Government publishes response to Earned Settlement consultation
Following the publication of the government's response to the consultation on proposed reforms to the UK's settlement system, we have developed this latest news page with the key elements of the announcement and what it could mean for employers and internationally recruited staff
Key points of the announced framework
- Individuals holding relevant immigration permission for eligible healthcare occupations at RQF level 6 or above, and paid on national pay scales, are expected to qualify for a five-year settlement pathway. This includes specified occupations such as doctors, registered nurses, midwives and allied health professionals, subject to the detailed Immigration Rules.
- Certain healthcare workers in eligible occupations below RQF level 6 are expected to retain a five-year settlement pathway where they were granted permission on the relevant route before 12 May 2025, subject to the detailed Immigration Rules and confirmation of the occupations covered.
- The general starting point for Skilled Worker visa holders will be a ten-year settlement pathway, although some individuals may qualify after three or five years depending on their earnings, occupation, immigration route and other relevant circumstances.
- People granted permission through designated safe and legal refugee routes are expected to retain a five-year settlement pathway, subject to the relevant route requirements and detailed Immigration Rules.
- Under the proposed route-based model, time spent on temporary routes such as student or graduate will not generally count towards the qualifying period on a settlement route as now. Further technical guidance is expected on how previously accumulated residence and transitions between routes will be treated.
Background information
The Earned Settlement consultation ran from 20 November 2025 to 12 February 2026 and sought views on proposals to move towards an earned settlement model. NHS Employers responded to the consultation on behalf of employers, highlighting the potential implications for recruitment and retention of international staff.
On behalf of employers, we raised concerns about fairness and the potential financial impact of the proposals. Our fairness concerns covered both changing settlement requirements for individuals who had already decided to come to the UK and work in the NHS, and treating support workers differently from other clinical staff on the basis of skill level, despite their contribution to NHS services.
In our response, NHS Employers was supportive of the proposal to offer a discount to RQF level 6 (and above) public sector workers, which would allow them to apply for settlement after five years.
Consultation outcome
The consultation outcome recognises and seeks to address concerns about fairness.
Eligible healthcare workers holding relevant immigration permission for specified roles at RQF level 6 or above and paid on national pay scales are expected to retain a five-year pathway, subject to the detailed Immigration Rules.
Healthcare workers in roles below RQF level 6 will also retain a five-year pathway where they entered, or switched into, the route before 12 May 2025.
Those not covered by the five-year transitional arrangements are expected to fall within the general ten-year settlement pathway, provided they remain eligible for qualifying immigration permission and meet the mandatory settlement requirements. This replaces the 15-year pathway proposed in the original consultation.
This 10-year pathway is the general baseline for skilled workers who do not qualify for the five-year public sector pathway.
Compared with the 15-year pathway originally proposed, the ten-year default may reduce some of the additional immigration-related costs and retention pressures identified by NHS employers.
Applicants holding qualifying immigration permission may be eligible to settle after three years where they meet the £125,141 earnings threshold, or after five years where they meet the £50,271 threshold, provided they also satisfy all mandatory settlement requirements. The announced figures are aligned with the relevant income-tax thresholds. The detailed rules will need to confirm how future changes to those tax thresholds will affect the settlement earnings requirements.
The consultation outcome also sets out the proposed approach to when dependants may qualify for settlement, although further detail will be provided through the Immigration Rules and technical guidance. The government response was published on 2 November 2026 and can be found on the GOV.uk website.
The government will introduce the framework in phases through future changes to the Immigration Rules. The full implementation timetable has not yet been confirmed. Further technical guidance and an impact assessment will be published before the changes take effect.
Further guidance will be published before the changes take effect, and we will update employers as details become available.
Further clarification and support for staff
We are seeking further clarification on how the announced framework will operate in practice. We will provide employers with more information as further details become available.
Individual circumstances will be different, and we know there are individuals working in the NHS on a visa who will not meet transitional arrangements.
If employees are concerned about how immigration changes may affect them, they can seek independent immigration advice.
Trade unions: Can provide members with advice, guidance and representation on workplace issues and help them understand how changes may affect their employment.
Citizens Advice: Provides free and confidential advice and may be able to refer you to a specialist immigration advisor.
Immigration Advice Authority (IAA): You can use the adviser finder to search for regulated immigration advisers. Some organisations may offer free advice.
- Law centres: Some law centres provide free specialist immigration advice, depending on your circumstances and eligibility.
Keeping up to date
If you would like to keep up to date with the latest developments affecting international recruitment you can join the NHS Employers International Recruitment Network.
