LeadershipNot yet confirmed elsewhere1 publisher2 min readPublished
NHS bodies put the cost of longer visa settlement for support workers at £169m
NHS Employers and health unions estimate that longer visa settlement for support workers would cost NHS employers at least £169m. The figure comes from parties opposing the change, and its published inputs do not multiply out to the total.
The Board Room · Leadership desk
Key figures: 12,000 healthcare workers at risk, NHS Employers and unions say; support workers could wait up to 15 years to settle, against 5 years on the current skilled worker route; the estimate adds £14,000 in employment costs per affected worker.
| Figure | Value | Note | Claim |
|---|---|---|---|
| Healthcare workers at risk, say NHS Employers, unions | 12,000 workers | 4 | |
| Support worker wait, up to | 15 years to settle | 3 | |
| Skilled worker route now | 5 years to settle | 2 | |
| Added employment cost | £14,000 per worker | 5 |
What happened
- Support workers recruited through specialist Home Office visa routes could wait up to 15 years to settle permanently, against five years for skilled workers today.
- NHS Employers and the unions say the changes put the futures of 12,000 healthcare workers at risk.
- Many of these workers are on the wrong side of a Home Office cut-off date of 22 July 2025, and the groups say it blocks them from renewing visas or settling.
- Final details of the government's earned-settlement reforms are expected later this autumn.
Why it matters
- cost The £169m excludes the visa fees workers pay themselves, so the full outlay across employers and staff is higher than the headline.
- decision Employers setting workforce budgets have to pick a planning case, five years or longer, before the final rule is published, and retention plans follow from that choice.
- exposure Staff on the wrong side of the 22 July 2025 cut-off face the effects first, because the groups describe the block on renewal and settlement as already in place.
The £169m is the groups' own estimate, and its published inputs do not multiply out to it. The two unit costs, about £7,000 in sponsorship costs per five-year cycle and £14,000 in employment costs per affected worker [5], add to £21,000 a worker [12]. If all 12,000 workers [4] carried that amount, the total would be £252m [13]. That is above the £169m quoted [1]. Working backward, £169m covers about 8,050 workers at £21,000 [14], and the £14,000 employment cost alone across 12,000 workers comes to £168m [15]. The source does not say which build NHS Employers used, or whether the 12,000 and the "affected" workers in the costing are the same group.
The skeptic's point is that the parties publishing the number are asking the government to keep the five-year rule [11]. That is true, and it is a reason to test the number. The groups published their unit costs [5] and said the figure covers the Certificate of Sponsorship and Immigration Skills Charge costs employers incur [6].
The length of the wait is the larger unknown. Settlement on these routes takes five years now [2]. Fifteen years is three such cycles [16], and the sponsorship cost is quoted per cycle [5]. Whether the estimate counts one cycle or three would move the total, and the proposal itself says only that the wait could be up to 15 years [3].
Retention is where we would look first. NHS Employers and the Social Partnership Forum are concerned that a longer pathway will make it harder to retain experienced staff and damage morale [17]. Ben Morrin, chief executive of NHS Employers, said: "The NHS needs stability, fairness and workforce growth, not policies that risk making it harder to retain crucial staff." [9] A support worker decides whether to stay on the proposal as it stands, so we'd expect any staffing effect to arrive before a sponsorship invoice does. Helga Pile, head of health at Unison, said: "There's still time for the government to do the right thing, treat staff fairly and rethink these proposals." [10]
What to watch
- Final earned-settlement details this autumn: whether the maximum wait stays at 15 years and whether staff already in the UK are exempted, as the groups ask.
- Whether NHS Employers publishes how it built the £169m, including how many workers and how many sponsorship cycles it counts.
- Whether the Home Office changes the 22 July 2025 cut-off for support workers who cannot currently renew or settle.
Clarity's read
What the record supports and how the coverage leans. The claims behind it follow.
Reality
- Evidence35
- Adoption
- Insufficient
- Hype gap+20
- Incentives80
- Confidence45
Claim ledger
Ranked by verification strength, evidence, and original report placement.
- [1]
Proposed immigration changes could cost the health service at least £169 million, according to an NHS employers organisation and trade unions.
ReportedSupportedSource: NHS Employers and health unions, as reported by Personnel TodayView cited source - [2]
The Home Office's specialist visa routes currently provide a pathway to settlement in the UK after five years for skilled workers, including those in health and care.
- [3]
Under the government's proposed immigration reforms, frontline healthcare support workers could face a wait of up to 15 years to settle permanently in the UK.
- [4]
NHS Employers and unions say the proposed changes jeopardise the futures of 12,000 healthcare workers.
- [5]
The £169 million estimate is based on approximately £7,000 in sponsorship-related costs per five-year cycle and an additional £14,000 in employment costs per affected worker.
- [6]
The calculation includes Certificate of Sponsorship and Immigration Skills Charge costs incurred by employers, but not individual visa costs paid by workers.
- [7]
Final details on the government's earned-settlement reforms are expected later this autumn.
- [8]
Many of these workers are on the wrong side of the Home Office cut-off date of 22 July 2025, which prevents them from renewing their visa or settling in the UK; NHS employers and unions said the date is unfair and causing additional uncertainty for employers and staff.
- [9]
Ben Morrin, chief executive of NHS Employers, said: "The NHS needs stability, fairness and workforce growth, not policies that risk making it harder to retain crucial staff."
- [10]
Helga Pile, chair of joint health unions and head of health for Unison, said: "There's still time for the government to do the right thing, treat staff fairly and rethink these proposals."
ReportedSupportedSource: Helga Pile, chair of joint health unions and head of health for UnisonView cited source - [11]
NHS Employers and unions are calling on the government to retain the five-year settlement period for healthcare support workers and other NHS staff who already live and work in the UK.
- [12]
The two unit costs in the estimate add to £21,000 per worker.
- [13]
If all 12,000 workers carried the full £21,000, the total would be £252m.
- [14]
At £21,000 a worker, £169m covers about 8,050 workers.
- [15]
The £14,000 employment cost alone across 12,000 workers comes to £168m.
- [16]
A 15-year wait is three five-year cycles.
- [17]
NHS Employers and the Social Partnership Forum are concerned that extending the settlement pathway will make it harder to retain experienced staff, damage morale and increase uncertainty for employees and employers.
Sources
1 independent publisher whose own reporting we read for this story.
- personneltoday.comGovernment immigration changes could cost NHS £169m
1 article · October 12, 2026
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