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Health and Care visas and the Immigration Health Surcharge

FAQ for RCN members

A Health and Care Worker visa allows healthcare professionals to work in the UK in the NHS, an NHS supplier or in adult social care.

If you are eligible for this visa then usually you wouldn't have to pay an Immigration Health Surcharge.

This page has some commonly asked questions and answers about the Health and Care Visa and the Immigration Health Surcharge.

Important announcement regarding Immigration Rules

In December 2023, the Home Secretary announced important changes to the Immigration Rules would come into effect in spring 2024. The Government has now announced the specific dates changes will be made.

From 11 March 2024, care workers and senior care workers who have applied to work in the UK on a Health and Care visa will not be able to apply for their partners/spouses to join them.  Care workers already in the UK with a Health and Care visa, but have not yet applied for the dependants to join them in the UK will not be affected by this rule change. Their dependants will still be able to apply to join them.

What is the Health and Care Worker visa?

The Health and Care Worker visa is a subcategory of the Skilled Worker visa, which replaced the Tier 2 General (Migrant) status in 2020.

The Health and Care Worker visa permits medical professionals such as nurses, nursing support workers, and doctors to work in the UK either in the NHS or in the independent sector.

The cost for a visa lasting for three years is £284 per applicant. A visa lasting more than three years is £551 per applicant.

If you have a Health and Care Worker visa, it means you and your dependants will be exempt from paying the Immigration Health Surcharge.

See the GOV.UK information on the Health and Care Visa for more detailed information.

What is the Immigration Health Surcharge?

The Immigration Health Surcharge (IHS) is a fee paid by migrants resident in the UK for more than six months. Payment of the IHS allows visa holders access to the NHS and NHS services.

Health and Care Worker visa holders and their dependant family members are exempt from having to pay the IHS.

If you are a nurse or nursing support worker working in the UK within a different immigration category, you will need to pay the IHS as part of your visa application. However, you might be able to apply for a refund.

For more information, see GOV.UK: Get an immigration health surcharge refund if you work in health and care.

Important advice about the Immigration Health Surcharge Increase

The Immigration Health Surcharge is set to increase from £624 to £1,035 per year. This increase will take effect on relevant visa applications made from 31 January 2024.

If you are about to make a visa application that is not exempt from the surcharge, you should submit your application before 31 January 2024 so that you can still pay at the £624 rate. 

If you had an application that you could not make until after 31 January, and you are concerned about affording the increase, please contact the Immigration Advice Team to discuss whether you are eligible to apply for a fee waiver.


Frequently Asked Questions

Partners, and children under the age of 18 can join you in the UK as Health and Care dependants. Unmarried partners, single parents, and parents of adopted children should contact the RCN immigration service for more information.

The Government recently announced that care workers and senior care workers will no longer be permitted to allow their partners and children to join them in the UK.

This change will not apply to care workers and senior care workers in the Health and Care visa category already resident in the UK before the new rules come into force.

The Government also announced that people already in the UK in other immigration categories cannot apply to remain in the UK with their family members once they apply to switch into the Health and Care visa category to work as care workers and senior care workers.

The immigration rules have not changed. We will provide an update once an announcement has been made.

Termination of sponsorship

If you have left your job voluntarily (e.g. resigned) or involuntarily (e.g., you’ve been dismissed or made redundant), your employer must inform the Home Office that they have terminated your sponsorship within 10 days of termination of employment.

Your right to live and work in the UK does not immediately end because your sponsorship has been terminated, so you do not have to leave the country.

However, as your visa status is tied to your employment, your leave to remain in the UK can be “curtailed” (reduced) by the Home Office if you cannot find another employer to sponsor you or apply for a new visa in a timely manner.

How long will it take?

The time it takes for the Home Office to issue a notice of curtailment after being notified that you've lost or left your job can vary and is not strictly defined. It’s possible that it could take anywhere from a couple of weeks to several months.

If you want to stay in the UK, it’s critical that you start looking for a new job or exploring alternative immigration routes as soon as possible, rather than waiting to receive official notice.

Make sure the Home Office has an up-to-date address, so you receive any important communication about a curtailment without delay.

Official notice of curtailment and the 60-day period

In time, the Home Office will send you a letter advising you that you have a curtailment of leave on your visa. This shortens your leave to remain legally in the UK to 60 days (or until the end of your visa, whichever is the shortest). The letter should inform you when this 60-day period will end.

Remember, the 60-day countdown only begins if and when you get a curtailment notice letter from the Home Office, not from the date the Home Office was notified about your termination. As mentioned previously, you might not receive a letter for several weeks or months after your termination. 

Your options following a notice of curtailment 

Once you receive the letter, you will now have 60 days or until the end of your visa to either:

  • find a new employer to sponsor you and apply for a new visa with their details, or
  • apply for a different type of visa (if eligible), or
  • leave the country.

If you have been dismissed but are appealing the decision

If you were dismissed from your job, and are formally appealing the dismissal, then your employer should not inform the Home Office that they have terminated your sponsorship yet. See our advice on appealing the dismissal for information on your rights, the appeal process, and how to get support from the RCN.

If you are in the middle of appealing a dismissal but receive a notice of curtailment, contact the Home Office immediately to explain that you are appealing the dismissal and inform your RCN representative if you have one. If you have any difficulties with this, contact RCN Direct to discuss a referral to the Immigration Advice Service.

Finding a new job and Certificate of Sponsorship (CoS)

If you want to stay in the UK to work, you must obtain a new job with a new sponsor and submit a fresh application to remain in the UK, with the details of your new employer.

Your new employer must provide you with a Certificate of Sponsorship (CoS). The CoS contains information that you will need to complete your visa application. 

Important: You cannot start working with the new employer until you have permission from the Home Office to do so. To avoid delays and loss of earnings, it is advisable to pay an extra fee for a Priority Service where a decision would be made by the Home Office within five working days.

If you find a new job and want support with applying for a new Health and Care Visa, contact RCN Direct.

You can use the RCN Careers service and resources to help you find a job. There is more information about this further below.

Applying for a different type of visa

If you feel you will be unable to find a new job to comply with the requirements of the Health and Care visa, then you may be able to stay in the UK by applying for a different type of visa, such as a spouse visa, unmarried partner visa, family visa, or a student visa. Check the GOV.UK information on applying for visas for guidance on eligibility.

If after checking your eligibility you think you meet the criteria to apply for another visa route, and would like support with applying, contact RCN Direct.

Leaving the country

If you cannot find a new job in time and/or are not eligible to apply for a different type of visa, then you will need to leave the UK.

Overstaying can put future visa applications at risk

Although you are not required to leave the UK until the end of the 60-day period advised by the Home Office, it is advised to leave as soon as is practicable to ensure that any future applications to enter the UK are not put at risk.

Overstaying without a very good reason can significantly impact your ability to return to the UK and/or apply for another UK visa in the future.

Travelling outside the UK

Travelling outside the UK without a valid sponsorship may complicate your ability to return, especially if the Home Office processes the curtailment of your visa while you are abroad. Upon attempting to re-enter the UK, you may face difficulties at the border if your visa status has changed to reflect that your sponsorship is no longer valid.

Support with finding a new job and managing your finances

The RCN Careers Service can offer advice and guidance with finding a job. This includes helping you with your CV, helping you write job applications or covering letters, one to one interview coaching, and more. If you have been dismissed from your role, see applying for jobs following investigation or dismissal

If you are facing or expect to face financial hardship as a result of being out of work, see the online advice from the RCN Welfare service as well as the RCN financial wellbeing pages.

You will not need to update your visa if you want to take on a second job if you meet certain conditions:

Type of job

Firstly, the additional job must be in the same occupation code and level as your primary job, or, be a shortage occupation role.

There are two lists for the shortage of occupation roles.

  1. Shortage occupations in health and education roles (GOV.UK)
  2. Skilled Worker shortage occupations (GOV.UK)

Number of hours

Secondly, the additional job cannot exceed 20 hours per week. At the beginning of 2023, the Government had allowed Health and Care Visa holders to work more than 20 hours per week, but this was a temporary measure which ended on 27 August 2023. 

Yes. Once you have resided in the UK for a continuous lawful period of five years on the Health and Care visa route, you are eligible to apply for Indefinite Leave to Remain.

Please contact RCN Immigration Advice for support on submitting an application for Indefinite Leave to Remain for yourself and for your family members who are noted as your Health and Care visa dependants.

We're here for you

If you're an RCN member needing advice on immigration matters, please contact the RCN Advice Team.