Last checked: October 2026. UK settlement rules are under review, so we’ll update this article when the government publishes its final decision.
For most international nurses in the UK, indefinite leave to remain (ILR), also called settlement, is the big goal. It means you can live and work in the UK without a visa or sponsor, change jobs freely, and later apply for British citizenship. But in 2026, settlement rules are in the middle of the biggest shake-up in years, and there’s a lot of confusing information on WhatsApp.
This guide separates what is confirmed from what is only proposed, so you can plan with facts.
The short version
| Issue | Status in October 2026 |
|---|---|
| 5-year route to ILR on the Health and Care Worker visa | Still in force |
| Higher English requirement (B2) for settlement | Confirmed for applications made on or after 26 March 2027 |
| 10-year “earned settlement” baseline | Proposed only, not in the Immigration Rules |
| Shorter route for public service workers such as NHS nurses | Proposed only, details not final |
| Protection for people already on the route | Not decided |
How ILR works today
The Health and Care Worker visa is a type of Skilled Worker visa. Under the rules currently in force, you can usually apply for ILR after five years on the route, if you meet these main conditions:
- Continuous residence: on most work routes, you mustn’t spend more than 180 days outside the UK in any 12-month period. Long trips home can break your continuous residence, so track every journey.
- Your sponsor still needs you: your employer must confirm they still employ you and will continue to.
- Salary: you must meet the settlement salary requirement. Special rules apply to healthcare occupations on national pay scales, so check your position with your employer or an adviser.
- The Life in the UK test: a test of British history, culture and customs, passed before you apply.
- English language: currently B1 for most applicants. This rises for applications from March 2027 (see below).
- Good character: no serious criminal record, no immigration breaches and no unpaid NHS debts.
- Keep your NMC registration current throughout. A lapse can affect your job and therefore your visa. See our NMC revalidation guide.
Fees change regularly, so check the current ILR application fee on GOV.UK before you budget.
Confirmed: B2 English from 26 March 2027
A change already written into the Immigration Rules means that applicants on most settlement routes, including Skilled Worker routes, will need English at CEFR level B2 (upper intermediate) for applications made on or after 26 March 2027.
What to do: if you will be eligible for ILR around that date, find out exactly which English evidence you’ll need. Your nursing degree, OET or IELTS may not automatically count for settlement, so check the approved evidence list on GOV.UK.
Proposed: “earned settlement”
In late 2025, the government consulted on a new earned settlement system. The consultation ran from 20 November 2025 to 12 February 2026 and received a very large number of responses. The main proposals are:
- A 10-year baseline for most work routes, including Skilled Worker and Health and Care Worker, instead of 5 years.
- Reductions for “contribution”, for example high earnings or working in specified public service occupations. Reports suggest graduate-level health and education roles on national pay scales, such as NHS nurses, could keep a five-year route, but the final criteria haven’t been published.
- A longer baseline (up to 15 years) for some roles below degree level, such as many care worker roles.
Where it stands now: as of early October 2026, these changes have not been laid before Parliament and are not law. In September 2026 the Home Secretary said the final policy, including any protection for people already on the route, would be set out “in good time before” February 2027, when the first people who arrived in 2022 become eligible for five-year settlement.
What this could mean for international nurses
- NHS nurses may be among the groups who keep a five-year route under the public service proposal, if their role meets the final definition.
- Nurses in private care homes or agencies could be treated differently, depending on how “public service” is finally defined.
- Nurses already close to five years are waiting to see whether transitional protection lets them settle under the current rules. The government has said it is considering options, including allowing some groups to qualify at five years without change.
- People who already hold ILR are not affected by the proposals.
How to protect your position now
- Work out your exact eligibility date from the date your visa was granted or you entered the UK on the route.
- Keep a travel log of every trip abroad, with dates, to protect your continuous residence.
- Pass the Life in the UK test early, so it’s not a last-minute obstacle.
- Get your B2 English evidence ready if you’ll apply on or after 26 March 2027.
- Keep your documents organised: payslips, P60s, employer letters, your visa history and NMC registration.
- Avoid gaps in employment and registration, which can cause problems with your sponsor.
- Follow official sources only: GOV.UK, your employer’s international recruitment team and regulated immigration advisers (OISC or solicitors). Be wary of social media rumours and unregulated “agents”.
Bottom line
Right now, the five-year route is still open, and the only confirmed change is the B2 English requirement from 26 March 2027. Everything else, including the 10-year baseline and any shortcut for NHS nurses, is still a proposal. Keep your record clean, stay continuously resident, and prepare your documents and English evidence now, so you’re ready whichever way the final rules go.
Subscribe to Nursing TV to be told as soon as the final settlement rules are published.
Read also: NMC revalidation guide · NMC fee rises as fewer Nigerian nurses join the UK register
This article is general information, not legal or immigration advice. For advice on your own case, speak to a regulated immigration adviser.
Sources: FSP Law: ILR changes (7 October 2026); Migrate UK: what is confirmed (13 October 2026); Wesbridge Associates: Home Secretary’s evidence, 15 September 2026; ILR Tracker: earned settlement changes.