Welcome to our international recruitment hub

Here you will find information and resources specific to the South East of England, designed to help you overcome the barriers to international recruitment while upholding ethical practices.

Here to support our providers

The Government is committed to helping providers make more effective use of international recruitment to help grow the adult social care workforce alongside wider action to improve domestic recruitment and retention.

We recognise that many providers find international recruitment difficult and experience various barriers, including administrative complexity and cost, together with issues around pastoral support, housing and travel. Our International Recruitment Hub contains guidance and resources, as well as signposting to support services, to help our providers overcome these barriers, whilst upholding an ethical approach.

It has been commissioned as part of the Department of Health and Social Care International Recruitment Funding initiative and produced by SESCA, in collaboration with the Association of Directors of Adult Social Care (ADASS). We would like to give special thanks to the contributors from across the sector involved in developing it.

The immigration system is constantly changing, and although our Hub is updated from time to time, the GOV.UK website provides official, up to date guidance.

International Recruitment Hub last updated: November 2023

Is international recruitment for you?

Recruiting from overseas is an effective way to strengthen your workforce, but it is not a quick fix. The Government supports overseas recruitment and has added care roles to the Skilled Worker Visa.

Overseas recruitment isn’t for everyone. It’s a serious commitment with significant responsibilities on you, the employer. However, most say the benefits outweigh the challenges, cost and effort involved.

Take a look at the steps below to find out whether you are ready to get started.

Do you have…

  • permanent vacancies for roles that pay in line with minimum requirements? (i.e. £20,960 or £10.75 per hour, based on a 37.5 hour week)
  • capacity to support the whole process?
  • dedicated people in your organisation who will take responsibility for the end-to-end process?
  • a long-term workforce plan?
do you have

Processing costs

Sponsor licence cost

Employer sponsor licence costs vary depending on size of business, from £536 for an organisation employing 50 people or less and with assets under £5m, to £1,476 for larger organisations.

The UKVI (UK Visas and Immigration) processing time for a sponsor licence is normally up to eight weeks.

Certificate of sponsorship

Before an overseas worker can apply for a health and care worker visa, the employer must assign them a certificate of sponsorship. This costs £239.

Immigration skills charge

An immigration skills charge is payable for each worker sponsored under the health and care worker visa.

The cost is either £364 (smaller companies and charities) or £1,000 (large companies) per sponsored worker per year.

This charge does not apply to international students switching to a health and care worker visa.

Health and care worker visa

Where roles fall under the health and care worker visa, the visa application fees are £284 (up to 3 years), or £551 (up to 5 years).

It normally takes 3 weeks for UKVI to process a visa, although you can pay extra for priority services, which can turn around applications in as little as one working day.

NOTE: Costs correct at 4th October 2023

Visa Processing Times

The visa processing times provided are based on current Home Office guidance. However, feedback from care providers suggests that applications can often take longer than expected. Delays may result from errors made by the care provider or external factors, such as a high volume of applications. It is advisable to consider engaging a legal specialist to ensure accuracy in the application process. Being prepared for potential delays is recommended.

group meeting

Overall cost and timescales

The overall cost to recruit from overseas varies considerably, depending on your organisation size, whether you engage a solicitor and / or recruitment agency, and how much of the extra costs you cover (flights, accommodation, etc.).

As a guide, you can expect to pay around £5,000 – 6,000 per person, although this can be considerably more.

Cost summary

Estimated Cost

Employer Sponsor Licence

Costs vary depending on size of business:  £536 for organisation employing less than 50 people, with assets under £5m; £1,476 for larger organisations. Licence must be renewed every 4-years.

£536 / £1,476 (paid every 4-years)

Certificate of Sponsorship

Before worker can apply for Visa, employer must assign a Certificate of Sponsorship.


Health & Care Worker Visa Application

Cost varies depending on whether worker obtains a 3 or 5-year Visa.

£247 (up to 3 years) / £479 (up to 5 years)

Immigration Skills Charge

Either £364 (smaller companies and charities) or £1,000 (large companies) per sponsored worker per year.

£364 / £1,000 per worker, per year

English Language Test Fee

Charge by International English Language Testing System (IELTS), or Occupational English Test (OET) to administer standard English Language Test.

£250 varies

Health Medical / Immunisations

A health check must be undertaken to confirm the worker is in good health and not a carrier of infectious diseases such as TB.

£200 varies

Flight & Transport to Accommodation

The physical relocation of the candidate to the UK.

£800 varies

1st Month’s Accommodation

It is common that employers provide at least the first month’s accommodation as part of the relocation package.

£800 varies

Other Charges

Depending on source country there may other processing fees. Other costs may include airport meet and greet, or training to prepare for English test.



£3,000 – £5,000

Optional Professional Service Fees

Recruitment Agency Fee

£2,500 varies

Legal Advisor Fee

Costs vary depending on law firm / immigration specialist. See Selecting a legal advisor.

£2,500 varies



Additional Costs for Overseas Nurses

NMC Application Fee

Levied by the NMC when nurse applies to the UK NMC register.


CBT Exam Fee

Part 1 of the NMC Assessment is a Computer Based Test which examines the nurse’s professional standards.


OSCE Exam Fee

Practical part 2 of NMC Assessment undertaken in the UK.


NMC Registration Fee

Levied by NMC when nurse registers for their PIN.


Additional Costs

OCSE preparation training. Accommodation and travel to test centre.




The process takes around six months from applying to become a sponsor, to your first overseas worker commencing employment. Once you’re set up as a sponsor, it will become quicker for subsequent recruits.

What are the benefits?

Loyal, committed workforce

Transferable skills on arrival

High retention

Future recruits from word of mouth

You’ll need a sponsor licence to employ someone to work for you from outside the UK. The process to apply is as follows:

Step 1

Check that your business is eligible. The UK Government has eligibility criteria for employers for visa sponsorship. Find out more here.

Step 2

Check if the job you are recruiting to is suitable for sponsorship. Find out what is needed for a Skilled Worker Visa. Check eligibility for a Health and Care Worker Visa.

Step 3

Decide who will manage the application. There are three roles required by the application; Authorising officer, key contact, and Level 1 user. This can be performed by the same person.

Step 4

Complete the online application form. This requires various supporting documents including covering letter and hierarchy chart. The process should take eight weeks to complete, but it can take longer.


It’s important that you understand the ongoing compliance duties under the sponsorship licence.
UKVI conduct unannounced site audits and an organisation found to be falling short
of the required standards may face enforcement action.

Compliance responsibilities continue throughout the lifetime of the Sponsorship Licence,
and there are strict deadlines for reporting via the SMS.
You will need to ensure that you have the right personnel, HR systems, and processes in place to handle this.

The main compliance duties include:

Record keeping

You must maintain up-to-date records for any worker you sponsor, including contact details, right to work documents and copies of pay slips.


You must track and record employee attendance to ensure compliance with the terms of their visa.

Complying with immigration rules

Such as conducting regular right to work checks on all prospective and existing employees.

Cooperating with UKVI

You must report activities via the SMS, such as regular non-attendance.

Legal Support

Legal support

International recruitment requires ongoing compliance with legal requirements. Although the process does not require legal expertise, using a legal advisor should ensure you get things right first time.

Our Legal Support section includes a guide on how to select a legal advisor, together with a directory of some of the advisors our members are using.

We’ve also linked up with leading immigration specialists who provide regular updates to our Legal Bulletins.

Ethical recruitment

All UK health and social care employer organisations must commit to recruiting ethically through adhering to the Code of Practice for International Recruitment, which implements the World Health Organization’s (WHO) Global Code of Practice.

The Code promotes high standards of ethical practice in the recruitment of overseas healthcare workers, whilst protecting countries with the most pressing health workforce challenges.

Our Recruitment Support section outlines the key principles of the Code, together with a guide on how to select an ethical recruitment agency.

We also touch upon Modern Slavery, providing links to key resources that will help you to understand, identify, monitor and mitigate against the growing risks in this area.

nurse with patient in the home

Onboarding support

Given the challenges and resources involved in obtaining a sponsor licence and the recruitment process, prioritising the onboarding of overseas care workers is essential for ensuring their successful long-term retention. There are two key areas of onboarding:

Pastoral Support – focuses on helping new recruits settle into their new home and community and supports their emotional wellbeing.
Professional Support – includes workplace induction, training, and mentoring.

Find out more in our Onboarding support section.

Hiring International Students

International students provide another valuable source of overseas talent. Recruiting students can be less expensive and more straightforward, given that they are already established in the UK, may have accommodation, and are exempt from the immigration skills charge.

Find out more in our International students section, including work limits, eligibility criteria, and post-graduation routes for successful recruitment.

Where can I find more information?

gov logo

Definitive, real-time guidance and regulatory information from the Department of Health, including the Code of practice for the international recruitment of health and social care personnel in England and the Health and Care Worker Visa application process.

local gov logo

For a concise overview with lots of helpful links, see the Overseas Recruitment Bite-size Guide for Social Care Providers in England.

NCF logo

Pastoral Care Guide for International Recruitment in Social Care great resource that will help employers to explore resettlement support and pastoral care for overseas recruits.

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