ILR changes for nurses, doctors and care workers: what the government decided on 2 November 2026

On 2 November 2026 the Home Office published its response to the "earned settlement" consultation. It sets out the final plan for indefinite leave to remain (ILR). A lot of what is being shared online today mixes up what was proposed last year with what has now been decided. This article sets out what the government has said, and what it means if you are a nurse, a doctor or a care worker.

It is based on the government response on GOV.UK ("A Fairer Pathway to Settlement: Government response to the consultation") and other GOV.UK and UK Parliament pages, checked on 2 November 2026. Immigration rules change, so check GOV.UK before you act, and speak to a regulated immigration adviser about your own case.

The most important point: the new plan does not apply yet

The 2 November announcement is a plan, not a rule. The government says it will now write the plan into detailed Immigration Rules, and will publish technical guidance and a full impact assessment before it starts. No start date has been given. Until the Immigration Rules change, the current rules apply, and for most Skilled Worker and Health and Care visa holders that still means ILR after five years. One change is already fixed in the current rules: from 26 March 2027 the English level for settlement rises to B2 on many routes, including Skilled Worker (see below).

What the government has decided

1. The usual wait goes from 5 to 10 years. Ten years becomes the starting point. People can qualify sooner through a "faster" route, or take longer if they break the rules or rely on certain public funds.

2. Five years for nurses, doctors and many other health professionals. Workers in specified health and education jobs paid on national pay scales will be able to qualify after five years, as long as they have worked in an eligible job for five years and meet the other requirements. The response describes these as public-sector jobs. It does not yet say whether, for example, nurses employed by private providers will count. The list in the response (Annex C) includes:

• registered nurses, including mental health, children's, community and specialist nurses, nurse practitioners and midwives
• doctors (generalist and specialist medical practitioners)
• physiotherapists, occupational therapists, speech and language therapists, pharmacists, dentists, optometrists, radiographers, podiatrists and paramedics

The list (Annex C, at the end of the response) is taken from jobs the Immigration Rules already treat as paid on national pay scales. Not every OET profession is on it: veterinary surgeons, for example, are not. Check the list itself for your exact job title.

3. Care workers who came before May 2025 can keep five years. Care workers who came to the UK on, or switched into, the care worker route before the Immigration White Paper (a government plan published on 12 May 2025) keep the five-year route. The response does not give an exact day; the new rules should confirm it. They must earn at least £25,000 a year and meet the sponsorship and job requirements. They must also meet the new minimum rules, including the B2 English level and the criminal record rules, unless an exemption applies. This is not for every care worker. If you do not meet these conditions after five years, you will not get ILR at that point. Instead, you will be able to apply for a further five-year Health and Care visa, for genuine work in the sector, to give you time to meet them. You will still have no recourse to public funds (no access to most benefits) on that visa.

The plan also says that from 1 February 2027, care workers whose sponsor loses its licence will have up to 120 days to find a new job offer and 60 more days to sort out their visa.

4. Care workers who came after May 2025 go on the 10-year route. The arrangement above does not cover people who started on the care worker route after the White Paper. They will qualify through the standard 10-year route if they meet its requirements.

5. The 15-year idea has been dropped. Last year's consultation suggested 15 years for jobs below degree level (RQF level 6). The response says these workers will no longer face 15 years. They will be on the 10-year route instead, with the chance to qualify sooner. Some health and education workers below degree level on national pay scales who came before May 2025, such as nursing auxiliaries, keep five years if they meet the requirements of their visa. This is a separate group from care workers.

6. Earnings can shorten the wait. On the standard 10-year route, you need to earn at least £12,571 a year in five of the seven years before applying (couples can combine income, with a household figure of £25,142). Earning at least £50,271 in three of the last five years can bring the wait down to five years. Earning at least £125,141 in three of the last four years can bring it down to three years. You still need to meet all the other requirements. These figures follow the income tax thresholds and will move with them.

7. Public funds and rule breaks matter. To use the 3, 5 or 10-year routes, you must not have used specified public funds (certain benefits) in the five years before you apply. Otherwise the wait is 20 years. Specified immigration breaches as an adult, such as overstaying a visa or breaking a visa condition, also mean a 20-year wait.

What every applicant will need

Whatever your route, the response lists minimum requirements that cannot be traded for higher pay or public service:

• good character and suitability, including a clean criminal record
• no outstanding debt to the government
• English at B2 level (upper intermediate), which the government compares to a UK A level in a foreign language
• a pass in the Life in the UK test
• a minimum level of earnings, at least £12,571 a year for a number of years (with exemptions, for example for children and people aged 65 or over)

The response also says that C1 English will not shorten the wait. That was suggested in the consultation and has been dropped.

What this means for your English test

B2 for settlement is not new. The Immigration Rules already raise the English level for settlement from B1 to B2 from 26 March 2027 on many routes, including Skilled Worker, and the Home Office says this applies to people already on a route. The 2 November response keeps B2 as the standard.

If you are a nurse, one detail is worth knowing. (Doctors should check the equivalent GOV.UK guidance for their own route.) Home Office guidance for its staff says that nurses and midwives sponsored for those jobs meet the English requirement for the Skilled Worker visa with the English test their UK regulator accepted. For nurses, that can be OET for the NMC. The version we checked (May 2025) was written before the B2 settlement change, and the 2 November response does not say which English tests will count at the ILR stage. Check the current GOV.UK guidance before you rely on an OET result for settlement.

If you are a care worker, the B2 requirement matters for you too: care workers keeping the five-year route must still meet the English rule. We cannot tell you which OET grades will count as B2 for settlement. Check GOV.UK before you book a test for this purpose.

If you are a care worker working towards NMC registration

Many care workers in the UK are qualified nurses from overseas who are working towards NMC registration. Under the plan:

• If you came on, or switched into, the care worker route before May 2025, you can keep five years if you earn at least £25,000 and meet the other requirements, including B2 English. If you do not meet them at five years, the plan offers a further five-year visa to give you time, rather than ILR straight away.
• If you started on the care worker route after May 2025, you would be on the 10-year route as a care worker.
• Registered nurse jobs are on the five-year public service list, but that route needs five years worked in an eligible job, and the response describes these as public-sector jobs.

The response does not say how time already spent in a care job would count if you later move into a registered nurse job. The technical guidance due before the start date may say more. NMC registration is worth planning for your career whatever happens to settlement, but it is not a promise about ILR.

What we checked from social media

Some summaries shared on 2 November are close but not quite right. The care worker arrangement is not for anyone "already in the UK earning £25,000": it depends on when you came to, or switched into, the care worker route (before May 2025), and you still need B2 English and the other requirements. The consultation used £125,140 as the top earnings figure; the final figure is £125,141. And none of the new plan applies until the Immigration Rules change.

What you can do now

• Keep your records in order. Keep payslips, P60s (your yearly tax summary), your eVisa details and a list of the dates you were away from the UK. The earnings rules will rely on several years of records.
• Note your key date. Write down when you started on your current route, especially if you are a care worker: the May 2025 cut-off now matters.
• Plan your English evidence. B2 is the level for settlement. Check which tests and results will count for you before you apply.
• Use regulated advice. Immigration advice in the UK must come from a solicitor or an adviser registered with the Immigration Advice Authority. Be careful with social media posts that sound certain.

We will update this article when the new Immigration Rules are published, and we will change the "checked on" date near the top when we do.

Preparing for OET?

If OET is your next step towards NMC registration, Clodia's free 2-minute score check shows whether Reading, Listening or clinical language is costing you the most marks. OET is an English test for healthcare registration. Passing it does not by itself decide anything about your visa or ILR.

Check the current rules. The Home Office sets these rules and can change them at any time. The authoritative sources are GOV.UK (the earned settlement consultation page and its government response, the Immigration Rules, fees and settlement guidance). This article is general information, not immigration or legal advice. Clodia is not an immigration adviser.