Switching employers on a Health and Care Worker visa

Being on a sponsored visa does not tie you to one employer for the life of your permission. You can move, and many people do. But the sequence matters a great deal, and the mistakes are the kind that affect your immigration status rather than merely your career. This is an area where taking proper advice is worth the cost.

The basic principle

The Health and Care Worker visa is a variant of the Skilled Worker route, and it is sponsored. Your permission to be in the UK is tied to a specific sponsor and a specific job described in your certificate of sponsorship.

That means you cannot simply resign and start somewhere else. Changing employer requires a new certificate of sponsorship from the new employer and an application to update your permission, usually described as a change of employment application. Until that application is made, and in most cases until it is decided, you should not start the new job.

The same applies to significant changes with your existing employer, such as moving to a different job with a different occupation code, or a change that takes you outside what your certificate describes. A promotion within the same occupation is usually handled by the sponsor reporting it; a genuine change of role often needs a new application.

The sequence that works

1. Apply and interview as normal. You do not need permission to apply for jobs. 2. Tell the prospective employer early that you require sponsorship, and confirm they hold a licence and are willing to sponsor the specific role. 3. Receive a conditional offer. 4. The new employer assigns a certificate of sponsorship. 5. You make the change of employment application, paying the fee and, where applicable, the immigration health surcharge. 6. You wait for a decision, or start only when the rules and your advice permit. 7. You resign from your current post with the notice your contract requires, timed so that you are not without either.

The step people get wrong is resigning at stage 3 or 4, on the strength of a verbal offer, before a certificate exists. Certificates are not guaranteed, licences can be suspended, and roles can be withdrawn. Do not give notice until the position is genuinely secure.

Whether you can start before a decision

There are provisions that allow a Skilled Worker to begin employment with a new sponsor once a valid application has been submitted, in defined circumstances, with the employer taking on certain risks if the application is later refused. Whether this is available and appropriate depends on the current rules, on the employer's own risk appetite, and on your particular circumstances.

Many NHS employers will not allow it and will require a decision first. Some will. Do not assume either way, and do not rely on what a colleague did in a previous year, because this is exactly the sort of provision that gets revised.

The care worker complication

This is the change that has affected the most people recently. New overseas sponsorship for care workers and senior care workers closed in July 2025, meaning employers can no longer sponsor people applying from outside the UK for those specific occupations.

Transitional arrangements were put in place for people already in the UK. In broad terms, those already here have been able to switch into or continue in these roles under defined arrangements running to 2028, and existing visa holders in these roles have been able to continue working, extend and change sponsor.

The practical effect is that the position of a care worker already in the UK on a sponsored visa is quite different from that of someone applying from abroad, and general commentary about "the care visa closing" is frequently misapplied to people it does not affect. Registered professions were not affected by this closure: nurses, midwives, paramedics, radiographers and the other registered clinical roles remain sponsorable in the normal way.

Because these arrangements have specific dates and conditions attached, and because they have been revised more than once, confirm your own position against current Home Office guidance or with an adviser rather than against a summary written at any particular moment.

Salary and role requirements

A change of employment application has to satisfy the salary and skill requirements applying at the time, not the ones that applied when you first came. Thresholds have risen over recent years, and there are specific arrangements for health and care occupations where national pay scales apply.

This catches people out when moving to a role that seems comparable but sits at a lower band, or when moving from a full-time post to part-time hours. Before committing to a move, check that the new role actually meets the requirements for your application, and ask the prospective employer's recruitment team to confirm it, since they will have had to satisfy themselves before assigning a certificate.

Things that go wrong

**Gaps between jobs.** Your permission is tied to sponsorship. A long unsponsored gap is a problem. Plan the transition so that one follows the other closely.

**Losing your job.** If your sponsorship ends, your sponsor must report it and your permission is normally curtailed, leaving a limited period to find a new sponsor, apply to switch to another route, or leave. If this happens, act immediately and take advice the same week; the period is short and people lose it to inaction.

**Second jobs and bank work.** There are rules about supplementary employment alongside sponsored work, with conditions on hours and on the type of role. Bank shifts for your own sponsor are generally straightforward; taking on additional work elsewhere is not automatically permitted and should be checked before you start, not after.

**Assuming your current employer will be reasonable.** Most are. Some are not, particularly where a private provider has invested in recruiting you. Watch for repayment clauses in your contract covering recruitment, relocation or training costs on early departure. These are common, are often enforceable if reasonable, and should be read before you accept a new offer rather than after.

**Using unregulated advisers.** Immigration advice in the UK is regulated. Use a solicitor or an adviser registered with the relevant regulator, and be cautious of anyone charging for guaranteed outcomes or offering to arrange sponsorship for a fee, which is a well-documented form of exploitation in the care sector.

Where to get help

Your trade union, if you are a member, will often have specialist immigration support. Many NHS trusts have international recruitment leads who understand these processes well. Regulated immigration advisers can advise on your specific facts, which general guidance cannot.

For the current rules on change of employment, salary thresholds, transitional arrangements for care roles and supplementary employment, GOV.UK is the authoritative source, and it should be checked at the time you act rather than relied on from memory.

This guide is general information, not legal, immigration or medical advice. Always confirm current requirements with the relevant official body.