The Health and Care Worker Visa has played a vital role in helping care providers address ongoing staffing shortages and access skilled international talent. For many organisations, it became a key part of workforce planning and service continuity. However, significant rule changes introduced in July last year altered who can now benefit from the scheme.
Under the updated guidance, care workers are no longer eligible for new sponsorship applications. Those who were already sponsored before 22 July — or who meet specific transitional criteria, such as having worked for their sponsoring employer for at least three months — may still be able to apply for visa extensions, but only up to July 2028. These changes have created uncertainty for employers and highlight the importance of forward-thinking recruitment and compliance planning within the sector.
Changes to the Health and Care Worker Visa
The minimum salary threshold for the Health and Care Worker Visa has increased to £25,000, which has pushed up the required pay levels for many roles across healthcare and education. As a consequence, some lower-paid or entry-level healthcare positions — including those commonly linked to Band 3 — may no longer meet the eligibility criteria.
In addition, care providers in England are now expected to demonstrate that they have first attempted to recruit suitable candidates already in the UK who hold a Skilled Worker visa before turning to overseas recruitment. Sponsors must obtain confirmation from their local regional partnership as evidence that domestic recruitment efforts have been made.
From 22 July 2025, the minimum skill threshold for the Skilled Worker visa increased from RQF Level 3 (roughly A-level standard) to RQF Level 6 (graduate level). This means roles below graduate level are no longer eligible under this route — including many care worker positions, which typically sit at RQF Level 3 — unless the occupation appears on the Temporary Shortage List (TSL) or the Immigration Salary List (ISL).
As a result, employers have seen reduced access to overseas talent for a number of mid-level roles and greater competition when recruiting within the UK labour market.
The Impact on Health and Care Sector
For employers, the changes to Health and Care Worker Visa goes beyond simple administrative updates and has a direct impact on day-to-day workforce planning. Restrictions on new sponsorships, alongside rising salary thresholds, can make it more difficult and costly to recruit from overseas and to retain existing sponsored staff. In sectors where pay rates are often set by funding arrangements or tight margins, salary increases may not be feasible, which increases the risk of losing experienced and already-trained employees.
There are also wider operational implications. Employers may face higher turnover, additional recruitment spend, and greater pressure on remaining teams if sponsored workers are unable to extend their visas. This can disrupt continuity of care and place further strain on service delivery, particularly in organisations that have relied heavily on international recruitment to fill persistent vacancies.
Overall, the Health and Care Worker Visa changes create a more restrictive and complex environment for employers to navigate. Compliance requirements remain, but the practical options for filling roles are narrowing, meaning organisations must place greater emphasis on long-term workforce strategies, retention planning, and exploring alternative recruitment and development routes within the domestic labour market.
Steps Employers Should Take
1. Review Your Current Sponsored Workforce
Start by auditing which employees are currently sponsored, their visa expiry dates, and any extension eligibility. Having a clear timeline helps avoid last-minute decisions and reduces the risk of losing key staff due to missed deadlines.
2. Strengthen Retention Strategies
With fewer opportunities to recruit internationally, retaining existing employees becomes even more important. Consider career development pathways, training opportunities, flexible working arrangements, and wellbeing initiatives that encourage long-term commitment.
3. Plan Workforce Needs Earlier
Recruitment planning should begin well in advance of vacancies arising. This may involve forecasting demand, succession planning, and identifying critical roles that would significantly impact service delivery if left unfilled.
4. Review Pay and Funding Structures
Where salary thresholds or funding models create barriers, employers may need to reassess pay bands, budgeting, or contract pricing to understand what is sustainable. Even if increases are not possible, being aware of the gap allows for more realistic planning.
5. Explore Domestic Recruitment and Development
Investing in apprenticeships, partnerships with local colleges, return-to-work programmes, or upskilling existing staff can help reduce reliance on overseas recruitment over time.
6. Ensure Ongoing Compliance
Maintain accurate right-to-work checks, sponsorship records, and reporting duties. Immigration compliance remains essential, and errors can be costly both financially and reputationally.
7. Communicate Clearly With Affected Employees
Open and supportive communication helps reduce uncertainty and builds trust. While employers cannot provide immigration advice, signposting staff to official guidance or reputable advisers can be helpful.
Taking proactive steps now allows employers to move from a reactive position to a more stable, forward-planned workforce strategy, reducing disruption and protecting service quality.
How The HR Booth can help
At The HR Booth, we can support employers by helping them take a proactive and compliant approach to Health and Care Worker Visa changes rather than reacting when issues arise. This might include:
- reviewing your current workforce structure
- identifying which roles are at risk due to visa or salary threshold changes
- building a longer-term people plan that reduces reliance on last-minute recruitment
- audit sponsorship and right-to-work processes
- update contracts and policies
- ensure managers understand their responsibilities when employing sponsored workers
Alongside compliance, we work with organisations on practical retention strategies such as:
- pay and benefits benchmarking
- career progression pathways
- manager training to improve engagement and reduce turnover.
Where international recruitment becomes more limited, we can also advise on alternative routes including apprenticeships, graduate pipelines, and domestic talent development. The aim is to give employers clarity, reduce risk, and create a sustainable workforce plan that supports both business continuity and employee wellbeing.
If you would like further advice on Health and Care Worker Visa changes, get in touch with us.
