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The government has curbed the recruitment of care staff from overseas with adults’ providers in England instead required to prioritise hiring international workers already in the country.
Ministers said the measure, which comes into force on 9 April 2025, was designed to provide work for care staff who had come to England and then been exploited, leaving them without a job.
However, provider leaders warned that the move, along with an accompanying rise in the minimum wage paid to care staff on health and care worker visas, would exacerbate the sector’s recruitment challenges.
This in the context of there having been a sharp fall in the number of staff recruited from abroad following a ban on care workers on these visas bringing dependants with them, which was introduced last year .
Sector’s increasing reliance on overseas staff
That had followed a two-year period in which providers had become increasingly reliant on overseas staff to tackle high vacancy levels, after being permitted to recruit care workers from abroad.
Independent sector providers hired 105,000 people from overseas into direct care roles in 2023-24, up from 80,000 in 2022-23 and just 20,000 in 2021-22, according to Skills for Care figures.
Over that time, the number of overseas staff from outside the EU working in the sector almost doubled, from 140,000 to 300,000, while the number of British staff fell by 70,000, from 1.26m to 1.19m.
Increasing exploitation concerns
However, the growth in the number of overseas care staff was accompanied by widespread reports of workers being exploited, either by employers or agencies recruiting workers from abroad.
The Gangmasters & Labour Abuse Authority (GLAA), which investigates worker exploitation, said last year that 61% of all concerns it received from April to June 2024 concerned abuses within the UK care sector.
Many workers reported being forced to work excessive hours with the threat that their sponsorship, obtained by their employer to enable them to work in the UK, would be cancelled, said the GLAA.
Others were forced to pay off debts resulting from excessive fees charged by exploiters to secure work, or reported not being properly paid, living in unsuitable conditions while being charged high accommodation fees and, in some cases, being offered no work at all.
Prioritising recruitment of staff who have lost sponsorship
Between July 2022 and December 2024, the government revoked more than 470 sponsor licences from care sector employers because of abuses, preventing them from recruiting from abroad. However, this has left many sponsored staff without a job.
Last year, the then Conservative government announced a £16m fund, allocated to regional partnerships of councils and providers, to help find care roles for these staff and offer them pastoral support.
The government has now gone further by barring providers from hiring care workers or senior care workers from abroad on health and care worker visas unless they have first tried to recruit from among the pool of workers already in England who have lost sponsorship.
Under changes to immigration rules, employers seeking to sponsor a care worker from abroad must provide confirmation to the Home Office from their regional partnership that they have fulfilled this requirement.
Employers will still be able to obtain sponsorship for staff who came to the UK via a different immigration route to the health and care visa, so long as they have already been working for them for three months.
Care workers ‘subjected to appalling exploitation’
At the same time, the government is raising the minimum wage employers must pay staff on a health and care visa from £11.90 to £12.82 per hour. This is above the £12.21 national living wage (NLW) that also comes into force next month.
In a statement announcing the changes, migration and citizenship minister Seema Malhotra said that “too many providers [had] recruited care workers to the UK and failed to provide them with the work they were promised, or have subjected them to appalling exploitation”.
“We have a duty to protect people against destitution, exploitation and modern slavery, and the best way to do so is through secure, properly paid work and employment conditions,” she added.
Requirements ‘will exacerbate recruitment challenges’
However, the Homecare Association said the requirements would “further exacerbate recruitment challenges for home care providers already struggling with an unsustainable commissioning system”.
This is a reference to the gap between the fees paid to providers by NHS and local authority commissioners and the minimum price the association has calculated is needed to meet costs and make an appropriate profit or surplus.
Last year, it identified a £1bn shortfall in commissioner fees and its minimum price in England, which it calculated as being £28.53 per hour in 2024-25.
However, the association’s minimum price has risen sharply for 2025-26, to £32.14 per hour, due to a 6.7% rise in the NLW, an increase in the rate of employer national insurance contributions (NIC) and a lowering of the salary threshold at which companies start paying NICs.
‘You cannot legislate for better conditions without funding’
“The government is imposing immigration restrictions without fixing the broken commissioning system that makes stable employment impossible,” said Homecare Association chief executive Jane Townson.
“You cannot legislate for better working conditions while simultaneously underfunding the services expected to provide them.”