Evolving UK Immigration Rules and Their Impact on the NHS International Workforce

As the UK government implements pivotal changes to its immigration rules, starting in March and April of 2024, a wide-reaching effect is anticipated for international employees within the NHS framework. To help you decipher these new regulations, an overview is provided below, derived from the latest official source on the UK government’s website.

Key Updates Effective from March and April 2024:

• Restrictions on family migration: From March 11, 2024, care workers and senior care workers will no longer have the privilege of bringing dependents when relocating to the UK. However, England’s CQC-registered providers maintain the ability to endorse applicants for the Health and Care Visa.
• Rising salary thresholds: With effect from April 4, 2024, NHS-band-paid occupations seeking a Health and Care Visa must comply with the national pay scales or surpass the new baseline salary requirement of £23,200 – an uptick from the previous £20,960. Positions outside national pay metrics must adhere to a £29,000 salary floor, applicable to all – from new visa aspirants to those seeking renewals.
• Exemption and health surcharge changes: Holders of the Health and Care Visa will retain their exemption from the Immigrational Health Surcharge (IHS). Meanwhile, the fee has climbed to £1,035 per annum as of February 6, 2024.
• General Skilled Worker Visa updates: Sponsored by the NHS but not on the Health and Care Visa path, professionals like IT and financial experts must meet a £38,700 salary threshold from April 4, 2024. There is no graduated increment for this threshold.
• Immigration Salary List adjustment: The Immigration Salary List (ISL), set to supersede the Shortage Occupation List (SOL) from April 4, sets lower threshold requirements for certain roles. Notably, certain occupations will need at least the lower of the two specified thresholds (£23,200 for health and care, £30,960 for skilled workers) or an occupation-specific rate, if higher.
• Minimum income requirement changes for family visas: The gradual hike in the minimum income requirement for family visas will unfold in stages, expected to ultimately land at £38,700 by early 2025.

Examples Illustrating the Changes:

• A Band 5 nurse from India, his spouse working in the private sector, and their child, upon renewal, will need the nurse to earn at least £23,200 to maintain their visa status, while the family will continue to sidestep IHS payments.
• A Band 3 healthcare assistant from Spain, despite the role changes, will remain above the new threshold due to pay progression and retain the ability to sponsor dependents.
• Future hires, such as a Band 3 healthcare assistant from Sweden, must juggle national pay scale obligations and potentially benefit from location-based supplements (like London weighting) to meet stipulated thresholds.
• NHS-employed non-healthcare professionals (like IT and finance staff) under the Skilled Worker Visa route must satisfy a £38,700 bar for new applications post-April 2024, but those already under the route before that may not face this requirement for sponsor or role changes.

Consequences for Existing and Prospective Visa Holders:

While the UK government reiterates the valued contributions of international workforce within health and care sectors, these impending changes underscore a need for both current and prospective visa holders – particularly those within the NHS or under NHS sponsorship – to be cognizant of their visa conditions, rights, and requirements for themselves and their dependents.

With the likelihood of rising immigration-related costs and evolving pathways to include dependents, advanced preparation and compliance with the new rules are essential for a smooth transition and continuity within the UK’s NHS employment landscape.

For a detailed understanding of how these changes may affect your specific circumstances, it’s important to refer to the full set of guidelines available on the official GOV.UK website.