NHS Immigration Policy Changes 2026: An NHS employers organization and trade unions say the proposed changes to immigration rules may cost the health sector at least £169 million and risk the careers of 12,000 healthcare workers.
The government’s plans to alter the visa system will impose substantial extra costs on health sector organisations, creating uncertainty for vital support staff and a two-tier NHS workforce, NHS Employers and health unions said.
The NHS has recruited many overseas health and care support workers through speciality visa pathways operated by the Home Office, which offer skilled professionals, including those in health and care, a road to settlement in the UK after five years.
But these frontline patient care professionals across the NHS could now be forced to wait up to 15 years to settle permanently in the UK under the government’s proposed immigration rules.
Ben Morrin, chief executive of NHS Employers (part of the NHS Alliance), said: “Thousands of healthcare support workers and other NHS staff made life-changing decisions to come to the UK and met the requirements to apply for settlement under the immigration rules that were in place when they came.
“If proposals for reform to these rules are confirmed by the government not only would it be extremely unfair to change the rules for workers who have planned their lives around them, but it would also leave NHS organisations faced with an eye-watering bill to the tune of at least £169 million.”
This estimate is based on existing costs of around £7,000 in sponsorship related costs every 5 year cycle and £14,000 in employment costs per worker affected. This figure includes the fees borne by businesses for Certificate of Sponsorship and Immigration Skills Charge, but not the costs of individual visas paid by workers.
“The whole team, including those in vital support roles, contributes to high-quality patient care,” Morrin noted. “The NHS needs stability, fairness and growth in the workforce, not policies that risk making it harder to retain the vital staff it needs.”
NHS businesses and the Social Partnership Forum are worried that extending the settlement pathway could put further pressure on retaining experienced workers, undermine morale and increase uncertainty for staff and businesses.
NHS Employers and unions are calling on the government to keep the five-year settlement period for healthcare support workers and other NHS staff already living and working in the UK.
Helga Pile, chair of joint health unions and health head for Unison, said: “These changes are nothing short of devastating for thousands of health workers and their families. They are an integral member of the NHS team and at the core of patient care. Well-trained and skilled in executing clinical chores and observations, keeping patients secure, reassured and cared for. Their skill and dedication are not easily replaced.
There is still time for the government to do the right thing, treat staff decently and reconsider these suggestions.
There is also fear that many of these workers have fallen on the wrong side of the cut-off date of 22 July 2025, enforced by the Home Office. That means they cannot renew their visa or get settled in the UK. But NHS employers and unions argued the date was “unfair and creating further uncertainty for employers and staff”.
The administration is anticipated to announce final details of the earned-settlement measures in the autumn.