Indefinite Leave to Remain (ILR) is the goal for many international nurses working in the NHS and care sector. It gives you the right to live and work in the UK without visa restrictions, and it’s the step before British citizenship. The UK is moving to an “earned settlement” model, so many nurses have questions. Here are clear answers to the most common ones.
UK immigration rules change frequently and individual circumstances matter. Always check GOV.UK and the current Immigration Rules, and get advice from a regulated immigration adviser (OISC-registered or a solicitor) for your case. This is general information, not legal advice.
The basics
1. What is ILR?
Indefinite Leave to Remain is permanent residence status. With ILR you no longer need a sponsor, you can change jobs freely, access most benefits and public funds, and later apply for British citizenship.
2. Can nurses on the Health and Care Worker visa get ILR?
Yes. The Health and Care Worker visa is a type of Skilled Worker visa, which leads to settlement once you meet the requirements.
3. How long do nurses need to wait for ILR?
Under the long-standing rules, Skilled Worker and Health and Care Worker visa holders could apply after five years of continuous residence. The government’s earned settlement reforms make 10 years the standard qualifying period for most migrants, with reductions for certain contributions. The government has said that nurses and other qualifying public service workers should keep a five-year route. Check GOV.UK for the rules that apply on the date you apply.
4. What is “earned settlement”?
It’s the new framework in which the time you must wait for ILR depends on your contribution and integration. It includes tests on suitability (criminal and immigration record), integration (including English) and contribution (such as earnings and National Insurance). Some groups may get reductions; others, such as those in lower-paid roles, may face longer routes.
5. Are care workers treated the same as nurses?
Not necessarily. Care workers and senior care workers have faced different, and often stricter, proposals than registered nurses. If you’re a nurse working as a care worker while waiting for your NMC PIN, the job you hold when you apply for ILR, and how long you’ve spent in each role, matters. Get advice if you’ve switched roles.
Continuous residence and absences
6. What counts as “continuous residence”?
Living lawfully in the UK for the qualifying period without breaks in your visa and without excessive absences.
7. How many days can I spend outside the UK?
Under the Skilled Worker rules, absences have generally been limited to 180 days in any rolling 12-month period. Check whether this limit is changing under the new rules, and keep a record of every trip.
8. Do short gaps between visas break continuity?
Overstaying or gaps in lawful leave can cause problems. Always apply to extend or switch before your current visa expires.
Requirements
9. Do I need to pass the Life in the UK test?
Yes, most ILR applicants aged 18 to 64 must pass it. Book early, as test slots can fill up.
10. What English level is required?
For ILR, applicants have traditionally needed English at B1 level (speaking and listening), though nurses usually meet this through the evidence used for their visa or NMC registration. The government has announced plans to raise English requirements under the new settlement framework, so check the current rule.
11. Does my salary matter at the ILR stage?
Yes. Skilled Worker applicants usually need to show that their employer still needs them and that they meet the required salary at the time of application. Under earned settlement, earnings over the qualifying period may also count towards the contribution test.
12. What documents do I need?
- Passport and biometric residence permit or eVisa details
- Life in the UK test pass reference
- Evidence of English (if required)
- Employer letter confirming your job and salary
- Payslips and bank statements
- Record of absences from the UK
Family
13. Can my spouse and children get ILR too?
Dependants can usually apply for ILR alongside you or later, but they must meet their own requirements, including continuous residence, the Life in the UK test (for adults) and English. Under the new framework, dependants may be assessed more independently, so check the latest rules.
14. What about children born in the UK?
A child born in the UK before either parent has ILR or citizenship isn’t automatically British. Once a parent gets ILR, the child may be able to register as a British citizen. Get advice on the right application.
Costs and process
15. How much does ILR cost?
The Home Office fee for ILR is substantial and changes regularly. Check the current fee on GOV.UK and budget for each family member, plus the Life in the UK test and any legal advice.
16. How long does a decision take?
Standard processing usually takes up to six months, although many decisions are faster. Priority and super-priority services may be available for an extra fee.
17. Can I travel while my ILR application is pending?
Travelling outside the Common Travel Area while your application is pending is usually treated as withdrawing it. Avoid travel until you get a decision.
After ILR
18. Can I lose ILR?
ILR can lapse if you spend more than two continuous years outside the UK, and it can be revoked in serious cases such as criminality or deception.
19. When can I apply for British citizenship?
Usually 12 months after getting ILR, or immediately if you’re married to a British citizen, provided you meet the residence, good character and other requirements. Check whether the government’s settlement reforms change citizenship timelines too.
20. Should I wait for the new rules to settle?
Don’t make major decisions (like resigning, changing roles or long trips abroad) based on rumours. Follow official announcements, keep your records in order and get regulated advice for your situation.
Practical checklist for nurses planning ILR
- Keep a spreadsheet of every trip outside the UK with dates.
- Save payslips, P60s and employment letters.
- Keep your NMC registration active and your revalidation up to date.
- Book the Life in the UK test well in advance.
- Track your visa expiry date and apply on time.
- Plan for the cost of ILR for your whole family.