Difference between Skilled Worker Visa and Health Care Visa

The UK enables employers to recruit skilled overseas nationals through sponsored work routes under the Immigration Rules. Two of the most used routes are the Skilled Worker visa and the Health & Care Worker visa. Both sit within Appendix Skilled Worker, with the Health & Care Worker visa operating as a defined sub-category limited to eligible health and social care roles. For employers and HR teams, understanding the distinctions in scope, salary thresholds, costs and benefits is critical to compliant, cost-effective recruitment.

What this article is about: This guide explains the key differences between the Skilled Worker visa and the Health & Care Worker visa for UK employers. It compares eligibility criteria, eligible job roles, salary thresholds (including the 22 July 2025 updates), financial rules, application costs and timescales, dependants, and the route to settlement. It is written for HR professionals and sponsors seeking practical, accurate guidance aligned to current Home Office rules.

Section A: Overview of the Visa Routes

The UK immigration system provides sponsored work options under the Skilled Worker route, with the Health & Care Worker visa forming a specific sub-category. While the process to apply is similar, the scope of each visa and the benefits attached differ in key respects. Employers must understand the structure of these routes before assigning Certificates of Sponsorship.

1. What is the Skilled Worker visa?

The Skilled Worker visa is the UK’s main sponsored work route for overseas nationals. It allows licensed employers to recruit eligible workers into qualifying roles across diverse sectors, from technology and finance to education and engineering. Introduced in December 2020 to replace the Tier 2 (General) visa, it broadened eligibility and simplified processes.

Applicants must meet requirements covering sponsorship, skill level, English language, and minimum salary thresholds. Successful applicants can work in the UK for up to five years at a time, extend their visa, and apply for Indefinite Leave to Remain (ILR) if they meet settlement requirements.

2. What is the Health & Care Worker visa?

The Health & Care Worker visa is a sub-category of the Skilled Worker visa. It was introduced in August 2020 to address workforce shortages in the NHS, adult social care, and certain healthcare providers. Only eligible roles can be sponsored, including doctors, nurses, midwives, paramedics, care workers, senior care workers, and allied health professionals.

Applicants and their dependants benefit from reduced application fees and exemption from the Immigration Health Surcharge (IHS). Employers gain a streamlined recruitment pathway for filling critical healthcare and social care roles.

3. Why these routes are important for employers

For UK employers, the Skilled Worker route provides flexibility across a broad range of industries, making it the default option for addressing general skills gaps. The Health & Care Worker route, while narrower in scope, is vital for addressing acute shortages in health and social care. Choosing the correct visa route ensures compliance, cost efficiency, and effective workforce planning.

Section Summary: The Skilled Worker visa covers a wide range of occupations across many sectors, while the Health & Care Worker visa is restricted to specific healthcare and social care jobs but offers additional financial and practical benefits. Employers must match the job role to the correct route to sponsor effectively and lawfully.

Section B: Eligibility & Job Roles

The key difference between the Skilled Worker and Health & Care Worker visas is the scope of roles that qualify for sponsorship. Both routes are governed by Appendix Skilled Worker, but only specific occupations are eligible, and the requirements differ. Employers must check the Home Office’s eligible occupation lists before issuing a Certificate of Sponsorship (CoS).

1. Eligible occupations under the Skilled Worker visa

The Skilled Worker visa applies to a wide variety of occupations across multiple industries. Roles must appear on the official Home Office list and usually require RQF Level 3 (A-level equivalent) or above. Eligible jobs include IT business analysts, software developers, secondary school teachers in shortage subjects, scientists, engineers, and skilled trades such as butchers, welders, and bricklayers.

Each sponsored role must meet the relevant salary threshold for Skilled Worker visas, unless exemptions apply (such as new entrants or shortage occupations).

2. Eligible occupations under the Health & Care Worker visa

The Health & Care Worker visa is restricted to roles in the NHS, adult social care, and certain approved healthcare providers. Eligible jobs include nurses, doctors, midwives, paramedics, senior care workers, care workers, and allied health professionals. Sponsorship must be by an approved organisation; private household sponsorship is not permitted.

This targeted scope reflects government policy to address critical shortages in the health and care sectors.

3. Differences in role-specific requirements

While both visas require sponsorship by a licensed employer, the Health & Care Worker visa is narrower in scope but more flexible in evidential requirements. Care roles, for example, are subject to lower salary thresholds than general Skilled Worker roles. The Skilled Worker visa offers broader coverage but applies stricter criteria to ensure only roles on the official lists qualify.

Section Summary: The Skilled Worker visa supports a broad set of roles across many industries, while the Health & Care Worker visa is limited to specified healthcare and social care positions. Employers must carefully align the job role with the correct route to ensure valid sponsorship and compliance.

Section C: Salary Thresholds & Financial Rules

Salary thresholds are a critical distinction between the Skilled Worker and Health & Care Worker visas. Employers must ensure that the salary offered meets the applicable threshold under Appendix Skilled Worker, otherwise the application will be refused.

1. Skilled Worker general salary thresholds (July 2025 updates)

From 22 July 2025, the updated Skilled Worker salary thresholds are:

• General threshold: £41,700 per year (£20.48 per hour)
• Discounted threshold: £33,400 per year (£16.47 per hour) – for new entrants and shortage occupations
• Transitional threshold: £31,300 per year (£15.40 per hour) – applies to workers sponsored before 4 April 2024 who are covered by transitional rules

These figures represent a substantial increase from earlier thresholds, reflecting government policy to reduce reliance on lower-paid migrant labour.

2. Health & Care Worker thresholds

For Health & Care Worker visas, the thresholds are lower to reflect acute workforce shortages in the health and care sectors:

• Care workers and senior care workers: £25,000 per year (£12.82 per hour)
• Other eligible healthcare roles: £33,400 discounted threshold may apply, depending on the role and applicant profile (for example, nurses and midwives)

These reduced levels make recruitment in health and social care more accessible for UK employers facing staff shortages.

3. Maintenance funds and exemptions

Applicants under both routes must usually show at least £1,270 in savings held for 28 days prior to application. However, this requirement is waived if:

• The sponsor certifies maintenance on the Certificate of Sponsorship, or
• The applicant has already been lawfully in the UK for 12 months or more

A major advantage of the Health & Care Worker visa is the exemption from the Immigration Health Surcharge (IHS). Skilled Worker visa applicants and their dependants must pay £1,035 per year, while Health & Care Worker applicants and their dependants do not pay the IHS, saving thousands of pounds over the course of a five-year visa.

Section Summary: Skilled Worker visas are subject to higher salary thresholds, with general rates at £41,700. Health & Care Worker visas allow lower salaries, particularly for care roles, and include exemption from the IHS. Both routes require proof of financial maintenance unless exempt. Employers must apply the correct thresholds to ensure compliance.

Section D: Application Process, Fees & Benefits

The Skilled Worker and Health & Care Worker visas share a similar application framework, but important differences exist in costs, benefits, and processing. Employers need to factor these into recruitment and workforce planning.

1. Visa fees and NHS surcharge

For Skilled Worker visas, application fees range between £719 and £1,500 depending on visa length and whether the job is in shortage. In addition, applicants and dependants must pay the Immigration Health Surcharge (IHS) at £1,035 per year. Over a five-year visa, this means an additional £5,175 per applicant, excluding dependants.

Health & Care Worker visa fees are lower, generally between £284 and £551 depending on the visa length. Crucially, Health & Care Worker visa holders and their dependants are exempt from the IHS, significantly reducing overall costs.

2. Processing times and documentation

The process for both routes requires a valid Certificate of Sponsorship, evidence of English language ability, proof of maintenance (unless exempt), and biometric enrolment. Standard processing times are around three weeks for applications outside the UK, with priority services available in many cases. Health & Care Worker applications are often prioritised by the Home Office because of the critical nature of the roles, resulting in faster decisions.

3. Family dependants and settlement (ILR) rules

Both visas allow dependants (partners and children) to accompany or join the main applicant. Dependants under the Health & Care Worker route also benefit from exemption from the IHS. Both routes provide a pathway to Indefinite Leave to Remain (ILR) after five years of continuous residence, provided the salary and other settlement requirements are met.

4. Advantages for employers sponsoring under each route

For employers, the Skilled Worker visa offers access to a wide range of international talent across multiple industries, but with higher salary and cost implications. The Health & Care Worker visa is narrower in scope but brings significant financial advantages, lower fees, IHS exemption, and typically faster processing. For organisations in the health and social care sectors, this makes it a crucial recruitment tool.

Section Summary: Both visa routes follow similar processes, but the costs and benefits differ. Skilled Worker visas involve higher fees and the IHS, while Health & Care Worker visas reduce costs, waive the IHS, and often enjoy faster processing. Employers should weigh sector needs, role eligibility, and budget when deciding which route to use.

FAQs

What is the main difference between the Skilled Worker and Health & Care Worker visas?

The Skilled Worker visa is a general work route covering a broad range of eligible occupations across industries. The Health & Care Worker visa is a sub-category limited to specific healthcare and social care roles, offering reduced costs and exemption from the Immigration Health Surcharge.

Do Health & Care Worker visa holders pay the NHS surcharge?

No. Health & Care Worker visa holders and their dependants are exempt from paying the Immigration Health Surcharge. Skilled Worker visa applicants must pay the surcharge in full.

Can Health & Care Worker visa holders bring dependants?

Yes. Both Skilled Worker and Health & Care Worker visa holders can bring partners and children as dependants if financial and eligibility requirements are satisfied. Dependants under the Health & Care Worker visa also benefit from the IHS exemption.

Is the Health & Care Worker visa faster to process than the Skilled Worker visa?

Yes, in practice. While the standard decision timeframe is around three weeks for both visas, Health & Care Worker applications are often prioritised by the Home Office given the urgent demand for healthcare staff.

Do both visas lead to ILR?

Yes. Both visa categories provide a route to Indefinite Leave to Remain after five years of continuous lawful residence, subject to meeting salary and residence requirements.

Conclusion

The Skilled Worker and Health & Care Worker visas operate under the same legal framework but serve different employer needs. The Skilled Worker visa offers a broad recruitment route across multiple sectors, but carries higher salary thresholds and additional costs such as the Immigration Health Surcharge. The Health & Care Worker visa, while limited to healthcare and social care roles, provides lower salary thresholds, reduced fees, exemption from the IHS, and often quicker processing.

For employers, the correct choice depends on the nature of the role and the sector. By aligning recruitment needs with the appropriate visa route and complying with sponsor licence duties, organisations can manage costs effectively while securing the overseas talent they need.

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