Health and Care Worker ILR: do nurses and carers need the B2 English test?

If you apply for ILR before 26 March 2027, usually not: Skilled Worker visa holders, including Health and Care Workers, are on GOV.UK's list of people who do not need to prove English again for settlement. If you apply on or after 26 March 2027, the Rules add a B2 speaking and listening requirement at settlement, unless one of the other ways of meeting it applies to you.

Why Health and Care Workers are covered

The Health and Care Worker visa is a type of Skilled Worker visa, and GOV.UK says that after 5 years you may be able to apply to settle. The new settlement-stage requirement is in Appendix Skilled Worker (SW 22A.1), added by HC 1691, so it reaches nurses, senior carers and other health and care staff in the same way as other Skilled Workers. The date that counts is the date you apply for ILR, not the date your visa started.

Does my nursing English count?

Only what the Rules list counts. Under Appendix KoLL, an English qualification that your current permission was granted on at B2 or higher can count for applications on or after 26 March 2027, if that provider is still approved. If your visa was granted on the basis of B1, that counts only for applications before that date. English tests used only for professional registration are not on the Home Office list of approved SELTs, so do not rely on them for ILR without checking GOV.UK. See I proved my English for my visa. Do I need it again?.

A nursing degree taught in English

A degree taught or researched in English can meet the requirement, with no date limit. A UK degree counts; a degree from outside the UK needs confirmation from Ecctis. GOV.UK says the degree must be academic, not vocational. See Does my degree count? and How do I use Ecctis?.

Nationality

Nationals of the majority-English-speaking countries on the GOV.UK list do not need to prove English. India, Nigeria, Ghana, Zimbabwe, Kenya and the Philippines are not on that list, even though English is used widely there: see Which nationalities do not need a test?.

Your partner and children

Partners applying as Skilled Worker dependants (SW 44.1) also move to B2 for applications on or after 26 March 2027. Children under 18 on the date of application do not need an English test. See Does my partner or child need B2?.

What the test would be

The Rules ask for a Secure English Language Test in speaking and listening at B2, taken no more than 2 years before you apply. The free checker asks about your route, age, nationality and qualifications and tells you whether you probably need it.

Last checked against GOV.UK: 21 October 2026.

Sources

1. Health and Care Worker visa (GOV.UK, checked 21 Oct 2026)
2. Immigration Rules: Appendix Skilled Worker (SW 22A.1, SW 44.1) (GOV.UK, checked 20 Oct 2026)
3. Prove your knowledge of English: who does not need to prove it (GOV.UK, checked 21 Oct 2026)
4. Immigration Rules: Appendix KoLL (updated 26 March 2026) (GOV.UK, checked 21 Oct 2026)
5. HC 1691 Explanatory Memorandum (paragraphs 5.60 to 5.62) (GOV.UK, checked 20 Oct 2026)

This is general information, not immigration advice. Check GOV.UK for your own route, or speak to a regulated immigration adviser (registered with the IAA, formerly OISC). Find a regulated adviser on GOV.UK.