The UK healthcare sector: immigration and employment facts
Organisations in the healthcare sector depend on skilled, reliable and properly supported staff. Delays in recruiting a healthcare professional, problems with a sponsor licence or an unresolved employment dispute can affect patient care, regulatory compliance and the continuity of essential services.
Templeton provides strategic business immigration and employment law advice to healthcare and social care organisations. We advise independent hospitals, clinics, care homes, domiciliary care providers, dental practices, pharmacies, laboratories, healthcare agencies, NHS contractors and other health and care businesses.
We help employers recruit international talent, meet their sponsor duties, manage their workforce and respond effectively when legal or regulatory problems arise.
Legal support for a regulated and people-focused sector
Healthcare employers operate in a demanding environment. They must maintain safe staffing levels while complying with immigration law, employment law, professional standards and regulatory requirements.
International recruitment continues to play an important role in the healthcare workforce. The Health and Care Worker visa allows qualifying employers to sponsor eligible doctors, nurses, allied health professionals and other health and care workers. Eligible applicants benefit from reduced visa fees and exemption from the Immigration Health Surcharge.
However, successful recruitment requires more than identifying a suitable candidate. The employer must select the correct occupation code, offer an eligible salary, demonstrate that the vacancy is genuine and coordinate the immigration process with professional registration, disclosure checks and onboarding arrangements.
Healthcare organisations must also manage complex employment issues. These may include shift patterns, working time, sickness absence, safeguarding concerns, performance management, whistleblowing, discrimination, grievances, disciplinary proceedings, restructuring and transfers of services.
We work with business owners, directors, registered managers, HR teams and healthcare professionals to provide practical advice that supports both legal compliance and the effective delivery of care.
Healthcare sector Factsheet
Adult social care has approximately 96,000 vacancies
The adult social care vacancy rate in England fell to 6.2% in 2025/26, its lowest level in a decade. This still represented approximately 96,000 vacancies on any given day and remained around three times higher than the vacancy rate across the wider economy.
International recruitment into social care has fallen sharply
Skills for Care estimated that the number of new recruits coming directly from overseas into adult social care fell to approximately 30,000 in 2025/26, the lowest level in four years. Over the same period, the number of posts filled by people with British nationality fell by approximately 40,000.
A further 410,000 care posts may be required by 2040
England’s adult social care sector is projected to require approximately 410,000 additional posts by 2040 to meet the needs of an ageing population. Recruitment, retention, workforce planning and lawful employment practices will therefore remain critical issues for care providers.
Overseas recruitment of new care workers has ended
From 22 July 2025, employers could no longer sponsor new care workers or senior care workers applying from outside the UK under occupation codes 6135 and 6136. Limited in-country sponsorship remains available for certain workers, including those who have been legally working for the proposed sponsor for at least three months. That particular transitional provision is currently scheduled to end on 22 July 2028.
Nearly one in three NHS staff reports burnout
The 2025 NHS Staff Survey found that nearly one in three NHS employees described themselves as burnt out. Healthcare employers must manage workplace stress, sickness absence, employee wellbeing, reasonable adjustments and health and safety responsibilities carefully.
Managing immigration, employment and workforce risk
For employers in the healthcare sector, immigration compliance cannot be separated from wider workforce management.
A change to a sponsored employee’s job title, duties, salary, working hours or work location may need to be reported to the Home Office. Long-term absence, unpaid leave, dismissal, resignation or the termination of a healthcare contract can also affect the organisation’s sponsor duties and the worker’s immigration position.
Employers sponsoring care workers or senior care workers in England must be carrying out a regulated activity and hold active registration with the Care Quality Commission. Where required registration is lost or allowed to lapse, the Home Office may revoke the sponsor licence.
Healthcare employers must also demonstrate that sponsored positions are genuine and that the salaries, hours and working arrangements comply with immigration and employment law. A breach of the National Minimum Wage Regulations or Working Time Regulations can lead to the refusal of a sponsored worker’s application and possible action against the sponsor licence.
International recruitment must be undertaken ethically. The Code of Practice for the International Recruitment of Health and Social Care Personnel applies to public and independent healthcare employers, social care providers and recruitment agencies. It restricts active recruitment from countries on the red list and requires employers to provide appropriate induction, pastoral support and fair employment arrangements.
Employment decisions also require careful handling. Healthcare employers frequently manage sensitive disciplinary, capability and safeguarding matters where the safety of patients or service users must be considered alongside the employee’s contractual and statutory rights. Poorly managed procedures can result in grievances, discrimination allegations, whistleblowing claims, unfair dismissal proceedings or regulatory concerns.
Early legal advice can help employers make defensible decisions, protect their sponsor licence and avoid disruption to their services.
How We Can Help
Sponsor licence applications
We prepare and manage sponsor licence applications for healthcare and social care organisations. We advise on eligibility, supporting documents, key personnel, HR systems, regulated activities and preparation for possible Home Office enquiries or compliance visits.
Health and Care Worker visas
We assist employers and healthcare professionals with Health and Care Worker visa applications. We advise on eligible roles, occupation codes, salary requirements, Certificates of Sponsorship and the evidence required for a successful application.
Sponsorship of doctors, nurses and healthcare professionals
We advise on the recruitment and sponsorship of doctors, nurses, pharmacists, allied health professionals, healthcare scientists, managers and other eligible healthcare workers. We can coordinate the immigration process with professional registration and proposed employment dates.
Care worker and senior care worker cases
We advise care providers on the restricted circumstances in which care workers and senior care workers may continue to be sponsored from within the UK. This includes assessing previous immigration permission, the three-month employment requirement and the evidence that must be retained.
Sponsor licence compliance
We conduct sponsor compliance audits, mock Home Office visits and reviews of HR files. We advise on record-keeping, absence monitoring, salary compliance, work locations, reporting duties and the correct use of the Sponsor Management System.
Sponsor licence suspensions and revocations
Where a healthcare organisation’s sponsor licence is suspended, downgraded or threatened with revocation, we provide urgent advice and prepare detailed representations addressing the Home Office’s concerns.
Right-to-work compliance
We advise on manual, online and Employer Checking Service right-to-work checks. We can review existing procedures, provide staff training and assist employers responding to illegal-working allegations or civil penalty notices.
Ethical international recruitment
We advise healthcare organisations on immigration compliance when recruiting internationally, including the Code of Practice, red-list restrictions, the use of recruitment agencies and the treatment of recruitment and sponsorship costs.
Employment contracts and workplace policies
We prepare and review employment contracts, staff handbooks and workplace policies for healthcare and social care employers. This may include policies covering sickness absence, safeguarding, confidentiality, data protection, whistleblowing, disciplinary procedures, grievances, equality and flexible working.
Disciplinary, capability and grievance matters
We advise employers on allegations of misconduct, poor performance, professional concerns, safeguarding incidents and employee grievances. We help ensure that investigations and hearings are fair, properly documented and consistent with employment law.
Sickness absence and reasonable adjustments
We support employers managing short-term and long-term sickness absence, occupational health evidence, disability-related issues and requests for reasonable adjustments.
Discrimination, harassment and whistleblowing
We advise on allegations involving race, nationality, sex, disability, religion, age and other protected characteristics. We also assist with whistleblowing complaints, victimisation allegations and concerns raised about patient or service-user safety.
Restructuring, redundancy and TUPE
We advise healthcare businesses on restructures, redundancies, changes to terms and conditions and the transfer of staff when services or contracts change. We help employers comply with consultation requirements and identify any immigration consequences for sponsored employees.
Employment Tribunal representation
We represent healthcare employers and professionals in Employment Tribunal proceedings, including claims involving unfair dismissal, discrimination, whistleblowing, wages, contractual disputes and working time.
Ongoing immigration and employment support
We provide retained legal support to healthcare businesses requiring regular advice. This can include visa applications, sponsor management, HR queries, document reviews, staff training and assistance with sensitive workplace matters.
Strategic legal advice for healthcare employers
Whether you are recruiting an overseas healthcare professional, managing a regulated care workforce or responding to an employment dispute, Templeton provides clear and commercially focused legal advice.
We help organisations in the healthcare sector recruit and retain the people they need, protect their sponsor licences and manage their employment responsibilities with confidence.
