Drop in visas for carers indicates tougher Home Office action on sponsors, but insufficient protection for migrants and the care sector

Health and Care visas issued to care professionals in Q3 2024 are 93% lower than 12 months ago. This indicates a change in Home Office practice, with stricter licensing requirements and more licence revocations, following reports of worker exploitation. We argue that while sponsor due diligence is welcome, further measures are required to protect migrant workers from exploitation. Furthermore, if this downward trend in Health and Care visas is to continue, there is a real question about the sustainability of the adult social care sector, where recent recruitment has been reliant on visa workers.

Number of visas for carers issued hits new low

In Q3 2024, 2,423 Health and Care visas were issued to applicants in ‘caring professional services’, down by 93% from an all-time high 12 months earlier, when 33,122 visas were issued.

Figure 1. Number of Health and Care visas issued to care professionals, 2022-2024

What drove the decline in visas issued to care workers?

Two main factors might explain the decline in visas issued to care workers. In December 2023, then-Home Secretary James Cleverly announced several policies aimed at reducing net migration. This included removing the right of care and senior care workers to bring dependants, which may have made the UK a less attractive destination. It also probably reduced the pool of care worker sponsors, by making it a requirement for sponsoring organisations to be registered with the Care Quality Commission (from 11 March 2024) and by increasing the annual salary requirement for care workers from £20,960 to £23,200 (from 4 April 2024).

Another factor that is likely to have contributed to this decline has been a change in Home Office practice, in response to reports that rogue businesses are abusing the immigration system and workers alike.

Home Office responds to reports of abuse

Starting in 2023 reports of migrant care workers’ exploitation soared, including from the Chair of the Migration Advisory Committee, the GLAA, Labour Unions and third-sector organisations. This triggered two responses from the Home Office.

Firstly, there has been an increase in enforcement actions against sponsors. A Freedom of Information request (FOI) we submitted shows that in 2024 the Home Office ramped up enforcement action against sponsors of care and senior care workers (Fig. 2). As many as 339 sponsor licences were suspended and 224 were revoked in the first half of 2024 alone, more than in 2022 and 2023 combined, and comprising more than one third (37%) of all Skilled Worker licence actions in that period. Action against these companies was taken for a range of reasons related to non-compliance with sponsor guidance, including questions over the genuineness of vacancies migrants were hired to fill and non-payment of wages.

Figure 2. Number of licences suspended and revoked for sponsors of care and senior care workers, 2022-2024

Secondly, the Home Office appears to have imposed stricter licensing requirements, leading to fewer new businesses obtaining a sponsor licence. The ICIBI report on the social care sector notes that by October 2023, the Home Office began “requesting more documentary evidence at the licensing and CoS allocation stage”. In the Home Office’s response to the ICIBI report, it noted that work was underway to ‘review all processes relating to the safeguards in the sponsor licensing process at both licence application stage and when allocating Certificates of Sponsorship’. The Home Office expected to implement these operational changes by July 2024.

Looking at the register of Skilled Worker sponsors, there has been a sharp (32%) decline in the number of new licences granted - from a peak in Q1 2024, when 13,800 businesses were licensed, to Q3 2024 when just 9,300 employers were added to the list. While this list reflects sponsors across all job roles (the Home Office register does not specify a sponsor’s industry), the trend is pronounced and correlates precisely with Home Office regulatory action in the care sector.

Figure 3. Number of new licences granted to Skilled Worker sponsors, 2020-2024

Further measures are needed to protect sponsored care workers

Greater Home Office regulation of sponsors is an important intervention against rogue businesses. We expect it to reduce the incidence of new cases where licensed sponsors dupe migrant workers into paying extortionate recruitment fees, for jobs that never existed. However, the drops in numbers alone are neither enough to protect the migrant workers who are already in the UK, deceived and in debt; nor sufficient to redress the power imbalance inherent in work sponsorship generally.

The main official worker-facing measure adopted by the government in response to evidence of exploitation is the £16 million allocation by the DHSC towards a sponsor rematching service.

This is not enough. There is no official policy that protects migrant workers from having their visas curtailed if, through no fault of their own, their sponsors lose the licence to employ them as a result of Home Office enforcement action. Without the right to work, workers are at high risk of destitution or re-exploitation in the black market. And while many of our clients would welcome the type of job-finding service proposed by DHSC, there have been few public facing materials about this programme to date, which makes it difficult to assess its reach and impact.

A more effective intervention would be to give exploited migrants the unrestricted right to work. This way, they can take their skills to businesses that actually need and value them (see our report on care workers).

Regulatory action may worsen labour shortages in care

The other concern is that if increased regulation dampens recruitment, the adult social care sector may face more serious labour shortages than it already does.

Skills for Care, the leading source of adult social care workforce intelligence in England, estimates that 430,000 extra roles will be needed by 2035. Despite heavy recruitment of international staff, as of March 2024 there were still 131,000 adult social care vacancies in England alone, with the sector having a higher vacancy rate than the NHS and any major industry group.

Figure 4. Estimated vacancy rates by sector, 2023/24

Without sufficient recruitment, the vacancy rate will likely grow. There has been far lower international recruitment this year, while British staff continue to leave the sector in significant numbers. It is also unclear what care staff presently on a Health and Care visa will do longer term. Some staff may wish to emigrate, while others might follow in the footsteps of their British counterparts and enter a more lucrative profession (particularly within the NHS).

There has been a policy response to boost domestic staff recruitment and retention. Skills for Care and other stakeholders published a Workforce Strategy for adult social care earlier this year, while the new Employment Rights Bill paves the way for the adoption of an industry-wide Fair Pay Agreement. The issue is that these reforms are likely to take years to bear fruit, while the sector is desperate for staff now.

Granting the right to work to exploited carers is a good start

The latest statistical release indicates that the government has increased regulation of visa sponsors and rapidly reduced immigration of care workers. Although this diminishes the risk of new migrants being duped into paying fees for non-existent jobs, it does not protect migrants who are already here from destitution, and it does not address the power imbalance inherent in sponsorship. What the drop in visa numbers is more likely to herald, is a threat to the viability of the adult social care workforce.

While the government mulls over next steps, providing thousands of exploited care workers on visas with unrestricted right to work would be beneficial to everyone. Carers could more easily find employment, care providers could address some of their labour shortages, while the government would save money on theinternational recruitment fund it is using to match exploited workers with new sponsors. Whether this happens is simply a matter of political will.