By Michelle Holmes, Managing Director, Holmes & Partners Ltd.

The UK healthcare sector is at a critical point as it grapples with ongoing workforce shortages, an ageing population and increasing demands on services. With substantial immigration rule changes coming into effect in 2025, many NHS trusts, care providers and private healthcare companies will need to reassess their recruitment and compliance strategies to avoid operational disruptions.

From rising visa costs to stricter compliance measures, these updates will have significant implications for international hiring and workforce planning. Understanding these changes now will be key for healthcare employers to navigate the evolving immigration landscape effectively.

Rising costs and compliance challenges

One of the most immediate financial pressures on employers will be the sharp increase in the Certificate of Sponsorship (CoS) fee, which is expected to rise from £239 to £525. For NHS trusts and care providers reliant on international staff, this additional cost, prohibited from being passed onto employees, could significantly impact budgets.

Effective from 31 December 2024, employers are explicitly barred from passing any sponsorship-related costs, including CoS fees and sponsor licence charges, onto foreign workers. Non-compliance could lead to the revocation of a sponsor licence, putting the employment of existing international staff at risk and severely limiting future recruitment.

In addition to these financial hurdles, as of 28 November 2024, stricter sanctions now apply to healthcare employers found exploiting foreign workers, particularly in the health and social care sectors. Repeat offenders could be banned from recruiting international staff for up to two years. Aside from the moral duty on employers to ensure compliance, with workforce shortages already causing strain on health and social care providers, such penalties could have a devastating impact on service provision.

The growing administrative burden of sponsorship

Sponsorship compliance has been a long-standing challenge for healthcare employers and 2025 will bring even greater scrutiny. Increased audits and monitoring of sponsor licence holders are expected, making it more important than ever for HR teams to ensure full compliance with Home Office regulations.
The government’s broader goal of reducing reliance on international workers is reflected in these measures. Employers will need to ensure their recruitment and sponsorship processes are watertight, with well-documented procedures in place for visa applications, right-to-work checks and record-keeping.

Additionally, from 8 January 2024, non-European nationals visiting the UK for short-term healthcare assignments or conferences must obtain an Electronic Travel Authorisation (ETA) before travel. This requirement will extend to European nationals from 2 April 2025, adding an additional administrative step for those bringing in healthcare professionals for temporary work placements or training.

Preparing for the future

These immigration rule changes represent one of the most significant shifts in workforce management for the healthcare sector in recent years. Employers must take proactive steps now, including reviewing sponsorship policies, training HR teams on compliance updates and assessing the financial impact of rising fees.

Holmes & Partners Ltd. specialises in helping healthcare employers navigate the complexities of sponsorship compliance and workforce planning. As immigration policies tighten, seeking expert guidance will be essential to ensure that recruitment strategies remain robust and that organisations continue to attract and retain the skilled professionals they need to deliver essential healthcare services.

Michelle Holmes, Managing Director, Holmes & Partners Ltd.