Compliance & legal support

Health & Care Worker Visa: Current Position and Post-July 2028 Outlook

Reviewed by Lester Aldridge Solicitors (March 2026)

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Key Points at a Glance

• Overseas recruitment of care workers closed on 22 July 2025.

• Limited in-UK sponsorship continues under transitional rules until 22 July 2028.

• From July 2028, sponsorship is expected to be limited to individuals already holding a Health & Care Worker visa; new entrants to the route will not be permitted.

• Salary thresholds are expected to rise to the general Skilled Worker level (currently £41,700+).

• Proposed “Earned Settlement” reforms could extend ILR eligibility from 5 to up to 15 years.

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Overseas Recruitment Closed for Care Worker Roles

From 22 July 2025, UK immigration rules prohibit the recruitment of care workers and senior care workers from overseas under the Health & Care Worker visa route. Adult social care employers can no longer sponsor new applicants who are based outside the UK into these roles.

However, transitional arrangements remain in place until 22 July 2028, allowing limited continued sponsorship within the UK.

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Can We Still Sponsor Care Workers?

Yes — but only in limited circumstances.

You cannot sponsor new care workers or senior care workers directly from overseas.

You may continue to sponsor:

• Workers already in the UK who are eligible to switch under transitional rules.

• Workers already sponsored on a Health & Care Worker visa in a care role (including displaced workers).

• Existing sponsored staff extending their visa.

• Health & Care Worker visa holders switching sponsors, subject to eligibility.

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Switching Into a Care Role (Until July 2028)

Under transitional arrangements, individuals already in the UK may switch into a Health & Care Worker visa for a care worker or senior care worker role when switching from another visa category (i.e. they do not already hold a Skilled Worker visa).

They must:

• Have been legally employed by the sponsor for at least 3 months before submitting the visa application; and

• Meet all other eligibility requirements.

The 3-month employment requirement does not apply where a worker was sponsored on a Health & Care Worker visa prior to 22 July 2025 and has held continuous permission since.

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Can Existing Health & Care Worker Visa Holders Switch Sponsors?

Yes.

They may switch to a new licensed sponsor provided:

• The sponsor holds a valid licence;

• The role remains within the same occupation code; and

• All visa requirements are met.

The 3-month rule does not apply in this scenario.

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Dependants

Since 11 March 2024, newly sponsored care workers and senior care workers are generally not permitted to bring dependants.

Limited exceptions apply (e.g. UK-born children or sole caring responsibility). Dependants already in the UK prior to the rule change may remain for the duration of the visa.

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Salary Requirements

Sponsored workers must be paid at or above:

• The applicable visa salary threshold; and

• The National Minimum Wage (where higher).

Salary thresholds are subject to revision and must always be checked against current Home Office guidance.

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English Language Requirements

Applicants must meet the English language requirements set out in the Immigration Rules. Recent changes have increased expectations under Skilled Worker routes.

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Post-22 July 2028 Arrangements

The current transitional provisions are expected to end on 22 July 2028.

The Government has indicated that:

• SOC Codes 6135 and 6136 will be removed from the Immigration Salary List.

• The reduced salary threshold (c. £25,000) will no longer apply.

• Sponsorship will fall under the general Skilled Worker framework — currently £41,700 per annum (or the applicable going rate, whichever is higher).

• Individuals not already sponsored in these roles will not be able to switch into them.

• Sponsorship will effectively be limited to existing visa holders, who may remain with their current employer or switch sponsors within the same occupation code.

At this salary level, ongoing sponsorship of frontline care roles is unlikely to be financially viable for most providers.

In practical terms, July 2028 represents a structural turning point for international recruitment in adult social care.

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Earned Settlement Proposals

The Government has consulted on proposals under an “Earned Settlement” framework that could extend the route to Indefinite Leave to Remain from 5 years to up to 15 years.

If implemented, this would require employers to maintain sponsorship — and meet Skilled Worker salary thresholds — for significantly longer before workers become eligible for settlement.

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Current Position

We are awaiting formal clarification from the Home Office regarding:

• The detailed post-2028 arrangements; and

• Confirmation of any further Immigration Rule changes following consultation on Earned Settlement reforms.

The overall policy direction is clear: the immigration route for internationally recruited care workers is being progressively restricted, with increasing emphasis on domestic recruitment and workforce retention.

UKVI Crackdown on Care Sponsor Licences

March 2026 Compliance Update

The adult social care sector is operating in the most stringent sponsorship compliance environment to date.

We are continuing to see a very significant increase in UKVI sponsor licence revocations across the sector. Enforcement activity is being driven by enhanced data monitoring, reduced tolerance for compliance errors, and a broader tightening of immigration controls affecting sponsored roles.

We expect this elevated level of revocation activity to continue.

What Has Changed?

Intelligence-Led Monitoring

UKVI now has enhanced access to HMRC payroll data, enabling remote cross-checking of:

• PAYE records

• Salary declarations on Certificates of Sponsorship (CoS)

• Sponsor Management System (SMS) activity

Crucially, this means enforcement action can be taken without a compliance visit.

Even discrepancies that may previously have gone unnoticed are now being identified through automated data matching.

Reduced Tolerance for “Technical” Breaches

Late reporting, incomplete HR records, inconsistent right-to-work documentation, and weak absence monitoring are now far more likely to result in suspension or revocation.

Mandatory Revocation Where Grounds Exist

Where mandatory revocation grounds are met, UKVI is not required to consider business impact before taking action.

Key Compliance Risk Areas

1. Salary and Hours

Providers must ensure:

• Sponsored workers are paid at or above the required salary threshold at all times.

• Pay reflects contracted hours as stated on the CoS.

• Any variations (e.g. sickness absence, reduced hours, unpaid leave, maternity leave, change in work pattern or location) remain compliant.

• Payroll data aligns precisely with CoS details.

Even unintentional administrative discrepancies may now trigger enforcement.

2. Genuine Vacancy Requirement

Revocation risk arises where:

• The role performed does not match the CoS description.

• The job does not exist in practice.

• The arrangement resembles labour supply to third parties rather than direct employment and control.

3. Reporting & Record-Keeping

Sponsors must:

• Update the SMS within required timeframes for any change to salary, duties, hours or work location.

• Maintain complete right-to-work records.

• Monitor attendance and absence effectively.

4. Prohibited Fees

Sponsors must not recoup licence or CoS fees from workers for any CoS issued on or after 31 December 2024.

Practical Steps for Providers Now

We strongly advise providers to:

• Conduct an urgent internal audit of all sponsored workers.

• Reconcile payroll data against CoS salary and hours.

• Review contracts, job descriptions and actual duties for alignment.

• Ensure all reportable changes have been updated via the SMS.

• Review right-to-work processes and visa tracking systems.

• Assign clear internal responsibility for sponsorship compliance oversight at senior level.

Early identification and rectification of issues is critical.

Selecting a legal advisor

Recruiting overseas care workers is complex and requires ongoing compliance with immigration law. While it’s possible to manage the process yourself, many providers choose to use a legal advisor specialising in commercial immigration to ensure accuracy and reduce risk. The decision will depend on your organisation’s capacity, experience and resources.

Typical Services

Depending on the advisor, services may include:

• Sponsor licence applications
• Allocation of Certificates of Sponsorship (CoS) and Skilled Worker visa applications
• Support with UKVI compliance and use of the Sponsor Management System (SMS)
• Preparation for, or delivery of, mock UKVI compliance audits
• Training and ad hoc legal advice

Law Firm or Immigration Advisor?

If you decide to use a legal advisor, you’ll first need to choose between a law firm or an immigration advisor. Both can be effective, but they differ in cost, scope, and regulation.

Law Firms – Authorised by the Solicitors Regulation Authority (SRA), law firms are staffed by qualified solicitors and can advise across multiple areas, including immigration, compliance, and employment matters.
Pros: Broad expertise, strong professional standards, robust regulation.
Cons: Higher fees and sometimes less personalised service.

Immigration Advisors – Regulated by the Immigration Advice Authority (IAA), advisors often provide more specialised, flexible support for smaller providers.
Pros: Lower cost, accessible, more personal (some may not charge VAT).
Cons: Limited to immigration matters and less formal oversight than law firms.

Indicative Costs

Costs vary depending on the type of advisor and level of service required. As a guide:

££££ – Large law firm (broad expertise, higher fees)

£££ – Smaller specialist law firm (sector-specific expertise)

££ – Immigration advisor (cost-effective, focused support)

£ – Online immigration platform (basic assistance)

Higher cost does not always mean better service. Choose based on relevance, experience, and responsiveness.

Making the Right Choice

To make an informed decision:

• Identify your organisation’s needs and objectives
• Research potential advisors with experience in health and social care
• Check credentials, registration and track record
• Compare proposals, services and fees (including VAT status)
• Request references or feedback from other providers

Screening Checklist

• Registered with SRA (law firms) or IAA (immigration advisors)
• Experience in Health & Social Care and Business Immigration
• Memberships such as ILPA or inclusion in Legal 500
• Transparent fee structure and VAT status
• Positive references or local recommendations
• Verified company history (via Companies House or LinkedIn)

Taking time to select the right advisor will help ensure your recruitment activity remains compliant, efficient, and well-supported as you expand your workforce internationally.

Legal advisor directory

UKVI  Compliance Visits

Supplemental Employment for Sponsored Workers

Sponsored workers can undertake a limited number of hours’ work each week for an employer that is not their sponsor. This is known as supplemental employment.

Workers may seek such work from you directly, or may be referred via an agency.

Eligibility

To be eligible:

• The worker must remain sponsored.

• Displaced workers or those who have been dismissed from their employment with their sponsor are not eligible.

Sponsored workers can undertake supplemental employment that either:

• Appears in Appendix Immigration Salary List, or

• Is in the same profession and at the same professional level as the job for which their Certificate of Sponsorship (CoS) was assigned.

Restrictions

Supplemental employment must not:

• Exceed 20 hours per week (including all time considered ‘working time’ under the Working Time Regulations, such as travelling or waiting time).

• Take place during the contracted hours of the worker’s sponsored employment.

Right to Work requirements

To establish a statutory excuse under Right to Work legislation, you must confirm that:

• The worker has the right to work in the UK by completing the standard Right to Work check; and

• The worker is permitted to carry out the work and meets the eligibility requirements above.

UKVI recommends asking the worker to provide a letter or evidence from the sponsor confirming:

• The worker remains employed by the sponsor;

• The job description and occupation code of their sponsored role; and

• Their contractual working hours.

Alternatively, you can request the following from the worker:

• Their contract with their sponsor;

• Their rotas (if the contract doesn’t specify normal working hours); and

• Recent payslips.

If you get it wrong

Providing supplemental employment to a worker who is not eligible or does not meet the UKVI criteria constitutes illegal employment.

This can result in a civil penalty of:

• Up to £45,000 per worker for a first offence; and

• Up to £60,000 per worker for subsequent offences.

Need advice?

This guidance has been prepared by the Immigration Team at Lester Aldridge Solicitors.

Frequently asked questions

Here are the frequently asked questions we’ve received from adult social care providers, with answers kindly provided by law firms including JMW, RWK Goodman and Lester Aldridge Solicitors.