What’s Changing in NHS Immigration Rules
On 1 July 2025, the UK government introduced a major update to legislative immigration rules, set to take effect from 22 July 2025. These changes will reshape Skilled Worker and Health & Care visa routes and impact over 100 occupations previously eligible.
Higher Skills Threshold
– The minimum skill requirement for Skilled Worker visas will rise from RQF 3 (A‑level) to RQF 6 (degree level).
– This shift removes 112 down‑to‑degree-level occupations (RQF 3‑5) from eligibility.
– Transitional protection allows individuals already in these roles (with valid CoS or visas issued before 22 July) to continue renewing, switching, and bringing dependents.
Increased Salary Thresholds
– General Skilled Worker visas require a new salary minimum of £41,700 (up from £38,700).
– Those already in the route before April 2024 now have a lower threshold of £31,300 (up from £29,000), with PhD holders also seeing an increase.
– Health & Care visa holders remain at £25,000 or national pay scale, whichever is higher; this remains unchanged.
Temporary Shortage & Immigration Salary Lists
– The Immigration Salary List (ISL) will be gradually phased out but remains active until December 2026.
– An interim Temporary Shortage List (TSL) will allow time-limited sponsorship for certain occupations vital to infrastructure and strategy, but without dependents.
– Key Health & Care occupations on the expanded ISL include care managers, lab technicians, pharmaceutical technicians, and nursing assistants.
– Five roles—medical/dental technicians, health associate professions, ambulance staff, and dental nurses fail the new thresholds and are removed from the ISL/TSL.
Social Care Visa Route Closing
– The Social Care Worker Visa is now closed to new overseas applicants.
– A transitional period until 22 July 2028 will allow extensions/switches for existing staff, but no new recruits after this date.
– Regional partnership requirements are abolished, though providers are advised to support displaced workers.
What Employers Should Do Now
– Map your workforce – identify employees affected by skill/salary threshold increases.
– Act fast on CoS – issue Certificates of Sponsorship before 22 July to lock in current rules; CoS are valid for 3 months, and visas can’t be renewed more than 3 months in advance.
– Review role eligibility – check if your roles remain on the ISL or TSL. If not, prepare domestic staffing or justify continued inclusion.
– Communicate transparently – clearly update staff on eligibility, especially regarding dependant rights and timeline impacts.
– Monitor MAC reviews – the Migration Advisory Committee will review these lists, meaning flexibility may be needed across 2026.
Final Thoughts
This July’s immigration rule changes represent a significant recalibration in the UK’s visa system. For many NHS and H&SC employers, this means urgent planning, accurate role mapping, and proactive communication to stay compliant and supportive. Begin now to issue valid CoS, review staffing strategies, and prepare for the next phases tied to the MAC’s outcomes and the gradual ISL/TSL transitions.
Source: NHS Employers
Immigration rule changes – July 2025
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