The old points-based immigration system


Recruiting and retaining individuals from outside the European Economic Area (EEA) is an important part of ensuring the NHS has the right number of appropriately skilled healthcare professionals to meet local patient needs. The old points-based system was phased in between 2008 and 2010. A new points-based system came fully into effect on 1 January 2021 and you can find out more in our dedicated section

Due to COVID-19, a number of changes have been made for visa applicants. More detail is available in our up to date section on overseas skilled supply during COVID-19, as well as on the GOV.UK website.

How did the old system work?

Under the old points-based system which ended on 31 December 2020, migrants had to pass a points assessment before they were given permission to enter or remain in the UK. Each of the system's four tiers had different points requirements and the number of points needed by the migrant and the way the points were awarded depended on the tier. Points were awarded to reflect ability, experience, age and where appropriate, the level of need in the migrant's chosen occupation. 


The old points-based system replaced all the previous work permits and entry schemes and was run by the Home Office (UK Visas and Immigration - UKVI). The system had four tiers, which offered different routes to employment, training or studying in the UK.

  • Tier 1 (General) This applied to highly skilled individuals (previously the Highly Skilled Migrant Programme). This route is now closed to all new applicants and extension applications.
  • Tier 1 (Post-study work). Previously granted to individuals, who had graduated from a UK university under Tier 4, two years of leave to remain with the ability to work without a sponsor. This route is now closed to all new applicants.
  • Tier 2 This applied to skilled workers who are offered a sponsorship to fill gaps in the UK labour force (previously the work permit route). The new skilled worker route launched in December 2020, superseding Tier 2.
  • Tier 4 This applied to students who wish to come to the UK to study. Individuals must be sponsored by the educational establishment to undertake their studies. From Summer 2021, newly graduated students will be able to transition from a Tier 4 visa to the Graduate Immigration Route to stay and work, or look for work at any skill level for two years.
  • Tier 5 This applies to individuals on a youth mobility scheme and temporary workers who are allowed to work in the UK for a limited period of time to satisfy primarily non-economic objectives, such as exchange schemes. Tier 5 (youth mobility and temporary worker) still currently exists in the new system.


Why Register?

Great reasons to register with NHS Employers

  • A personalised website
    Manage your profile and select topics of interest to you
  • Access your dashboard
    Bookmark useful content to help you quickly find what you're looking for
  • Get involved
    Contribute to our Talking Points discussions, comment on and rate our webpages
  • Keep up to date
    Receive the latest newsletters and media summaries

Log In