What the new immigration rules mean for NHS Trusts
The Home Office has announced updates to immigration rules — here’s what they could mean for NHS Trusts.
Sharifa Chowdhury ● Mar 28, 2025
The UK Home Office has announced changes to immigration rules that are likely to have a real impact on how NHS Trusts recruit and sponsor overseas staff. Due to take place on 9 April 2025, the updates are part of a wider plan to manage immigration and encourage more local hiring – but they also bring new challenges, especially for trusts that rely heavily on international workers to keep services running.
Here’s a breakdown of the key changes and what they could mean for you and your teams.
Higher salary requirements for sponsored roles
The salary threshold for Skilled Worker visas is increasing from £23,200 to £25,000 a year (or from £11.90 to £12.82 an hour). While this might not seem like a huge jump, it could make a big difference for NHS trusts, especially for roles in lower pay bands.
For example, Band 3 roles, such as healthcare assistants and junior admin staff, often fall below this salary level. This means that they may no longer qualify for visa sponsorship unless salaries are raised. In turn, trusts may find it harder to fill these essential roles unless they can recruit locally, which isn’t always easy, especially in rural or underserved areas.
Stronger focus on local recruitment
NHS trusts that provide social care services will now need to demonstrate they’ve tried to hire locally before offering care worker roles to overseas workers. This will mean more thorough advertising of care worker roles in the UK and keeping records to show that local candidates were given a fair chance.
It is anticipated that there will be more stringent checks regarding the unavailability of local candidates for other roles in the near future.
This could create extra admin and delay the hiring process. And for some areas, particularly those that already struggle to attract homegrown staff, this may make workforce gaps even wider.
New sponsorship rules for care workers
There are also changes around sponsoring care workers. Some roles that previously didn’t require as much scrutiny will now face tighter controls. For NHS trusts involved in social care or community services, this could make hiring from overseas more complex, especially if those roles don’t meet the new salary threshold.
The result? More pressure on already stretched care teams and more time spent figuring out new compliance requirements.
Visa application scrutiny is increasing
The Home Office is giving caseworkers more power to refuse visa applications if they think an applicant isn’t genuine or if the information provided isn’t accurate. This adds a layer of risk – and potential delay – for NHS trusts sponsoring staff from abroad.
You’ll need to make sure that your sponsorship processes are watertight, and that all the necessary paperwork is in order, or you may face delays that could disrupt recruitment and onboarding.
Stricter rules for international students
Changes are also coming to short-term Student visas. Caseworkers will be able to reject applications if they’re not convinced a student is genuine, which could reduce the number of international students taking part-time roles within the NHS while studying.
This matters because international students have often helped fill part-time and support roles, especially in larger hospitals or urban areas. With fewer of them able to work, staffing challenges may become even more pronounced.
What does this mean for NHS Trusts going forward?
These changes could have a lasting impact on NHS recruitment strategies. Trusts may find it harder to sponsor staff for some essential roles, especially in lower bands. Raising salaries to meet new visa requirements might be an option, but it also increases costs and could spark competition between trusts for limited talent.
On top of that, tighter visa scrutiny and local recruitment rules mean longer lead times and more complex processes. In short, many trusts will need to rethink how they recruit and start planning for more workforce development and upskilling within the UK.
While the government's aim is to reduce immigration and boost local employment, the reality for NHS trusts is more complicated. Filling roles, particularly in frontline care and admin, is already tough, and these changes are likely to make it even harder in the short term.
To stay ahead, NHS trusts may need to focus more on training local staff, improving internal processes around sponsorship and documentation and adjusting recruitment strategies to cope with the evolving landscape.