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The UK government has announced major changes to indefinite leave to remain (ILR) that will affect many nursing staff across the UK.

On 2 November 2026, Home Secretary Shabana Mahmood . While the standard route to settlement for most migrant workers will increase to 10 years, registered nurses in public service roles will continue to be eligible for ILR after five years. 

However, nursing support workers who arrived in the UK after 12 May 2025 or who arrive in the future will be subject to the same 10-year wait as other migrant workers.

These changes affect all four countries of the UK, as immigration isn鈥檛 a devolved issue.

This follows months of campaigning by nursing staff, the RCN and other organisations, which raised concerns that earlier proposals would make settlement significantly harder to achieve and worsen staffing shortages across health and care services.

While the announcement includes important concessions, the RCN believes that the UK government must go further to make international staff feel welcome and encouraged to stay. We've updated this article to explain what's changed, who's affected and what the RCN continues to call for.

What's ILR and why does it affect nursing staff? 

More than 70,000 internationally educated nurses and midwives have arrived in the UK in the past five years. That鈥檚 almost one in 10 nursing professionals on the UK Nursing and Midwifery Council (NMC) register. Many supported the UK through the COVID-19 pandemic and continue to play a vital role in sustaining health and care services.

Under the previous system, people who鈥檝e lived in the UK on a work visa for five years can apply for ILR. Once granted, they no longer need a visa to remain in the country and gain many of the same rights as UK citizens. Under the government's new settlement framework, eligibility periods now vary depending on occupation, earnings and immigration history.

What are the new ILR rules? 

The government has introduced a new "earned settlement" model, under which different groups of workers will become eligible for ILR at different points.

Some of the key routes announced by the government are:

• three years: people earning over 拢125,140 and those on the Global Talent visa
• five years: registered nurses and other qualifying public service workers
• five years: higher-rate taxpayers earning more than 拢50,271 annually
• five years: social care workers and nursing support workers who arrived before 12 May 2025 and meet the conditions of their visa
• 10 years: the new standard route to settlement for most migrant workers
• 10 years: social care workers and nursing support workers who arrived after 12 May 2025. 

Anyone applying for ILR must also meet the following minimum requirements.

• Having no criminal record in the UK.
• Passing the Life in the UK test.
• English spoken to a high standard (equivalent to A-Level English as a foreign language).
• No government debt including unpaid taxes.
• A record of sustained National Insurance contributions. 

Anyone who has claimed benefits within the five years before applying will be excluded from the three-, five- and 10-year settlement routes. If they continue to claim benefits, they may have to wait up to 20 years before becoming eligible.

Anyone who has breached immigration rules, such as by overstaying a visa before obtaining a new one, will be placed on a 20-year route to settlement, regardless of higher earnings or other positive contributions.

There will also be a separate set of qualifying periods for people granted refugee status (or a similar form of protection). These range from five to 30 years depending on the scenario.

The government has also confirmed it will not proceed with one of the most concerning elements of the original proposals: extending the longer settlement routes to registered nurses.

Following sustained pressure from the RCN and others, registered nurses will continue to have access to settlement after five years.

Partner dependants of nursing staff will continue to be eligible to settle alongside them at five years provided they arrived in the country at the same time, or complete a 5-year qualifying period following their own arrival in the UK.

Child dependants under 25 will maintain the ability to settle alongside their parents. Individuals who arrived in the UK as child dependants but are aged over 25 at the time their parents qualify for settlement will be required to apply for settlement independently.

Fears that the government might seek to extend the no recourse to public funds condition (NRPF) to those with ILR  鈥� meaning a person cannot access most state benefits or housing support 鈥� have also not materialised. 

Is there a group of nursing staff most affected?  

Although registered nurses working in the public sector will retain a five-year route to settlement, uncertainty remains for parts of the wider health and care workforce. We still need clarity from the government on whether this will apply to nurses working in the independent health and care sector.

Nursing support workers and care workers who arrived before 12 May 2025 will continue to be eligible after five years if they meet the conditions of their visa, too.

However, care workers and nursing support workers who arrived after 12 May 2025 will face a 10-year route to settlement.

These changes are deeply unfair for those who arrived after a deadline they knew nothing about. 

We鈥檙e also concerned about the impact these changes could have on retention across health and social care, particularly at a time of growing workforce shortages, and the future attractiveness of the UK for internationally educated nurses.

The government's new skills threshold means nursing support worker roles also no longer qualify for sponsored work visas, effectively ending overseas recruitment into these posts. 

What's the RCN鈥檚 position on ILR and the government鈥檚 changes? 

The RCN welcomes the government's decision to retain a five-year route to settlement for registered nurses, many nursing support workers and care workers.

However, we continue to believe that more fundamental reform is needed to make the system fair and protect workforce recruitment and retention.

Even before the recent changes, the UK already had one of the most restrictive settlement systems for internationally educated nursing staff among comparable countries, with high costs, long routes to permanent settlement and restrictions on access to public funds. Read more on this further down. 

We understand the extraordinary contribution that internationally educated nursing staff make to life in the UK, and we believe they all should be able to access ILR immediately upon arriving in the UK. 

We remain concerned that the current costs are far too high, at 拢3,226 per person. That means a family of three would need to have close to 拢10,000 to apply. ILR should be both accessible and affordable for all nursing staff.

While we welcomed the government鈥檚 decision not to deny access to benefits to those with ILR, we will continue to call for no recourse to public funds condition to be scrapped. Nursing staff deserve to know that the system they pay into will be there for them in emergencies, regardless of how long they鈥檝e lived in the UK.

It cannot be fair that migrant nursing staff experiencing destitution in the UK should be threatened with a longer route to settlement for seeking public assistance.  

Why does this matter? 

ILR is crucial to ensure nursing staff are given stability to plan their long-term futures here. It reduces the barriers to finding new jobs, improving career progression and reducing the risk that international staff become trapped in exploitative conditions.

It also improves the financial safety of nursing staff by ensuring they can access benefits that they need based on their income and family circumstances, and as taxpayers who are contributing to these public funds.

Not only does ILR provide critical safety nets, but it also brings improved opportunities for the families of nursing staff. For example, young people with parents who don鈥檛 have ILR might be expected to pay fees for university as if they were an international student, even if they came to the UK as a child and studied in UK schools. 

What happens next? 

These changes will be listed in new immigration rules published in December 2026 and come into force throughout 2027. The government has stated that an impact assessment will be prepared to accompany the implementation of earned settlement, to be published at some point next year. 

We鈥檒l be seeking urgent clarification from the government on whether the five-year route applies to registered nurses in all sectors. 

We鈥檒l keep you updated with the latest information, so watch this space.  

How did the RCN respond to the original proposals? 

The RCN campaigned extensively against aspects of the original proposals and called on the government not to extend settlement routes for nursing staff. 

Here鈥檚 some of the action we鈥檝e taken to date.

• Written letters to the Home Secretary to share our dismay at the changes and call for faster, not longer, routes to settlement.
• Briefed MPs in Parliament about the impact of the changes on nursing staff ahead of a Westminster Hall debate.
• In December 2025, we responded to an inquiry held by the Home Affairs Select Committee on changes to ILR, highlighting the failure of the proposals to recognise the value of internationally educated nursing staff.
• We鈥檝e also held webinars for RCN members explaining how these changes would affect them.
• We responded to the government鈥檚 earned settlement consultation to highlight our concerns and recommendations.
• Encouraged more than 5,000 people to write to their MP on this issue.
• Published a report on different countries鈥� pathways to settlement for internationally educated nursing staff.

How does the UK鈥檚 ILR system compare to other countries? 

The RCN commissioned consultancy MigrationWork CIC to undertake a comparative analysis of pathways to settlement for registered nurses across six comparable high-income countries: Australia, Canada, Germany, New Zealand, Ireland and the United States.

The study found that the UK already offers one of the least favourable settlement routes for internationally educated nursing staff and that the UK government鈥檚 proposals would make the UK a significant outlier internationally. 

Among the findings, the analysis reveals that the UK already has the longest qualifying period for permanent settlement and the highest costs for applying. The UK also has among the most restrictive access to public benefits system for those without permanent settlement. Read our full report.

We鈥檝e raised the alarm with the prime minister and home secretary, describing the then proposed immigration reforms as 鈥渆ntirely incompatible鈥� with the vision for a National Care Service. Read what we said in full.