In February 2022, the inclusion of Care Workers and Senior Care Workers on the Shortage Occupation List marked a pivotal change in UK immigration policy. For the first time, overseas nationals could be sponsored into these roles at a reduced salary threshold, opening the door to large-scale international recruitment within the care sector.
The policy shift resulted in unprecedented demand. Between 2022 and 2024, approximately 616,000 individuals entered the UK under the Health & Care visa route. As many individuals reach the point at which they would traditionally expect to qualify for settlement, the Home Office has initiated a comprehensive consultation on proposed reforms to Indefinite Leave to Remain (ILR) for Health & Care and Skilled Worker visa holders.
At the heart of the proposals is a clear policy position: permanent residence is to be earned through sustained contribution to the UK, rather than acquired automatically through time spent in lawful residence.
Extending the Qualifying Period for Settlement
The central proposal seeks to reduce the number of migrants eligible to settle permanently by increasing the length of residence required before an ILR application can be made.
Under the consultation, the standard qualifying period would increase from five years to ten years. While this period may be adjusted upwards or downwards based on individual circumstances, the presumption is that settlement will no longer be achievable within the current timeframe for most applicants.
Crucially, the Home Office has indicated that these changes are intended to apply retrospectively, affecting not only future visa grants but also those already on a pathway to settlement. This will be of particular concern to individuals who are nearing the existing five-year threshold.
A Separate and More Restrictive Route for Care Workers
The proposals are especially stringent for Care Workers and Senior Care Workers. For sponsored roles classified below degree level, a fifteen-year residence requirement before eligibility for ILR has been proposed.
Limited Scope for Reducing the Qualifying Period
The earned settlement model does allow for the possibility of reducing the qualifying period in certain circumstances. These include factors such as advanced English language ability, sustained high earnings, long-term community contribution and extended service in specified public sector roles.
In practice, however, these concessions are unlikely to offer meaningful benefit to most individuals working in the care sector. Salary thresholds linked to reductions are well above typical earnings for care roles, and Care Workers are expressly excluded from some of the public service provisions.
At the same time, the consultation proposes that the qualifying period could be increased in cases where an applicant has relied on public funds, breached immigration conditions, or previously entered the UK unlawfully or as a visitor before switching routes.
Engaging with the Consultation
The Home Office consultation on earned settlement remains open until 12 February 2026. Employers, workers and sector representatives are strongly encouraged to engage with the process, as the proposed reforms will have far-reaching consequences for workforce planning, retention, and long-term sustainability within social care. The Government has indicated that legislative changes are likely to be implemented in 2026.
Conclusion and Next Steps
The proposed move to an earned settlement model would represent a significant shift in the settlement framework for Health & Care and Skilled Worker routes, with particularly acute implications for the care sector. Extended qualifying periods and stricter eligibility requirements are likely to increase uncertainty for sponsored workers and place additional financial and operational pressures on employers. With the consultation open until February 2026 and reforms expected to follow in 2026, both employers and individuals should assess their current arrangements and seek timely advice to prepare for the changes ahead.
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