The health and care visa vs skilled worker visa question matters more than it looks, because the two are not close. The Health and Care Worker visa has a salary floor GBP 16,700 lower, fees roughly a third of the price, and complete exemption from the immigration health surcharge. If you qualify for it and apply on the general route instead, you pay thousands of pounds for nothing.
This guide sets out the difference, who is eligible for which, and what exists for care workers caught by the closure of their route in 2025, including a Scottish scheme that reopened recently and is not widely known.
The two routes side by side
| Health and Care Worker visa | Skilled Worker visa | |
|---|---|---|
| Salary floor | GBP 25,000 on a national pay scale, or GBP 31,300 otherwise | GBP 41,700, or GBP 33,400 on the Immigration Salary List |
| Also required | 100% of the going rate for the occupation | 100% of the going rate for the occupation |
| Application fee, up to 3 years | GBP 324 | Around GBP 950 |
| Application fee, over 3 years | GBP 628 | Around GBP 1,900 |
| Immigration health surcharge | Exempt, including dependants | GBP 1,035 per adult per year |
| Who can sponsor you | An NHS body, an organisation providing services to the NHS, or a CQC regulated provider | Any employer on the Home Office register of licensed sponsors |
| Skill level | By eligible occupation | RQF 6, degree level, since 22 July 2025 |
Work the surcharge through and the gap becomes obvious. A family of four on a five year Skilled Worker visa pays GBP 1,035 x 4 x 5, which is GBP 20,700, before a single application fee. On the Health and Care Worker visa that figure is nothing. It is the largest single saving available anywhere in UK immigration, and it is why establishing your eligibility is the first thing to do rather than the last.
Which one you need
Eligibility for the Health and Care Worker visa turns on two things at once, and you need both:
- Your occupation must be on the eligible list. It is decided by the occupation code on your certificate of sponsorship, not by your job title. Doctors, nurses, midwives, paramedics, pharmacists, physiotherapists, radiographers and the other allied health professions are in scope.
- Your sponsor must be an NHS body, an organisation providing services to the NHS, or a provider regulated by the Care Quality Commission. A private clinic outside that definition cannot use this route even for a nurse.
If either fails, you are on the general Skilled Worker visa with its GBP 41,700 floor. Full detail of the cheaper route is in our Health and Care Worker visa guide.
Care workers: the route closed, but not for everyone
On 22 July 2025 the UK closed the care worker and senior care worker occupations to new overseas applicants. Two groups are unaffected, and the difference between them and everyone else is now the most important fact in this field:
- Nurses, doctors and allied health professionals. Never affected. The route is fully open to them, and anyone telling a registered nurse that the UK is closed is wrong.
- Care workers already in the UK. Existing holders can extend and switch sponsor until 22 July 2028, and providers can still recruit care workers already in the country.
That second group is larger than people realise, and it includes a lot of people whose employer collapsed or lost its licence. Which is where Scotland comes in.
Scotland’s scheme for care workers who lost sponsorship
The Scottish Government runs the Adult Social Care Displaced Workers Scheme, backed by GBP 500,000, and it has reopened to new applications. It has already helped 37 employers recruit 120 workers, with 138 expressions of interest received.
Be precise about what it is, because the headlines are easy to misread. It is not a route into the UK. It pays the extra costs a Scottish employer faces when hiring a worker already in the UK who has lost their employer’s sponsorship, against a vacancy they cannot otherwise fill.
| If you are | Does the scheme help? |
|---|---|
| A care worker in the UK who lost sponsorship | Yes. This is exactly who it exists for. |
| A care worker overseas hoping to come to Scotland | No. The visa route closed in July 2025 and this scheme does not reopen it. |
| A nurse or allied health professional, anywhere | Not needed. The Health and Care Worker visa is open to you. |
It sits inside a wider commitment to add up to 45,000 extra hours of care a month. First Minister John Swinney has framed it as mitigating two UK decisions: excluding dependants from care visa applications in March 2024, and closing the social care route entirely in July 2025. If you are in the affected group, the SSSC publishes the employer facing detail and it is worth sending to a prospective employer who has not heard of it.
Why this might diverge further
Immigration is reserved to Westminster, so Scotland cannot create a visa. It can and has published proposals, and Business Minister Tom Arthur has set out three:
- A Scottish Visa, tailored to Scottish labour market needs rather than UK-wide averages.
- A Rural Visa, proposed as a five year pilot across three to five rural and island communities.
- A Scottish Graduate Visa, giving international graduates two further years to work, bridging the existing graduate route and a Skilled Worker visa.
None of these exists. They are proposals to the UK Government, and nobody can apply for one. They matter as a signal rather than a route: the pressure for regional variation is coming from an ageing and in places declining population, and the closure of the care route is the example Scottish ministers keep citing. If you are planning several years ahead, it is worth watching.
What to do
- Check your occupation code against the Health and Care Worker list first. If it is there and your sponsor qualifies, the general route is a costly mistake.
- If you are a care worker already in the UK, look at the Scottish scheme and at the transitional rules running to 22 July 2028. You have more options than the headlines suggest.
- If you hold a nursing qualification you have never registered, register it. It moves you from a closed route to an open and much cheaper one.
- Check the employer is licensed on the Home Office register before anything else.
Related: countries that need nurses in 2026 and what replaced the UK shortage occupation list. Browse UK healthcare and care roles with visa sponsorship on our board.
Last checked September 2026. Fees and thresholds are revised most Aprils, the care worker transitional arrangements run to 22 July 2028, and the Scottish visa proposals are proposals only. Confirm with gov.uk and gov.scot before acting.