The UK has published a list of 17 countries and territories whose citizens are exempt from proving English language proficiency when applying for the Health and Care Worker visa. This exemption means applicants from these countries do not need to sit an approved English test or submit language qualifications. The list includes Antigua and Barbuda, Australia, the Bahamas, Barbados, Belize, British overseas territories, Canada, Dominica, Grenada, Guyana, Jamaica, Malta, New Zealand, St Kitts and Nevis, St Lucia, St Vincent and the Grenadines, and Trinidad and Tobago.
Ghana, a major source of nurses and doctors for Britain's National Health Service, is not among the exempted countries. Neither are Nigeria, Kenya nor South Africa, despite all four countries being significant suppliers of workers to the NHS and Britain's wider care sector. As a result, applicants from Ghana must still sit an approved English proficiency test before their Health and Care Worker visa application can move forward. This adds an extra step, with associated costs and preparation time, for Ghanaian nurses and doctors seeking to work in the UK.
The UK's exemption criteria are based on historic and constitutional ties to Britain rather than on how widely English is actually spoken in a given country. This explains why nations such as Guyana and several small Caribbean islands qualify automatically, while Ghana — an English-speaking country with a British colonial history of its own — does not. The criteria prioritize countries with strong historical and constitutional links to the UK, rather than assessing English language proficiency directly.
The Health and Care Worker visa has been one of the main routes through which Ghanaian nurses and doctors have moved to the UK in recent years, helping fill staffing shortages in the NHS. The absence of Ghana from the exemption list means applicants face additional hurdles compared to their counterparts from exempted countries. This disparity may impact the number of Ghanaian healthcare professionals seeking to work in the UK.
This development comes as Ghana grapples with the wider effects of health worker emigration. Concerns have been raised about the country's public service losing capacity to deliver services as skilled workers, including nurses, continue to leave for opportunities abroad. The English test requirement may influence the decision of some Ghanaian healthcare professionals to seek opportunities in other countries.
In a mixed picture on UK immigration policy, the UK has kept a discount visa lane open for Ghanaian tradespeople in its 2026 Immigration Salary List. This suggests that UK migration policy is shifting unevenly across visa categories for Ghanaians — offering relief in one lane of the system while maintaining extra hurdles in another. The UK's immigration policies continue to evolve, with varying impacts on different countries and communities.
It remains unclear whether the UK plans to review or expand the exemption list to include Ghana or other African countries. No timeline for any policy change has been given, and it is not known whether Ghanaian health authorities or the government have raised the disparity with UK counterparts. The impact of this policy on Ghanaian healthcare professionals and the NHS will continue to be monitored as the situation develops.
Key points
- Ghana excluded from UK's English test exemption list for Health and Care Worker visa.
- Exemption list based on historic and constitutional ties to Britain, not English language proficiency.
- Ghanaian healthcare professionals face additional hurdles in seeking to work in the UK.
