Who the route is for
The route covers qualifying roles delivered by the NHS, by an organisation providing services to the NHS, or in adult social care. Doctors, nurses, midwives, paramedics, allied health professionals, dentists, pharmacists and social care roles are the main categories.
Three things must line up. The job must be an eligible occupation for this route. The employer must hold a sponsor licence and be an eligible sponsor for it. And for adult social care roles in England, the provider must be regulated by the Care Quality Commission — a requirement introduced on 11 March 2024 which removed a large number of previously eligible sponsors overnight.
Where those conditions are not met, the standard Skilled Worker route may still be available for the same person and the same job, without the fee and surcharge advantages. Establishing which applies is the first thing to do.
The care worker rules have changed repeatedly — check before you act
We are going to be more cautious on this page than anywhere else on the site, and the reason is straightforward: the rules governing overseas recruitment into care roles have been restricted more than once since 2024, and the position has moved faster than most published guidance.
What is stable is the structure. The role must be eligible, the sponsor must be licensed, adult social care providers in England must be CQC-registered, and the salary and English requirements must be met.
What is not stable, and what you must confirm before making any decision, is whether a particular care role is currently open to recruitment from overseas at all, what the current salary thresholds are for these occupations, and what dependant rights attach. These have each been the subject of change, and we are not going to print a position on this page that might be a month out of date when someone reads it and reorganises their life around it.
If you are an employer planning recruitment, or a worker considering a move, call us and we will check the current rules for your specific occupation code before you commit to anything. That call is free and it takes minutes.
What the exemption is actually worth
The Immigration Health Surcharge is charged per person per year of visa granted, and it is paid upfront for the whole period at the point of application.
For a worker on a five-year visa with a partner and two children, the surcharge on the standard Skilled Worker route runs to a substantial five-figure sum, payable in one go before the visa is granted. On the Health and Care Worker route it is nil — for the applicant and for their dependants.
That, together with the reduced application fee, is why establishing eligibility for this route matters so much financially. It is also why it is worth checking whether a role qualifies even when the employer has assumed the standard route applies — we have seen families pay a surcharge they need not have paid because nobody asked the question.
What we do
For workers and for employers, though never both sides of the same matter.
- Establish which route applies Whether the role qualifies for Health and Care Worker or only for standard Skilled Worker, and what that difference costs.
- Confirm the current rules for the occupation This branch changes often. We check the position as it stands today rather than as it stood when a page was written.
- Check CQC registration where it applies For adult social care sponsors in England, this is a threshold question.
- Prepare the application Evidence, English, the online form and the submissions.
- Advise on dependants Who can come, what they can do, and what it costs.
- Extensions and settlement Planning the five years so nothing derails indefinite leave.