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UK immigration policy: latest updates and employer implications

A summary of the most recent confirmed changes affecting the Skilled Worker and Health and Care Visa routes.

27 April 2026

This page provides information on changes to UK immigration policy that affect international recruitment and retention across NHS trusts. Highlighting the most recent confirmed changes and their implications for employers.

Latest updates  

From April 2026 

  • The Band 3 entry point has increased to £25,760, meeting the minimum salary threshold for the Health and Care Visa. 

  • UK visa fees have increased by 6.5 per cent for most applications submitted on or after 8 April 2026. 

Recent policy changes 

  • English language requirements for new Skilled Worker, High Potential Individual and Scale Up Visa applications are now set at B2. 

  • For new applications made on or after 1 January 2027, the length of sponsorship for Graduate Visas will reduce from two years to 18 months. PhD Graduate Visas will remain at three years. 

Employers should note that visa applications are assessed against the Immigration Rules in force at the time of application. There is no guarantee that roles meeting current eligibility or salary thresholds will continue to do so in future. 

Salary thresholds - current position 

  • Salary thresholds apply to both new visa applications and extensions, and applicants must meet the higher of the relevant visa salary threshold, or 
  • the occupation‑specific going rate.  

Updated salary thresholds came into effect on 22 July 2025 for Skilled Worker and Health and Care Visa routes. Visa salary thresholds are reviewed periodically by the Home Office and may increase in future. 

Recent changes and key points for employers 

  • The announced 2026/27 Agenda for Change pay award confirms that entry‑level Band 3 roles now exceed the minimum salary threshold for the Health and Care Visa. 

  • Employers should be aware that repayment clauses which guarantee recovery of immigration or business costs (such as visa fees) must be counted against the salary stated on the Certificate of Sponsorship. If this reduces salary below the eligibility threshold, the individual may not be able to apply. 

  • Individuals already on a Skilled Worker Visa before 4 April 2024 are exempt from the higher general salary threshold when changing occupation, sponsor or applying for settlement, but must still meet the applicable lower threshold and going rate for their role. 

Care worker and senior care worker restrictions - current position 

New visa applications for care workers (SOC 6135) and senior care workers (SOC 6136) are closed. 

A transition period until 22 July 2028 allows eligible individuals already in the UK to extend or switch from other visa routes, subject to meeting the relevant conditions. Individuals switching from another visa route must have been legally employed by their sponsor for at least three months prior to application. 

These arrangements remain under review. 

Immigration Salary List (ISL) - current position 

The Immigration Salary List (ISL) identifies occupations eligible for salary and skill‑related flexibilities within the Skilled Worker and Health and Care Visa routes. 

The ISL remains in place until December 2026, after which flexibilities will no longer apply in the same way. 

Key points for employers 

  • Occupations on the ISL can be recruited to below the general salary threshold but must still meet the relevant minimum thresholds. 

  • New applications for the following roles will no longer be possible after December 2026: 

  • SOC 1232 (residential, day and domiciliary care managers and proprietors)  

  • SOC 3111 (laboratory technicians) 

  • SOC 3213 (pharmaceutical technicians)  

  • SOC 6131 (nursing auxiliaries and assistants) 

  • Transitional arrangements for individuals already working in ISL roles are expected to be confirmed by the Home Office and will be shared once available. 

A full and up‑to‑date list of roles on the Immigration Salary List is available on GOV.UK

Interim Temporary Shortage List (TSL) - current position 

The Temporary Shortage List (TSL) is a time‑limited list intended to support international recruitment only where roles are critical to industrial strategy or essential infrastructure. 

Current scope and review 

  • Laboratory technicians (SOC 3111) are currently the only Health and Care Visa role on the TSL. 

  • Roles on the TSL are due to run until the end of 2026, subject to government decisions following the Migration Advisory Committee’s review. 

  • NHS Employers has submitted evidence to the MAC and will share updates once recommendations are published. 

Immigration Health Surcharge – current position 

The Immigration Health Surcharge is currently: 

  • £1,035 per person per year for most visa holders and dependants 

  • £776 per year for applicants under 18 

All Health and Care Visa holders remain exempt from paying the Immigration Health Surcharge. Some roles may also be eligible for reimbursement in line with existing guidance

Dependants – current position 

  • Individuals sponsored into RQF level 3–5 roles cannot bring dependants with them for new applications or when switching from another visa route.  

  • Individuals sponsored into RQF level 6 roles and above remain eligible to bring dependants.  

  • Dependants of Health and Care Visa and Skilled Worker Visa holders can work in any role without needing a sponsor, subject to normal professional requirements.  

Care workers and dependants 

  • Care workers and senior care workers already in route before 11 March 2024 may remain with their dependants and continue to extend, change employer (within their SOC code) and settle. 

  • Those eligible but who have not yet brought dependants may do so during their sponsorship. 

  • Individuals in the UK who switch from another visa into the Health and Care Visa as a care worker or senior care worker after 11 March 2024 will not be able to stay with (or bring over) dependants. 

What employers should do 

  • Ensure staff understand that visa extensions and switches and assessed against the rules in force at the time of application.

  • Review roles against current eligibility and salary thresholds as part of workforce planning.

  • Monitor upcoming changes where transitional arrangements or reviews are underway.

Keeping up to date 

Check back to this page regularly for updates when changes are formally announced through Immigration Rules, Home Office guidance, or government statements.

As policy develops over time, older updates may be removed or summarised to ensure the page remains focused on current and forthcoming changes only.