Published: 29 June 2026 | Category: Immigration Law | Reading time: ~6 mins
Care workers who came to the UK on the promise of permanent settlement after five years are now facing the prospect of waiting up to 15 years — or never qualifying at all. As campaigners march on Westminster and unions label the changes “cruel and unnecessary,” the debate over the UK’s proposed indefinite leave to remain (ILR) reforms has intensified to a breaking point.
Here is what you need to know, and what it means if you or someone you know is affected.
What is the proposed change to leave to remain for care workers?
Under current rules, most overseas workers — including those on the Health and Care Worker Visa — can apply for indefinite leave to remain (ILR) after five continuous years of lawful residence and employment in the UK. ILR grants permanent settlement, meaning you are no longer subject to immigration control and are free to change employers without visa restrictions.
The UK government’s Restoring Control over the Immigration System white paper, published in May 2025, proposed a radical shift to an “earned settlement” model. The standard qualifying period for ILR would double from five years to 10 years for most migrants. However, for workers in roles classified below degree level (RQF level 6) — which includes most care workers and senior care workers — the proposed qualifying period is as long as 15 years.
To put that into perspective: a care worker who arrived in the UK in 2022 expecting to settle by 2027 could now be looking at 2037 — or beyond.
Why care workers specifically face the longest wait
The government has divided migrants into skill tiers, with the qualifying period for ILR linked directly to the level of work performed:
- High earners (£50,270+) and Global Talent visa holders: potentially 3–5 years
- Standard Skilled Worker visa holders (RQF 6+): 10-year baseline
- Medium-skilled workers (RQF 3–5) and care workers (RQF below degree level): up to 15 years
The rationale given by Home Secretary Shabana Mahmood is that settlement should be a “privilege that must be earned” rather than an automatic entitlement based on time. The government has also pointed to forecasts predicting up to 1.6 million ILR grants between 2026 and 2030 under the old rules — including 462,000 individuals from the Health and Care route alone — as a driver of the reforms.
However, critics argue this logic punishes the very workers the UK recruited during a social care workforce crisis.
The human cost: "Moving the goalposts is morally wrong"
UNISON, the UK’s largest public service union, has been at the forefront of opposition to the proposed changes. General Secretary Andrea Egan described the plans as “cruel, unnecessary and needing to be scrapped,” accusing ministers of breaking a promise to workers who were actively encouraged to come to the UK to fill essential roles during a staffing emergency.
The union’s Fair Visa Campaign has escalated significantly in 2026, with care workers and supporters lobbying MPs, staging a mass leafleting campaign in the Home Secretary’s Birmingham constituency, and marching on Westminster with a vigil outside the Home Office. UNISON has also flagged the deeply troubling reality that some workers who have experienced exploitation under the current sponsorship system have taken their own lives.
Under the existing visa structure, a worker’s legal right to remain in the UK is entirely tied to a single sponsoring employer. The unions argue this creates conditions ripe for exploitation — and that extending the qualifying period to 15 years will only intensify this vulnerability.
The House of Commons Home Affairs Committee has also raised serious concerns, noting that workers facing a 15-year wait are “at incredibly high risk of exploitation” due to their prolonged dependency on a single employer.
Who is affected — and is retrospective application on the cards?
One of the most controversial aspects of the reforms is whether the new rules will apply retrospectively to those already in the UK. The government’s consultation document suggested the changes should apply to “everyone in the country today who has not already received indefinite leave to remain,” including those who arrived years ago under the expectation of a five-year path to settlement.
The consultation closed in February 2026. Final decisions on retrospective application have not yet been published, but the Home Office has confirmed that implementation of some changes began in April 2026.
Importantly, there are also reports — as yet unconfirmed in law — that the Home Office may be considering exempting Health and Care Worker Visa holders from the extended qualifying period, potentially preserving the five-year ILR route for this group. These proposals have not been incorporated into the Immigration Rules and should not be relied upon until formally confirmed.
What does this mean for care providers and NHS trusts?
The financial and operational impact on care sector employers is substantial. Ward Hadaway has calculated that for a large employer, the additional Immigration Skills Charge alone — payable to the Home Office for each sponsored worker — could total £13,600 per care worker over the additional 10 years of required sponsorship beyond the old five-year threshold.
This cost burden was never factored into workforce planning, hiring agreements, or sponsorship contracts entered into in good faith under the previous rules.
Furthermore, overseas recruitment of new care workers from abroad has effectively been halted since July 2025, meaning providers can no longer replenish their workforce from international sources while simultaneously being asked to retain their existing sponsored workers for far longer.
What are the key demands from campaigners?
UNISON and the wider care worker campaign are urging the government to:
- Maintain the five-year route to settlement for care workers
- Introduce a sector-wide visa that allows care workers to move between employers without losing their visa rights
- Accelerate the Fair Pay Agreement for the care sector to improve conditions and reduce reliance on migration
Get specialist immigration advice
If you are a care worker, healthcare professional, or employer sponsoring overseas staff and you are concerned about how these proposed changes could affect your visa status, settlement eligibility, or sponsorship arrangements, it is essential to take specialist legal advice without delay.
The immigration landscape is changing rapidly, and the decisions you make now — including whether to apply for ILR before new rules take effect — could have lasting consequences.
Adam Bernard Solicitors are experienced immigration law specialists based in Central and East London. Our team can assess your current visa status, advise on ILR eligibility, and help you understand your options under the evolving rules.
