In the last year or so, the immigration specialists at Truth Legal have written a lot of content about sponsoring workers in the care sector.  We understand the staff shortages currently afflicting the sector, and we know that employers are looking at overseas sponsorship as a reliable and effective alternative to UK recruitment.

For us it all started back in Feb 2021 with our Care Worker’s Guide to Covid-19 Immigration Policy.  In March 2021 we published How to Sponsor a Senior Care Worker.  And over the winter we talked you through the Government’s changing approach to the care sector staff shortage, through beginning …… middle …… and finally end …… or at least the end for now.

That last one marked a real shift in Government policy, and one we very much welcomed.

In the last year we became official suppliers to the National Care Association. We also did our best to keep our sector-specific webpage up-to-date, and in July we exhibited at UK Care Week.

That’s already a lot to be proud of, but the cherry on top is our track record.

At the time of writing, we’ve directly advised more than 20 different providers across the UK care sector.  We have the benefit of their insight into staff shortages, and what employers in the care sector are hoping to achieve through sponsorship of overseas workers.

What’s more, in the care sector and elsewhere, no Truth Legal client has ever had a sponsor licence application rejected or refused.

We think all that makes us perfectly placed to launch the legal guide you’re now reading. Read on to find out how to sponsor a care worker, whether that be a care assistant, senior care worker or nurse.

How to Use This Guide

This guide is like a sandwich.  The first slice of bread is Section 3, sponsor licence basics.  Section 4 is the meat or veggie alternative: everything you need to know to sponsor a care worker.  We close out with Section 5, the last slice of bread, which asks if sponsorship in the care sector is really worth it.


Sponsor Licence Basics

The real basics are in this section, but you can find much more detail in our separate Legal Guide, comprehensive and free to access here.

The Sponsor Licence

The first step is to apply for a sponsor licence.  Once granted, the licence sits with the business and gives you the ability to sponsor a care worker from overseas.

In our view, a good application is made up of three, possibly four, key components:

  1. A properly completed online application form. This is fairly straightforward and can be started here.
  2. A full set of evidence which meets Home Office requirements, listed in their Appendix A: Supporting Documents. Be careful about the mandatory evidence which applies to certain businesses in the care sector.  The Home Office list is prescriptive and their wording is precise, so small errors here can lead to rejection.
  3. A well-written cover letter which includes all the mandatory information required by the Home Office. You can find the mandatory information threaded through Appendix A: Supporting Documents, especially on pages 7 and 8.  Take particular care to explain in full your reasons for applying for a sponsor licence.
  4. This last one is optional but increasingly sensible to provide: an explanation and evidence of how your business will comply with its duties as the holder of a sponsor licence. Since January 2022, we’ve noticed a significant increase in the Home Office making requests for this information prior to granting a sponsor licence.  You’ll save considerable time and hassle by addressing this early.

Getting all this together can be a headache, especially if you’re tight on time.  Truth Legal’s Immigration specialists will take the stress off you and your business.

We can:

  • Complete the application form on your behalf, so all you have to do is check and submit.
  • Create an evidence checklist in plain English and tailored to your business, so you know exactly what evidence you need.
  • Review your evidence to ensure nothing is missed, and make recommendations about how you might strengthen the evidence you want to provide.
  • Write a cover letter on your behalf, checking off all the mandatory information and presenting your case in the best possible light.
  • Draft an optional Pre-Licence Compliance Report. We’ve consolidated all the questions the Home Office has sent our former clients into one comprehensive report, which is designed to pre-empt the Home Office asking you the same questions.  We believe the report reduces your risk of a pre-licence check or inspection.

Crucially, we won’t let you hit ‘submit’ until we’re confident that your application for a sponsor licence will be successful.

Certificates of Sponsorship

Once your licence is granted, you’ll need a Certificate of Sponsorship (CoS) for each worker you intend to sponsor.  There are two types of CoS: defined and undefined.

You’ll need a defined CoS to sponsor someone who will be overseas when they apply for their work visa.  You’ll need an undefined CoS to sponsor someone who is already in the UK on a different type of visa.

There are important differences in the process and timeframes for obtaining each type of CoS – see below for more details.  It’s an area primed to cause confusion, and getting your certificates mixed up can at worst mean refusal or revocation.  We can guide you through it and help you avoid common mistakes.

You can read all about certificates in our article: Certificates of Sponsorship: Everything You Need to Know

The Visa Application

Once you have your licence and a CoS assigned and ready to go, it’s time for your worker to apply for their visa.

Most health and care professionals are eligible to apply for the Health and Care Worker visa, which is a special type of Skilled Worker visa attracting lower fees and (in some cases) quicker decision times.

See here for the full list of eligible health and care professionals. You’ll see that Care Workers and Senior Care Workers are both eligible.

Process, Timeframes and Costs

The below is an overview of the process to sponsor a care worker. You can find much more detail in the Legal Guide linked at the top of this page.  For specific costs information, see our article: Sponsor Licence Costs: Everything You Need to Know.

The fees at 1 to 3 below attach to the employer by default, while the fees at 4 are payable by the worker.  You are generally free to depart from this position, most commonly by offering to cover the worker’s fees on their behalf.  The only exception is the Immigration Skills Charge, which must be paid by the employer.

1 Apply for the sponsor licence 8 weeks1 £536 for small businesses


£1,476 for medium/large businesses

2 Apply for a defined CoS 5-6 weeks for the first request, a few days for subsequent requests
3 Assign the CoS to the worker Instant effect £199 per CoS


£364 per worker per year for the Immigration Skills Charge (ISC), for small businesses


£1,000 per worker per year for the ISC, for medium/large businesses

4 Worker applies for their visa 3 weeks4 £247 for a visa lasting three years or less


£479 for a visa lasting more than three years


£0 per worker per year for the Immigration Health Surcharge (IHS)5


  1. Priority service is available, in theory.  See here for everything we know about that.
  2. You can apply for a defined CoS only after the licence has been granted.  You can apply for an undefined CoS at the same time as applying for the licence, and at any time thereafter.  If you apply for an undefined CoS with your licence application, the two will be granted together after about eight weeks.  If you want to apply for an undefined CoS later, the wait is much longer: 12-13 weeks.  More info here: Certificates of Sponsorship: Everything You Need to Know.
  3. Although this is a “per-year” fee, the whole amount is payable upfront at the time you assign the CoS.  So if you’re sponsoring for five years, you’ll pay £1,820 upfront if you’re a small business.  You can spread the cost by breaking the period of sponsorship down into smaller chunks – more information about that here: How Long Should I Sponsor my Skilled Worker for?
  4. This is the standard processing time for a Health and Care Worker visa, although there may be some delay at the moment due to the high number of applications generated by the Ukraine invasion.
  5. Applicants for a standard Skilled Worker visa have to pay £624 per year for the IHS.  Applicants for the Health and Care Worker visa are (quite rightly) exempt.

Sponsoring in the Care Sector

What’s new for 2022?

It’s been a time of change for sponsorship in the care sector. If you want to sponsor a care worker, now is a good time.

In December 2021, the Government finally gave way to mounting pressure and promised that Care Workers would be made eligible for sponsorship.  This was a significant concession, as the Government had previously stuck rigidly to its line that Care Workers were not skilled enough for sponsorship.

The Government’s promises became actions on 15 February 2022, when Care Workers under code 6145 were finally made eligible for sponsorship on the same terms as their Senior Care Worker colleagues under code 6146.  This means that, since February, Care Workers have been eligible to apply for the Health and Care Worker visa. Their employers have also been able to benefit from their inclusion on the Shortage Occupation List – more on that below.

Which jobs can be sponsored?

  • 6145 Care Workers and Home Carers
  • 6146 Senior Care Workers
  • 2231 Nurses, pre- and post-registration.
  • …and many other healthcare roles.

And remember it’s the substance of the role which makes a job eligible for sponsorship, rather than the specific job title.  If your business wants to call them Support Workers or Care Assistants, for example, you can go right ahead.  Just make sure your job descriptions align with those recognised by the Home Office. These are available here by typing the correct occupation code into the first box.

What’s the Shortage Occupation List, and what does it mean for the care sector?

The inclusion of Care Workers and Senior Care Workers on the Shortage Occupation List is recognition from the UK Government of the staff shortages currently afflicting the care sector.

The Shortage Occupation List means that when you sponsor a care worker, you can pay them a lower minimum rate of pay than would otherwise apply.

What are the minimum salary requirements for roles in care?

Generally, Care Workers and Senior Care Workers must be paid no less than £20,480 gross per annum, and £10.10 gross per hour.  This is much lower than the standard £25,600 minimum salary which applies to non-Shortage Occupation roles.

What’s the Health and Care Worker visa, and how can it help?

There are two key benefits of the Health and Care Worker visa:

  1. Cost: Firstly, applicants for the Health and Care Worker visa pay £247 or £479 depending on the length of their visa.  This is a big saving on fees for an ordinary Skilled Worker visa, which will cost an applicant any of £625, £719, £1,235 or £1,423, depending on the length of their visa and whether they’re in the UK or overseas when they apply.
    Secondly, applicants for the Health and Care Worker visa are (quite rightly) exempt from the Immigration Health Surcharge, which will set other Skilled Workers back an eye-watering £624 per year of sponsorship, up to a possible total of £3,120.
  2. Time: This is only really a benefit for workers already in the UK. Workers applying from overseas can expect a three-week wait for a decision on either the Skilled Worker visa or the Health and Care Worker visa.  However, applicants in the UK can expect the same three-week wait for the Health and Care Worker visa, but a lengthy eight weeks for a Skilled Worker visa.

Do I need to advertise for my care sector roles?

You may have heard the rumour that care providers wishing to sponsor don’t need to advertise, since staff shortages in the sector are so well known.

The Truth Legal view is that this will remain a rumour until we see it written into formal guidance.  As such, we will continue to advise that it’s sensible to provide some evidence of advertising with your licence application. It is also important to retain that evidence in case of a Home Office inspection.

The good news is that advertising for your roles is far less of a headache than it used to be. This is due to the abolition of the Resident Labour Market Test (RLMT) in December 2020.

The RLMT was designed by the Home Office as a highly prescriptive list of steps a business had to take to prove that it absolutely could not recruit from the UK domestic workforce.  Employers had to advertise in two places from a prescribed list, for a minimum of 28 days, under strict requirements about the content of their job adverts.

Happily, all that remains of the RLMT is the requirement to prove ‘a genuine vacancy’.  We find the best way to do this is through some evidence of advertising, although it’s far less prescriptive than it used to be.

As a minimum, we’d recommend including with your licence application:

  • a screenshot of an Indeed advert for each job role you want to sponsor, posted for at least three weeks; and
  • a record of applicants (if any) and the reason(s) each was unsuitable for the role.

It’s also sensible to retain interview notes, interview questions, and copies of your sponsored worker’s qualifications, CV, and employment references.

All this tells the Home Office that you have a genuine business need to recruit from overseas, strengthening your case for a sponsor licence.

What are my responsibilities as a sponsoring employer in the care sector?

By granting a sponsor licence, the Home Office places significant responsibility on an employer to assist in day-to-day immigration enforcement.

This doesn’t mean you’re expected to take to the streets and start seeking out overstayers, but you are expected to monitor and manage the workers sponsored by your business.

In practice, this involves things like:

  • appointing Key Personnel within your organisation to manage the licence, who themselves have a clean criminal and immigration history;
  • carrying out perfect right-to-work checks;
  • keeping accurate records of sponsored worker absences, both planned and unplanned;
  • keeping accurate and up-to-date contact details for your sponsored workers;
  • reporting to the Home Office if a sponsored worker doesn’t start the role, or doesn’t show up for work for ten consecutive days without excuse;
  • reporting to the Home Office if there are changes to a sponsored worker’s job role, such as a promotion or salary increase;
  • reporting to the Home Office if sponsorship of a worker ceases for any reason, including resignation or termination; and
  • diarising visa expiry dates.

We understand that none of this is particularly difficult.  Indeed, you’ve probably breezed through the above list thinking – “we do that one already”, or “we can easily incorporate that one into existing processes”.

It’s great if that’s the case, but pay attention to fine-tuning anything not quite right, and give some consideration to how you’d prove it to the Home Office if asked.

Truth Legal can help by assessing your existing processes and making recommendations to cement your compliance with Home Office requirements.  As part of the work we do for you, we will provide a Quick Reference Guide to Sponsor Licence Duties, which is a good way into the reams of Home Office guidance on this subject.

Sponsoring in the Care Sector: Is It Worth It?

The simple truth is: if you want to do sponsorship properly, be prepared to sink some time, effort, and money into the project at the outset.

Many of our clients in the care sector tell us they’re already committing time, effort, and money to UK recruitment exercises. However, they simply aren’t getting the results they need.  One of them said – “yes sponsorship is expensive, but you should see my Indeed bill!”.  That particular client had decided to redirect their valuable resources into overseas sponsorship instead, and perhaps you’re thinking the same thing.

What’s more, sponsorship can deliver in ways that domestic recruitment cannot. One of those ways is worker retention.  Unlike British or settled workers, sponsored workers are tied to your business by the conditions of their visa. They can also bring dependants with them to the UK.  This means a whole family’s right to stay in the UK can be dependent on the worker’s employment with you, and they’re not likely to give that up on a whim.  While it’s true that a sponsored worker can leave your employment to work for another sponsoring employer, the pool of employers with a sponsor licence is far smaller than the pool of employers competing for British or settled workers.

How Can Truth Legal Help?

Throughout this guide we’ve indicated how Truth Legal can take some of the time and effort commitment off your shoulders, but of course you will incur extra cost by using any solicitor.

At Truth Legal we try to quote competitively, and we will always be upfront and transparent about what we will charge and when.  We also tend to work in stages, with each stage attracting a fixed fee, so you can spread the cost and avoid nasty surprises.  We offer a free, no-commitment, 20-minute consultation before starting anything, so you can get to know us and we can learn more about your business.

We’re one of very few UK solicitors who can claim to be genuine specialists, not only in the legal technicalities of the sponsorship process, but specifically sponsoring in the care sector.  We understand your business and we truly care about care. So, if you’d like to sponsor a care worker, we are best placed to advise you on this.

Finally, we’ve never had a sponsor licence application refused, and we’re not about to start now!

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