Settlement for health and care workers

The Published Requirements

The requirements for settlement on this route are:

• Have spent a continuous period of 5 years in the UK with permission on the Health and Care Worker or Skilled Worker route, or on one of the other routes listed in paragraph SW 21.2.
• Have a sponsor who is still approved by the Home Office to sponsor Skilled Workers on the date of decision, and who confirms they still require the applicant to work for them for the foreseeable future (paragraphs SW 24.1 and SW 24.2).
• Be paid at least the salary in the relevant row of the table at paragraph SW 24.3, and at least the going rate for the occupation code. See our guide to health and care worker salaries.
• Meet the continuous residence requirement (no more than 180 days absent in any 12-month period).
• Pass the Life in the UK test.
• Not fall for refusal under Part Suitability of the Immigration Rules, and not be in breach of immigration laws or on immigration bail, subject to the exceptions for overstayers set out there.

Two requirements that apply elsewhere do not apply here. GOV.UK states that the English language requirement does not have to be met again when settling on a Skilled Worker, Health and Care Worker, T2 or Tier 2 visa, because it was met at the visa stage; paragraph SW 22A.1 introduces a level B2 requirement for applications made on or after 26 March 2027. And the good character requirement is a requirement for British citizenship, not for settlement; at settlement the equivalent test is Part Suitability.

Salary at the Settlement Stage

Paragraph SW 24.2 requires the sponsor to confirm that the applicant “is paid, and will be paid for the foreseeable future” at least the required salary, so the figure that matters is the one in force at the settlement application, not at the original visa.

GOV.UK sets out how the figure is arrived at for healthcare jobs: where the going rate is based on national pay scales, the salary must be the higher of £25,000 a year or that going rate. The national pay scale tables list eligible healthcare jobs by NHS pay band and area of the UK, and eligible teaching and education leadership jobs by role and area. GOV.UK states that these going rates apply whether the work is in the public or the private sector.

For a Health and Care Worker visa holder whose job is in one of the occupation codes with different salary requirements, the salary must be the higher of £31,300 a year, or £25,000 a year if the job is on the Immigration Salary List (or was at the time of the application), or the lower going rate for the work. The general row, where none of those apply, is at least £41,700 a year and at least the standard going rate. See our guide to health and care worker salaries.

Evidence

The application draws on:

• A document from the sponsor confirming the role, the salary, and that the applicant is still needed for the foreseeable future. GOV.UK names this as a requirement of the route.
• Payslips for the most recent period.
• The Life in the UK test pass notification.
• Travel history for the qualifying period. See our evidence of residence guide.

For the full list, see our documents checklist.

Application Process

The application is made online on GOV.UK on form SET(O). The earliest date is 28 days before the 5 years are complete; GOV.UK says an application made earlier may be refused. It costs £3,226 for each person applying, and a partner and children can be included on the same form if they are eligible.

Fingerprints and a photograph are then given, either through the “UK Immigration: ID Check” app or at a UK Visa and Citizenship Application Services appointment; there is no fee for this, and children aged 6 or over included on the form must give them too. Supporting documents are uploaded into the online service or scanned at the appointment. GOV.UK says a decision usually follows within 6 months of the fingerprints and photograph. The priority service costs £500 for a decision within 5 working days and the super priority service £1,000 for the next working day, or 2 working days if the appointment falls at a weekend. See our guide to processing times. GOV.UK also states that the application is withdrawn if the applicant travels outside the UK, Ireland, the Channel Islands or the Isle of Man before the decision. See our guide to the biometrics step.

What Changes for the Sponsor

GOV.UK states that a sponsor licence is not needed to employ someone who has indefinite leave to remain. So when a sponsored worker settles:

• the worker is no longer sponsored on that job;
• the sponsor’s duties in respect of that worker end;
• the worker can change employer without a new certificate;
• changes are registered through the sponsorship management system, which GOV.UK says can take up to 18 weeks, or 5 working days on the £350 priority service.

See our health care sponsorship guide for employer guidance.

After Settlement

GOV.UK states that indefinite leave to remain allows the holder to work, run a business, study, use public services such as healthcare and schools, and apply for public funds and pensions. It also states that indefinite leave to remain can be lost after more than 2 continuous years outside the UK, the Channel Islands and the Isle of Man. See our guide to what settlement allows. GOV.UK says an application for British citizenship usually follows after a minimum of 12 months holding settlement. It costs £1,839: £1,709 to apply and a £130 citizenship ceremony fee.

Questions and answers