rate for the role, whichever is higher. The route is a sub-type of Skilled Worker, comes with a full Immigration Health Surcharge exemption, and still requires ongoing sponsorship at ILR. The 2025 closure of the care-worker sub-route to new overseas applicants does not stop existing holders from settling.

The Health & Care Worker route to ILR

The Health and Care Worker visa is a sub-type of the Skilled Worker route for NHS staff, doctors, nurses, allied health professionals and adult social care workers sponsored by an approved employer. Time on it counts in full towards the 5-year Skilled Worker qualifying period for settlement, and it can be combined with ordinary Skilled Worker or Tier 2 (General) time. Its advantages over the standard route are a lower salary floor, reduced visa fees and a full exemption from the Immigration Health Surcharge. Check your timing with the ILR eligibility calculator.

The settlement salary test

The salary requirement is the biggest difference from the main Skilled Worker page. The Health and Care route uses a reduced salary option, so the floor is far lower — though you must still be sponsored and meet the going rate for your occupation at the date you apply.

Source: UK Immigration Rules, Appendix Skilled Worker (Health and Care salary option) and the GOV.UK Health and Care Worker visa guidance. Some Health and Care roles not on national pay scales face a higher general threshold; always check the rate for your occupation code.

The care-worker closure and what it means for settlement

From 22 July 2025, new overseas recruitment of care workers (SOC 6135) and senior care workers (SOC 6136) ended — these roles can no longer be sponsored for entry clearance from abroad. This was widely reported and has caused real anxiety, but it is important to separate recruitment from settlement.

Other Health and Care Worker roles — nurses, doctors and many allied health professionals — are not affected by the care-worker closure and continue to recruit and settle as before, subject to the salary and going-rate rules for their occupation.

What counts towards the 5 years

As a Skilled Worker sub-route, the qualifying time is the same as for the main route: sponsored work counts, study and post-study routes do not.

Source: Appendix Skilled Worker and Appendix Continuous Residence. The same 5-year rules are set out on our Skilled Worker ILR guide.

Other requirements and the IHS exemption

Alongside time and salary, settlement requires:

• Ongoing sponsorship — you must still hold a genuine sponsored role with a licensed sponsor (in England, a CQC-registered provider for care roles), with an employer letter confirming your salary, role and SOC code.
• The 180-day absence rule — no more than 180 days outside the UK in any rolling 12-month period. Check it with the absence calculator.
• English at CEFR B1 for settlement (rising to B2 for ILR applications on or after 26 March 2027), unless exempt.
• Life in the UK test and the Part 9 suitability rules.

Throughout the visa, neither you nor your dependants pay the Immigration Health Surcharge — a substantial saving compared with the main Skilled Worker route. The ILR application itself costs £3,226 from 8 April 2026, with no surcharge on settlement.

Dependants

Most Health and Care Worker visa holders can bring a partner and children under 18 as dependants, who can settle alongside the main applicant once they each meet 5 years and the absence rules. One important exception applies to care workers: since 11 March 2024, new care worker (SOC 6135/6136) applicants cannot bring dependants, with transitional protection only for those already in the route under a Certificate of Sponsorship assigned before that date. Dependants’ absences are assessed separately, so check each family member’s travel history.

Reform watch: a longer pathway for care?

The settlement reforms could hit lower-paid work routes hardest. The 2025 earned-settlement proposals would extend the qualifying period for many routes, and social care roles have been specifically flagged for a significantly longer pathway to ILR than the current 5 years.