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Midwives provide antenatal, labour and postnatal care to women and newborns, must be registered with the Nursing and Midwifery Council to practise in the UK, and SOC 2231 is sponsorable on the Health and Care Worker visa route once that registration is confirmed.
The role covers monitoring pregnancy and delivery, supporting parents through birth, and postnatal checks for mother and baby, delivered in NHS maternity units, birth centres, and a smaller number of private maternity providers. For candidates trained overseas, NMC registration usually involves passing the Test of Competence (including the OSCE), and a sponsor should not assign a Certificate of Sponsorship before confirming where the candidate stands in that process, since timelines vary considerably by individual.
The NMC registration pathway in practice
The Test of Competence for overseas-trained midwives has two stages: a computer-based test of theoretical knowledge, followed by the OSCE, a practical assessment carried out at a limited number of UK test centres. Because those centres have finite capacity, candidates can face a genuine wait for an OSCE slot even after passing the theory stage, and that wait is largely outside either the sponsor's or the candidate's control. Building sponsorship timelines around an assumption that registration will complete quickly is one of the more common planning mistakes in this occupation; it's safer to ask the candidate for evidence of exactly where they stand — theory passed, OSCE booked, OSCE passed and awaiting the registration decision — before committing to a start date. A midwife who has not yet completed registration cannot lawfully practise as a midwife in the UK, and there is no straightforward substitute role to place them in instead that would still match what was sponsored.
Registration isn't a one-off checkpoint either. Midwives on the NMC register must revalidate periodically to keep their registration active, so a sponsor's compliance checks should confirm registration is current at the point of hire and have a way of noticing if it later lapses, rather than treating the initial check as sufficient for the life of the visa.
Ethical international recruitment considerations
Health and social care employers recruiting midwives internationally should also check their recruitment activity against the UK Code of Practice for the International Recruitment of Health and Social Care Personnel, which sets out how employers and recruitment agencies should behave when hiring from overseas, and against the WHO Health Workforce Support and Safeguards List of countries facing the most acute health workforce shortages. Recruiting directly from a listed country without a relevant government-to-government agreement in place runs against the spirit of the code even though it isn't, by itself, a bar to a Skilled Worker or Health and Care Worker visa application. This applies to individual employers and agencies, not only NHS trusts, and it's worth building into recruitment due diligence rather than treating it as someone else's problem.
Self-employed and independent midwifery arrangements
Independent midwifery is a recognised part of the UK maternity landscape, with some midwives working on a self-employed or freelance basis, sometimes loosely attached to a birth centre or through a caseload agreement with clients directly. Sponsorship, however, depends on a genuine employer-employee relationship between the sponsor and the worker, so a midwife who is genuinely self-employed, or whose arrangement with a provider looks more like a contract-for-services than employment, is unlikely to be sponsorable in that form. Where a maternity provider wants to bring in an overseas midwife under an independent-style working arrangement, it's worth restructuring the relationship into genuine employment before relying on it to support a Certificate of Sponsorship, rather than assuming the clinical arrangement translates automatically into a sponsorable role.
Where this route differs from other health sponsorship
Health and Care Worker visa applicants can benefit from reduced application costs compared with the standard Skilled Worker route, but the exact fees and any exemptions change from time to time, so check current terms directly on GOV.UK rather than relying on a fixed figure. What doesn't change is the underlying sponsor licence duty to report when a sponsored midwife's registration status, work location or hours change — something Level 1 Users should be across under the key personnel requirements. Keeping registration certificates and the paperwork behind each stage of the Test of Competence organised is easier with structured document storage, and setting an automated reminder ahead of a revalidation date reduces the chance of a lapse going unnoticed.
Pay should be checked against the going rate for SOC 2231 and the wider salary floor, and providers operating in a regulated care setting alongside maternity services may also find our care worker sponsorship rules guide and sponsor licence compliance guide for care providers useful for the wider CQC-facing side of the business.
Questions employers ask
Do international recruitment agencies handling midwife placements still need the employer to hold a sponsor licence? Yes — an agency can assist with recruitment, but only the licensed employer can assign the Certificate of Sponsorship and carries the ongoing sponsor duties.
Is NMC registration required before or after the CoS is assigned? Best practice is to have registration confirmed, or a clear and evidenced pathway to it, before assigning the CoS, since a midwife cannot legally practise unregistered and this affects genuineness. Verify right to work status with a share code check and cross-check the role against the GOV.UK occupations list.
What if a midwife has passed the OSCE but is waiting on the NMC's final registration decision? This is a normal part of the process rather than a red flag, but it's worth having the candidate share the confirmation once it comes through and updating internal records promptly, since acting as though registration is complete before it actually is can cause problems if the role or right to work is ever queried.
Does the international recruitment code apply if the midwife found the role themselves and no agency was involved? The code is primarily aimed at active recruitment activity by employers and agencies, so a candidate applying speculatively is a different scenario, but employers should still be able to show they haven't been actively recruiting from a safeguarded country without an appropriate agreement in place.
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