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Skilled Worker vs Health & Care Worker vs Senior Specialist Worker

Three sponsored work routes cover most people coming to the UK for a job, and the differences between them go well beyond the salary threshold. One is exempt from the health surcharge and has much lower fees. One does not lead to settlement at all and forces a period outside the UK at the end. Dependant rights differ sharply too, and have been restricted in recent years. This comparison sets out what each route costs, what it leads to, and who it is actually designed for.

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FeatureSkilled WorkerHealth & Care WorkerSenior/Specialist Worker
Sponsorship needed
Minimum salary£41,700 or going rate (higher of)£23,200 + going rate test£48,500 or going rate
IHS surcharge£1,035/yearExempt (free)£1,035/year
Visa fee£769 (3 years, outside UK)£304-£490 depending on circumstances£769-£1,500 depending on length
Route to ILR (settlement)Yes after 5 years continuous residenceYes after 5 yearsNo — separate route required
Can switch from inside UK
Dependants allowedRestricted from 2024 — only senior roles
Maximum stayRenewable indefinitely (until ILR)Renewable indefinitely (until ILR)5 years (then leave UK for 12 months)
English language test required

Each route has specific occupation codes ("SOC codes") and going rates. The Health and Care Worker visa is significantly cheaper but care worker dependant rights were restricted from March 2024. Always check the current Immigration Rules.

Which route should the sponsorship be under?

The job decides the route, not the applicant's preference. Eligibility turns on the occupation code the role genuinely falls under and the going rate attached to it, so a sponsor cannot simply pick the cheapest option. Where a role does qualify under the health and care route, the savings are substantial — exemption from the Immigration Health Surcharge alone can be worth thousands over a five-year grant, and the visa fee is lower too.

  • Standard sponsored employment? Skilled Worker is the default, and the years count towards settlement.
  • Eligible health or care occupation with a qualifying sponsor? The health and care route is materially cheaper and also leads to settlement, though dependant rights are restricted for some roles.
  • Intra-company transfer of a senior or specialist employee? The senior or specialist route suits a defined assignment, but it does not lead to settlement and imposes a period outside the UK at the end.

The expensive mistake is treating a temporary transfer route as a career move. Someone who spends five years on it and then wants to stay has built no time towards indefinite leave to remain and must switch to a qualifying route, effectively restarting the clock. If settlement is the goal, say so at the outset and pick accordingly.

Occupation codes, going rates and dependant rules change frequently. Check current Immigration Rules on GOV.UK before committing to a route or making an offer.

Frequently asked questions

What happens to my visa if I change jobs?
Sponsored leave is tied to the sponsor and the role, so a new employer means a new certificate of sponsorship and an application to change sponsor, which you must have granted before you start. Changing duties significantly or moving to a different occupation code with the same employer can also require an application. Do not begin new work on the strength of an offer alone. If the job ends, your sponsor must report it and your leave is normally curtailed to a short grace period.
Can I switch between these routes without leaving the UK?
Switching between sponsored work routes from inside the UK is generally possible where you hold valid leave and meet the requirements of the route you are moving to, including having a sponsor licensed for it. The practical constraint is timing: apply before your current leave expires, because falling out of status removes the option. Switching also affects your continuous residence for settlement, so check how the time already accrued will be treated before you commit.
What should we budget for beyond the visa fee?
The Immigration Health Surcharge is usually the largest item where it applies, charged per person for every year of leave granted. Add the certificate of sponsorship cost, the immigration skills charge payable by the employer, English language testing, priority processing if used, and the same again for each dependant. Then plan for extensions and the eventual settlement application. For a family over five years the total commonly runs into five figures, so agree in writing who is paying what.
What happens if my sponsor loses its licence?
Your leave is normally curtailed, and you are given a limited period to find a new licensed sponsor, switch to another route you qualify for, or leave the UK. It is not an immediate removal, but the window is short. Keep your own copies of your certificate of sponsorship, contracts and payslips rather than relying on the employer's records. If you become aware of compliance problems at your sponsor, take immigration advice early rather than waiting for a Home Office letter.

Related guides

Skilled Worker Visa Overview

The Skilled Worker visa is the main route for people from outside the UK to work in the country. It replaced the Tier 2 (General) visa in December 2020 as part of the post-Brexit points-based immigration system. To be eligible, you generally need a job offer from a UK employer with a valid Skilled Worker sponsor licence, and your role and salary must meet the required thresholds.

9 min

Health and Care Worker Visa

The Health and Care Worker Visa is a sub-route of the Skilled Worker visa designed specifically for doctors, nurses, allied health professionals, and senior care workers taking up eligible roles with the NHS, an NHS-commissioned service provider, or an adult social care employer. It offers reduced fees and an immigration health surcharge exemption.

6 min

Senior or Specialist Worker Visa

The Senior or Specialist Worker Visa (formerly known as the Intra-Company Transfer or ICT visa) allows multinational businesses to transfer established senior managers or specialist employees from an overseas branch to a UK branch of the same organisation. It is a non-settlement route with a maximum stay of five years, or nine years for high earners.

7 min

Sponsor Licence for Employers

UK employers who want to hire workers from outside the UK (and outside the existing settled workforce) generally need a sponsor licence issued by the Home Office. Without a licence, you cannot issue Certificates of Sponsorship to prospective employees, meaning overseas workers cannot apply for a Skilled Worker visa to work for you. This guide explains the process and ongoing obligations.

8 min

Family Visa Minimum Income Requirement: 2024 Changes

On 11 April 2024 the Home Office raised the minimum income requirement for spouse and partner visas from £18,600 to £29,000 — the biggest single change to family migration since 2012. Further increases to £34,500 and then £38,700 were announced but never implemented — the Migration Advisory Committee's June 2025 review recommended lowering the threshold instead. This guide explains who the new threshold affects, the transitional protections, and what to do if you cannot meet it.

10 min

Disclaimer

The information on this page was correct at the time of writing. Amounts, thresholds, and rules may change. Always check the latest official guidance.