Health and Care Worker visa: the 5-year route to ILR
The Health and Care Worker visa is a variant of the Skilled Worker route, and it leads to indefinite leave to remain (ILR) after 5 years of continuous residence in the UK. At the 5-year point you must still be sponsored in an eligible health or care job, meet the salary requirement in force on the day you apply, have kept absences under 180 days in any 12-month period, and pass the Life in the UK test if you are aged 18 to 64.
- ILR is available after 5 continuous years; the application fee is £3,226 per person from 8 April 2026
- Visa fees are reduced: £324 (up to 3 years) or £628 (over 3 years), and there is no immigration health surcharge
- Absences must stay under 180 days in any rolling 12-month period
- Care worker and senior care worker roles (SOC 6135 and 6136) closed to new overseas applicants on 22 July 2025
- Workers already legally sponsored can still extend, change sponsor and apply to settle
A Skilled Worker visa with lower costs
The Health and Care Worker visa sits inside the Skilled Worker rules but with two big financial advantages. First, the application fee is heavily discounted: £324 for a visa of up to 3 years, or £628 for more than 3 years, whether you apply from inside or outside the UK. Second, holders are exempt from the immigration health surcharge entirely, saving a typical family thousands of pounds over 5 years.
ILR and citizenship both need the Life in the UK test — see how you'd score on a free mock test, no sign-up needed.
Because it is a Skilled Worker variant, the settlement rules are the Skilled Worker settlement rules. Time on the Health and Care Worker visa counts towards the same 5-year qualifying period, and time spent on a standard Skilled Worker visa in an eligible role can combine with it.
What you must meet at the 5-year settlement point
GOV.UK sets out four core requirements for settlement on this route. You must have lived and worked in the UK for 5 years. Your employer must confirm that you are still needed for your job. You must be paid at least the salary requirement that applies on the date you apply: for Health and Care jobs this is usually at least £25,000 or the going rate for your occupation code, with NHS roles checked against national pay scales. The thresholds have moved several times, so check which salary threshold applies to your ILR application before you rely on an older figure.
You must also pass the Life in the UK test (£50 per attempt) if you are 18 to 64. On the English language side, GOV.UK currently confirms that you do not need to prove English again when settling on a Skilled Worker or Health and Care Worker visa, because you proved it when you got the visa. Be aware that the English level for settlement rises from B1 to B2 for applications made from 26 March 2027, so check the current position close to your application date.
The ILR fee is £3,226 per person under the fee table in force from 8 April 2026, and dependants pay the same amount each.
Where care workers stand in 2026
Since 22 July 2025, sponsors can no longer recruit care workers or senior care workers (occupation codes 6135 and 6136) from overseas. New entry clearance applications in these roles are closed.
Crucially, this does not strip settlement rights from people already in the route. Home Office guidance confirms that workers already legally sponsored in the sector can continue to extend their stay, change sponsors and apply to settle. There is also a transitional window for people already in the UK on another route: a care provider can still sponsor you in-country if you have been legally working for them in the role for at least 3 months, but that application must be made no later than 22 July 2028, when the transitional provision ends.
Sponsorship and salary are tested on the day you apply for ILR, not just across the 5 years. If you are made redundant, your sponsor loses their licence, or your pay dips below the threshold shortly before you apply, your settlement application is at risk even after years of qualifying residence. Time any job changes carefully in the final year.
Absences, gaps and continuous residence
Continuous residence is governed by Appendix Continuous Residence of the Immigration Rules: you must not have been outside the UK for more than 180 days in any 12-month period during the 5 years. This is a rolling check, not a per-calendar-year allowance. Limited exceptions exist, including travel disruption from natural disasters or pandemics, serious illness, and assisting with humanitarian crises overseas. If your travel history is complicated, work through how the 90, 180 and 450-day absence limits interact well before you apply.
Dependants and the family position
Partners and children on this route qualify for ILR after their own 5 years as dependants, with the same absence rule applying to partners. For care workers specifically, new dependants can generally only be added if you have been continually employed as a care worker or senior care worker on a Health and Care Worker or Skilled Worker visa since before 11 March 2024, or in limited cases such as a child born in the UK. Dependants need funds of £285 for a partner, £315 for the first child and £200 for each additional child, unless the family has already been in the UK for 12 months or the sponsor certifies maintenance.
Settlement on this route is very achievable, but salary, sponsorship, absences and the Life in the UK test all have to line up on the day you apply.