The Bottom Line
- GOV.UK guidance for Skilled Worker / Health & Care ILR is explicit: <strong>5 years</strong> qualifying time and you can apply <strong>up to 28 days before</strong> you reach 5 years.
- The silent ILR killer is messy evidence: absences, pay, and dates that don’t reconcile. Run a clean timeline.
- If your visa will expire before you can apply for ILR, GOV.UK warns you should <strong>renew first</strong> (don’t leave it late).
ILR is less about ‘knowing immigration law’ and more about disciplined record-keeping. Doctors often move Trusts, rotate, take leave, and travel. That’s fine—if you can evidence it cleanly. This page is a systems approach: build a timeline, keep it updated monthly, and avoid last-minute forensic reconstruction.
The mindset
Treat your ILR prep like a portfolio: small updates monthly beat a panic audit at the end.
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Step 1 — Confirm your qualifying clock and the 28-day rule
Start with the GOV.UK ILR page for Skilled Worker / Health & Care and identify: date you entered qualifying status, your earliest application date, and any dependencies.
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Step 2 — Build a travel/absence tracker now
Create one spreadsheet tab: departure date, return date, reason. Keep boarding passes or calendar evidence. You’re reducing ambiguity.
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Step 3 — Make pay and employment evidence coherent
Ensure your job history and pay evidence are consistent. If you changed employers, document the transition cleanly with start/end dates and sponsorship evidence.
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Step 4 — Pre-empt the “visa expires before ILR” trap
If you will not reach the qualifying period before your current permission expires, renew in good time. Don’t drift into an avoidable cliff-edge.
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Step 5 — Do a “compliance check” 3 months before applying
Run a final audit of timeline, absences, and evidence. Your goal is to surface inconsistencies while you still have time to correct them.
Your ILR evidence hygiene checklist
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