NHS Employers written evidence submission to the Home Affairs Committee Routes to Settlement Inquiry

Our written submission to the Home Affairs Committee Routes to Settlement Inquiry outlines the implications of proposed changes to UK visa settlement routes, distinguishing between two groups:

• Individuals currently in the UK working in health or social care who hold a Health and Care, Skilled Worker visa or have another time limited visa which enables them to work in the sector. 
• Individuals who will arrive after the changes come into effect.
  For existing visa holders, maintaining the current five-year route to Indefinite Leave to Remain (ILR) is essential. Many individuals and families have made life-changing decisions based on the rules and policy set out at the time. 

Retrospective application of extended settlement timelines would create significant human, social, and financial impacts, including increased costs for health and social care organisations in an already challenging financial landscape. The Home Secretary’s “fairer pathway to settlement” statement made on 20th November 2025 proposed moving toward longer standard settlement routes , creating uncertainty for those currently on a five-year pathway and reinforcing the need for firm transitional protections. Our members are clear that they need to retain the talented people who are already in our teams, wherever in the world they have come from, to offer care to our patients.

For future applicants, NHS Employers supports a fast-tracked settlement route-of under 10 years-for those sponsored by NHS or care organisations. This should apply across both clinical health and care roles (such as those on a Health and Care Visa) and key support functions such as digital, finance, estates, and administration (such as those on a general Skilled Worker Visa). Parity between NHS and care sector workers is crucial, as shortages in social care directly and negatively impact NHS service delivery and the overall experience the patient has of health or care. To respond to the new 12-week statutory consultation launched on 20 November 2025 on ‘Earned Settlement’ , we will be undertaking extensive engagement with NHS employers to provide a full response to the Home Office on behalf of the NHS in England.