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Health and Care Worker Visas

The care sector across the UK continues to face challenges around staff recruitment and retention.

The UK Government has attempted to address this acute staffing problem by amending the Immigration Rules to allow care sector employers to sponsor “care workers” and “home carers”. Previously, these roles had been ineligible for sponsorship on the grounds that they did not meet the “skills” threshold. However, please be aware that as part of recent changes introduced in March, those in “carer” roles are no longer able to be joined by their dependants.

Sponsored employees benefit from significantly reduced visa fees and are exempt from the Immigration Health Surcharge, which increased for other visa holders to £1,035 per year in February 2024. These benefits mean that experienced and highly qualified care workers who are based overseas will often look first at businesses which hold a sponsor licence when seeking a new role. The Register of Sponsors is updated daily by the Home Office and is available here.

Overseas recruitment is not for every business, but it can be a worthwhile investment. Our care sector clients report high retention and low absence rates among sponsored workers and committed and highly professional staff.

Sponsor licences for care sector employees

Our Business Immigration Law team can provide end-to-end support on all steps in the international recruitment process, from becoming a licensed sponsor to hiring overseas staff to supporting you with licence maintenance.

The Home Office operates a two-tier cost system depending on the size of the business.

The cost of obtaining a sponsor licence is £536 for small businesses/charities and £1,476 for all other organisations. You are usually a small sponsor if at least two of the following apply:

  • Your annual turnover is £10.2 million or less
  • Your total assets are worth £5.1 million or less
  • You have 50 employees or fewer

The fee of £536/£1,476 is a one-off cost for your sponsor licence. Sponsor licences granted from 6 April 2024 are valid for ten years, at which point they will be automatically renewed.

Once the licence is in place, you can start to recruit international staff, who then apply for their own individual Skilled Worker visa and potentially the Health and Care Worker visa, subject to the requirements being met. For your prospective employee to make their own visa application, you will need to assign them a Certificate of Sponsorship, which costs £239 per Certificate.

You will also have to pay the Immigration Skills Charge when you assign the Certificate of Sponsorship to a prospective new hire. For small or charitable sponsors, this costs £364 for the first year and £182 for each additional six months. For medium or large businesses, the charge is £1,000 for the first year and £500 for every six months after that. You may be exempt from paying the Immigration Skills Charge, but this will be subject to the employee’s circumstances. For example, if your employee is switching from a student visa, this visa application is exempt from the Immigration Skills Charge.

You cannot pass the costs of the Immigration Skills Charge and the Certificate of Sponsorship to the prospective employee. If you did so, the Home Office Guidance states that they would revoke (take away) your sponsor licence.

The table below highlights the costs of sponsoring an individual for five years. five years on the Skilled Worker route, the individual can apply for permanent residence, and will no longer require sponsorship.

Cost of sponsoring a Skilled Worker for 5 years  
 Small or charitable sponsorMedium or large sponsor
Certificate of Sponsorship£199£199
Immigration Skills Charge£364 per year£1000 per year


Sponsor licences granted after 6 April will be valid for ten years, at which point they will automatically renew. This effectively means your licence will not expire once you have it – as long as you continue to meet your responsibilities as a sponsor.

You will require people in your business to take responsibility for managing your sponsor licence and ensuring your organisation complies with its sponsor licence duties. This ongoing management is important, as your licence may be downgraded, suspended or withdrawn if your business does not comply with its duties and responsibilities. If your licence was revoked, your international sponsored workforce would lose their right to live and work in the UK and would be required either to leave the UK or find a new sponsored employer.

While employee sponsorship may seem daunting if you have not applied before, it can be a relatively straightforward process. Our experienced Immigration Law team can guide you through it all, advising on employer responsibilities, the sponsorship licence requirements and process, and support you with ongoing licence compliance. You can find out more details on our dedicated Sponsor Licence page.

As a sponsoring employer, you will need to assign a Certificate of Sponsorship to each individual you are sponsoring. This is an electronic certificate, and you apply for it through your online Sponsorship Management System. Each certificate has its own number, and the sponsored individual uses that number to apply for their Skilled Worker visa or Health and Care Worker visa.

It is important to remember that sponsoring someone does not guarantee that they will be able to get a UK visa. There are additional requirements that the individual must satisfy. For example, they must meet an English language requirement, which in most cases means that they must set a prescribed English Language test, and pass each of the four components; reading, writing, listening and speaking. 

Our Immigration experts can advise you on the application requirements and any potential sues so that applicants have the best chance of success and so that you only assign a Certificate of Sponsorship to candidates who have good chances of visa success.

Being a sponsor licence holder, you have certain responsibilities. These include:

  • Checking that all of your sponsored employees have the necessary skills, qualifications or professional accreditations to carry out their roles and keeping copies of documents that prove this.
  • Assigning Certificates of Sponsorship to workers only if the job is suitable for sponsorship.
  • Ensuring the UK Visas and Immigration (UKVI) is informed if any of your sponsored workers are not complying with the conditions of their visa.
  • Carrying out correct Right to Work checks for all employees.

An integral part of our service is providing you with tailored training to ensure that the people in your organisation who are responsible for the sponsor licence are fully trained and understand how to carry out their sponsor licence duties.

You can apply for a sponsor licence whatever the size of your care business, as long as you meet the eligibility requirements and have the right HR systems and processes in place to monitor sponsored employees.

Your business may be ineligible if you have unspent criminal convictions for crimes such as immigration offences, or you have had a sponsor licence revoked within the last year. We can advise you on any eligibility issues and help you through the whole sponsorship process.

You can sponsor an employee for up to five years on a single visa. In that time, if the sponsored worker wants to change from the role listed on their Certificate of Sponsorship or employer in that time, they will have to apply for a new visa. In what is a high-turnover sector, having loyal staff who are disinclined to leave and make a new visa application can be beneficial for business stability.

After five years, the sponsored employee and any of their dependants will be able to apply for settlement in the UK, subject to certain requirements being met.

The minimum annual salary for most care workers is £23,200, based on a 37.5 hour working week. Care Worker and Senior Care Worker roles are on the Immigration Salary List, which means they qualify for a discount on the normal minimum salary threshold of £38,700. 

Other roles within your business may also qualify for a discount on the normal minimum salary threshold.

There have been major changes to salary thresholds already in 2024. The current position is extremely complex, with a mixture of new and transitional salary requirements currently in operation. We would recommend obtaining specialist immigration advice before issuing an offer of employment to any new sponsored employee.  At Thorntons Law LLP, our Immigration experts can advise you to ensure you and your employee are fully compliant with the salary requirements for this process.

The Home Office have committed to carrying out an audit on all new sponsor licence holders within their first four years. This means they may visit your organisation to check you are complying with your licence obligations, and with immigration rules and regulations. You would normally get notice of the visit, but they can also do a surprise visit. A Home Office visit may highlight areas you need to address, or it may uncover major issues, which could mean the downgrading or revocation of your sponsor licence.

Our Immigration team can carry out a compliance audit for you to make sure you are complying with your sponsorship obligations and regulations ahead of any Home Office visit. We will highlight any problem areas to you and advise you on any improvements needed to ensure immigration compliance. We can also help you resolve any issues highlighted in a Home Office visit to help you keep your sponsor licence.

We can provide bespoke training for your organisation on ongoing sponsorship management and immigration regulation compliance to help your staff understand and effectively handle your organisation’s responsibilities as a sponsor.  Contact our team on 03330 430150 for more information. 

Many health and care roles and occupations are eligible and the full list is available on the UK government website here.

How can Thorntons help?

Our expert business Immigration Law team can advise and support you throughout the process of sponsoring non-UK nationals to work in your care home or domiciliary service, from applying for a sponsor licence through to ongoing sponsorship compliance. With three specialist immigration lawyers on the team, including a Law Society of Scotland Accredited Immigration Lawyer, we are able to act quickly on your behalf, avoiding potential problems and guiding you through the whole process.

As part of a full-service law firm, we can also help you with any related legal issues, such as employment or corporate matters, all in one place - making it easy to achieve the right outcome for your business.

Whatever your business size, from local domiciliary services and individual care homes to national care companies and care home providers, our experienced team are on hand to help you through the immigration visa sponsorship process and ongoing management of your UK sponsor licence.

Call the Thorntons Immigration Law team on 03330 430350 to find out more about how we can help with UK work visa advice and applications, or complete our enquiry form and we will contact you.