Indefinite leave to remain (ILR)

Indefinite leave to remain, often called ILR or settlement, removes the time limit on your stay. You no longer need a sponsor, so you can change employer or leave the NHS without a new visa. It is also usually a step towards applying for British citizenship.

For health professionals, the relevant GOV.UK route is indefinite leave to remain for Skilled Worker, Health and Care Worker and Tier 2 (General) visa holders. Time on these visas counts towards the qualifying period.

GOV.UK currently says you must:

• have lived and worked in the UK for 5 years on a qualifying visa, such as the Health and Care Worker visa
• meet the salary requirements
• still be needed for your job, confirmed in a document from your employer
• pass the Life in the UK Test if you are aged 18 to 64

You do not currently need to prove English again at settlement on this route, because you did so for your visa. That is changing. A Statement of Changes laid on 5 March 2026 raises the English requirement for settlement on routes including Skilled Worker, which covers Health and Care Worker visa holders, to CEFR level B2, for applications made on or after 26 March 2027.

The government has consulted on an earned settlement model. The Home Office has consulted on an earned settlement model that proposes a 10-year baseline qualifying period for most migrants, with shorter periods proposed for some groups, including doctors and nurses as frontline public servants. The consultation closed on 12 February 2026, the outcome has not been published and the Immigration Rules still set 5 years. The details and timing depend on Immigration Rules changes, so check the GOV.UK settlement pages on the day you plan your application rather than relying on any summary, including this one.

1. Count your qualifying time and check the absence rules on GOV.UK.
2. Book and pass the Life in the UK Test if it applies to you.
3. Ask your employer for written confirmation that you are still needed and of your salary.
4. Apply online, no earlier than 28 days before you reach 5 years.
5. Prove your identity and provide your documents.

GOV.UK sets the fee at £3,226 for each person applying. A decision usually takes up to 6 months from when you provide your fingerprints and photo. Priority (an extra £500, 5 working days) and super priority (an extra £1,000) services may be available. You must not travel outside the UK, Ireland, the Channel Islands or the Isle of Man until you get a decision.

• Applying too early. GOV.UK sets 28 days before you reach 5 years as the earliest point to apply.
• Absences. GOV.UK has rules on what counts towards your time in the UK, so check them before you travel or count your years.
• Salary below the threshold at the time of the settlement application.
• Planning on old rules. The English and qualifying period rules are being reformed.

Our Health and Care Worker visa guide covers the full route to settlement.