01 April 2025

28 March 2025

Dear Home Secretary,

I am writing to raise an urgent concern regarding the immigration policy changes
announced by the Minister for Migration and Citizenship on the 12th of March which are
set to increase the minimum salary threshold from £23,200 to £25,000 for staff on the
Skilled Worker visa.

As you will be aware, the Royal College of Nursing (RCN) is the UK’s largest nursing trade
union and professional body. We represent more than half a million members across the
NHS, the independent sector, and the social care sector. We have many internationally
educated staff in our membership who make vital contributions to the UK’s health and
social care sector each day.

I am concerned about the impact of immigration rule changes on NHS Band 3 staff, in
England, Wales and Northern Ireland, this includes nursing support worker roles (under
occupation code 6131: nursing auxiliaries and assistants) who are critical to the delivery
of safe and effective care. The new immigration rule changes will mean that entry-level
Band 3 staff in England and Wales, and all Band 3 staff in Northern Ireland, will no longer
meet the required minimum salary threshold for sponsorship.

It is our understanding that the Agenda for Change NHS pay award will not be made
before the 9th April 2025. A delayed pay award will mean that entry-level band 3 staff will
become ineligible for visa renewals until a revised pay scale is in place. If action is not
taken by the Home Office and Department of Health and Social Care to address this gap,
it will have devastating consequences for those affected. There is a risk that if
governments do not take action to ensure that 2025/26 pay scales provide Band 3 staff
with a salary above the new threshold, these roles will no longer be eligible for
sponsorship.

I would be grateful if you can provide detail on how the Home Office intends to bridge
this gap and confirm if an exemption will be applied for Band 3 staff requiring visa
renewals in the period before the NHS Agenda for Change pay process for 2025/26
concludes.

I would also like to ask the Home Office to confirm what assessment it has made on the
potential impact on health and care delivery, and if this has been raised with officials in
governments’ health departments.

This announcement will also impact migrant care workers working in social care teams,
many of these staff will be paid below the new salary threshold of £25,000. The RCN
recognises the need to address the pay of staff in the care sector and continues to
engage in discussions to further this aim. However, an immediate increase of the
minimum salary threshold has the potential to leave care workers with visas due for
renewal without a sponsored job and at risk of destitution and exploitation.

I look forward to receiving your response and would welcome an opportunity to meet with
you to discuss these issues alongside my concerns regarding the exploitation of migrant
staff in the care sector as outlined in in my letter dated 7th March 2025.

Yours sincerely

Professor Nicola Ranger
General Secretary & Chief Executive