In November 2025, the UK government published proposals to reform the Indefinite Leave to Remain (ILR) system. ILR grants the right to live, work, and study in the UK without time limits, and is sometimes called settlement.
These changes would affect all four countries of the UK, as immigration isn鈥檛 a devolved issue.
We鈥檝e published a report analysing the impact of the proposed ILR changes on the nursing workforce. In the report, we highlight findings from our survey, where members voice their concern for these proposals.
These proposals fail to recognise the value of internationally educated nursing staff (IENs) and pose a significant threat to both their retention in the workforce and the attractiveness of the UK as a destination for nursing professionals.
Although these changes aren鈥檛 confirmed, they could significantly affect IENs working across health and social care. One of the most concerning proposals is to double the standard qualifying period for ILR from five to ten years, with some staff, including nursing support workers, potentially waiting up to 15 years before becoming eligible.
Read on to find out more about ILR, the proposed changes and what our report outlines.
What's ILR and why does it affect nursing staff?
Around 75,000 IENs have arrived in the UK in the past five years. That鈥檚 almost one in ten nursing staff 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 care services.
Under current rules, 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. This includes freedom from employer sponsorship and ability to access benefits in times of emergency or sickness.
What are the proposed government changes to ILR rules?
The government's proposing to extend the ILR qualifying period to 10 or possibly 15 years, and intends to apply this retrospectively to people already living in the UK. Now, these are just proposals, and we鈥檒l have to wait to see what the government will decide.
A key benefit of ILR is that people can access benefits when they need them most. Most work visas have a no recourse to public funds (NRPF) condition attached to them.
This means visa holders are unable to access a wide range of benefits, including universal credit, child tax credits, housing support and more.
The government has also proposed extending the NRPF condition to ILR, meaning that even after being granted settlement in the UK, people would still be excluded from these vital safety nets.
The government has sent mixed signals about what these changes will mean for nursing staff. Since the reforms were first outlined in an in May 2025, it鈥檚 not been clear what occupations would be exempt from the changes.
This has left tens of thousands of IENs uncertain about their futures in the UK.
After sustained pressure from the RCN and other health organisations, the in November 2025 that nurses in the NHS would be effectively exempt from the changes.
However, it remains unclear what this means for nurses working in the independent sector and social care settings, but we鈥檒l continue to demand equity for all nursing staff, regardless of setting.
Is there a group of nursing staff most affected?
So far, the government has only confirmed that NHS nurses will be eligible for ILR after five years 鈥� there鈥檚 no such commitment for nurses in other settings.
We鈥檙e particularly concerned about the impact on the non-registered nursing workforce, including nursing assistants and nursing support workers. Under the proposals, their ILR qualifying period could be extended to as long as 15 years.
What are the key findings in the report?
Our report looks at how changes to ILR could affect the retention of IENs.
In 2025, we surveyed more than 5,000 IENs on proposals to extend the qualifying period for ILR from five to 10 years. Despite limited detail from government at that time, the findings showed overwhelming opposition to the proposals and deep concern about their potential retrospective application to staff already living and working in the UK.
Many respondents reported growing uncertainty about their future in the UK and, in some cases, regret over their decision to migrate.
Nearly all respondents without ILR (97%) opposed the proposed extension, with more than half (55%) already within two years of being eligible to apply.
The survey also highlighted a significant risk to workforce retention: 60% of respondents without ILR said it was very likely that extending the qualifying period would affect their decision to remain in the UK, equating to around 46,000 nursing staff potentially at risk of leaving.
In addition, 74% said they'd have been unlikely to choose the UK as a destination had the qualifying period been ten years.
These findings reflect our earlier report, which found that increasingly restrictive and punitive immigration policies are driving IENs to reconsider their future in the UK, posing serious risks to workforce stability and patient care.
What's the RCN鈥檚 position on ILR and the government鈥檚 plans?
We're strongly opposing these proposals. By creating uncertainty and making settlement harder to achieve, these proposals risk turning brilliant colleagues away.
Not only will the UK become a less attractive place for the global nursing workforce, but internationally mobile professionals already in the UK might begin to reconsider their futures here. We know many already are.
What’s the RCN calling for?
Our report makes several recommendations.
- Nursing staff in all settings must continue to be eligible for ILR after five years.
- All health care workers and their dependents must continue to be eligible for ILR after five years continuous employment and residency.
- Any changes to ILR, including to the qualifying period, must not apply to anyone already living in the UK.
- The government must not add an NRPF condition to ILR.
In the immediate term we’re calling for the government to scrap their proposals and meet the above demands – and then ultimately, we want to see the government provide immediate eligibility for ILR for nursing staff across all roles and settings.
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 tax payers 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 this country as a child and studied in UK schools.
What's the RCN done so far?
We鈥檝e been raising the alarm with government since the proposals were made in 2025. Here鈥檚 what action we鈥檝e taken to this point.
- 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 may affect them.
Our survey of IEN members last year also underpins our policy report, which we hope will influence the ongoing conversation about the future of settlement in the UK.
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 proposed immigration reforms as 鈥渆ntirely incompatible鈥� with the vision for a National Care Service. Read what we said in full.
We鈥檙e calling for the UK government to scrap their proposals and ultimately we want to see immediate eligibility for ILR for all nursing staff.
More information
Help us put pressure on the UK government. Whether you’re affected personally or not, write to your MP and demand the government scrap the proposed changes. .
If you are an internationally educated nurse and 麻豆视频 member, you can find more information about the government proposals on Indefinite Leave to Remain in our webinar from earlier this year. You can also contact the RCN Immigration Advice Service for confidential advice, support and assistance with immigration-related issues.
