There are two routes to the UK for skilled healthcare workers: the standard Skilled Worker route and the Health & Care Worker route. The eligibility criteria are identical — same points, same SOC codes, same salary thresholds. The difference is cost.
On the standard route, a nurse applying for a 3-year visa pays approximately £1,400 in application fees and over £3,000 in Immigration Health Surcharge. On the Health & Care Worker route, the application fee drops to around £284, and the IHS is waived entirely.
That is a difference of more than £4,000 for a single applicant. For a family relocating with a partner and children, the gap is larger still.
Many eligible healthcare workers are not using this route. Some are on the standard route because their employer did not mention it. Some assumed it only applied to NHS doctors and nurses. Some were processed through a recruitment agency that was not aware of the distinction.
This guide explains what the route offers, who qualifies, and what to verify before applying.
What the Health & Care Worker route provides
The route is a sub-route of the Skilled Worker visa. It does not have separate eligibility criteria or a different points system. What it changes is:
Application fees
Standard Skilled Worker fees are based on the salary and duration of the role. For a 3-year visa on a salary above the general threshold, the fee is currently around £1,400. The Health & Care Worker fee is set at approximately £284 for all qualifying roles and durations, regardless of salary level.
Immigration Health Surcharge
The IHS is a mandatory surcharge that most visa applicants pay to access NHS services. The rate is currently £1,035 per year — meaning a 3-year visa costs an additional £3,105, and dependent family members pay the same rate individually.
Health & Care Worker route holders and their dependants are fully exempt from the IHS. This is the larger saving for most applicants, particularly those with families.
Processing
There is no formal difference in processing time between the routes, but Health & Care Worker applications are handled by the same Skilled Worker caseworking teams and are generally processed within the same standard timeframes.
Who qualifies
Two conditions must both be met:
Condition 1: The role must be on the eligible occupations list for the Health & Care Worker route
Not all healthcare roles qualify. The route is available for specific SOC codes that correspond to clinical and care roles — including doctors, nurses, midwives, pharmacists, paramedics, physiotherapists, occupational therapists, speech and language therapists, radiographers, and care workers in adult social care.
Administrative, managerial, and non-clinical support roles in healthcare do not qualify, even if the employer is the NHS.
Condition 2: The employer must be a qualifying organisation
Qualifying employers are:
- NHS trusts and NHS foundation trusts
- GP practices and primary care networks
- Social care providers registered with the relevant regulator (Care Quality Commission in England, equivalent bodies in Scotland, Wales, and Northern Ireland)
- NHS suppliers — private companies contracted to provide services directly to the NHS under specific arrangements
Non-NHS private hospitals, private clinics, and medical staffing agencies that supply workers to the NHS generally do not qualify as employers for the Health & Care Worker route, even if their workers primarily serve NHS patients.
A recruitment agency placing nurses in NHS trusts does not make the agency itself a qualifying Health & Care Worker employer. The employer named on your Certificate of Sponsorship must be the qualifying organisation — the NHS trust or social care provider. If your CoS names the agency as your employer, you may be on the standard route even if you will work in NHS settings.
The salary thresholds still apply
Being on the Health & Care Worker route does not change the salary requirement. You must still meet the going rate for your specific SOC code, or the general threshold of £38,700, whichever is higher.
For nurses (SOC 2231) and many allied health professions, the going rate is below the general threshold, meaning the general threshold applies. However, these roles often appear on the Immigration Salary List — which changes how the rate is calculated for new entrants (those switching from a student visa or under 26), but does not grant a salary discount on the standard rate.
For doctors, the going rate varies by grade and is typically well above the general threshold.
Professional registration
Most regulated health professions require registration with the relevant UK regulatory body before you can start work. This is separate from — and in addition to — the visa requirement.
- Doctors: registration with the General Medical Council (GMC)
- Nurses and midwives: registration with the Nursing and Midwifery Council (NMC)
- Allied health professionals (physiotherapists, occupational therapists, radiographers, etc.): registration with the Health and Care Professions Council (HCPC)
- Pharmacists: General Pharmaceutical Council (GPhC)
- Dentists and dental care professionals: General Dental Council (GDC)
The NMC process for internationally educated nurses is typically the longest — it involves a Computer Based Test (CBT), an Objective Structured Clinical Examination (OSCE), and English language testing, and the full process can take 6–12 months. Starting this process before or immediately after receiving a job offer is essential.
Your employer may ask to see evidence of registration progress before assigning a Certificate of Sponsorship. At minimum, you should be able to show your application is in progress and your CBT result if applicable.
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Build my checklistThe TB test still applies
Healthcare workers applying from countries on the tuberculosis testing list must still provide a certificate from a UKVI-approved clinic. This applies regardless of whether you are on the Health & Care Worker route or the standard Skilled Worker route.
The list of countries subject to this requirement is published at gov.uk/tb-test-visa. It includes most countries in sub-Saharan Africa, South and Southeast Asia, and Central Asia. If you are from a listed country, allow 1–2 weeks for the test and certificate — and book it no more than 6 months before you intend to apply.
What to verify with your employer
If you believe you qualify for the Health & Care Worker route, confirm the following before your employer assigns your Certificate of Sponsorship:
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Is your employer a qualifying organisation? Confirm they are an NHS trust, GP practice, registered social care provider, or NHS supplier — not an agency or private clinical provider.
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Is your SOC code on the Health & Care Worker eligible occupations list? Your employer should be able to tell you the SOC code they are using. You can verify it against the eligible occupations list on gov.uk.
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Will the CoS be assigned under the Health & Care Worker route? This must be specified at the time of CoS assignment. It cannot be changed after the CoS is submitted. If the employer assigns a standard Skilled Worker CoS, you will be on the standard route and cannot switch to the reduced-fee route for that application.
The savings from this route are not retroactive. If you apply on the standard route and later realise you qualified for the Health & Care Worker route, you have already paid the higher fees. The difference can be thousands of pounds — the verification takes five minutes.
This article provides general information only and does not constitute immigration or legal advice. Eligibility criteria, fee levels, and the list of qualifying employers and occupations are set by the Home Office and subject to change. Always verify current requirements on gov.uk/health-care-worker-visa and consult a regulated immigration adviser (OISC) or solicitor if your situation involves complexity.
