International recruitment of care workers has ended, the impact may be disastrous
There’s a mismatch between visa policy and labour market realities in adult social care. Home Office data published today showed that international recruitment of care workers had slowed to a trickle by Q2 2025, driven by an increasingly restrictive immigration regime. The final nail in the coffin was hammered in on 22 July, when new international recruitment on the Health and Care Worker visa was banned altogether, under the guise of tackling exploitation. Worryingly, the impact of these policies on the sector was not assessed.
What we do know is that England’s adult social care sector is still struggling to fill vacant posts, and industry leaders are raising alarm bells. But the government’s plans to address these labour shortages are very much long-term and point to an evident problem - when it comes to ending migration into the care sector, you can’t have your cake and eat it.
International recruitment - close to zero
Grants of Health and Care Worker visas to internationally-based care professionals are at an all-time low, with just 1,062 individuals successfully recruited from abroad in Q2 2025 (see Fig. 1).
Figure 1. Number of Health and Care Worker visas issued to workers in caring personal services, 2023-2025
This has been a long time in the making. Since March 2024, the government instituted several changes to the route, including a ban on visa dependants and two increases in the required salary threshold. These were largely aimed at reducing net migration to the UK. The government also sought to address widespread exploitation of sponsored staff, by ramping up compliance checks on employers and revoking licences of hundreds of non-compliant visa sponsors. The combination of these measures inevitably resulted in a sharp decline in legitimate recruitment of overseas care workers.
Then, on 22 July 2025 the government enacted changes initially proposed in its May Immigration White Paper, banning international recruitment of care and senior care workers altogether. The government’s explanatory memorandum justified this by citing “well-known” and wide-ranging concerns around worker welfare, but the impact on the wider sector is yet to be fully understood. Recent labour market data, however, gives us a sense of how the sector might be affected.
Still in the midst of a staffing crisis
Skills for Care data on England’s adult social care sector paints a less than optimistic picture of the state of the workforce. Despite several years of significant hiring from overseas, in March 2025 there were still 111,000 vacant posts. As of last month, the vacancy rate stood at 6.4%, nearly three times higher than across the UK labour market (2.2%). And for care worker roles specifically, the vacancy rate was even higher (8.3%).
Although international staff had driven the number of unfilled posts down from a peak of 165,000 in March 2022, their recruitment was counterbalanced by a number of factors. Notably, an ageing population and increasingly complex care needs are increasing demand for services, and Skills for Care estimates that 470,000 more posts would need to be filled by 2040. On the flip side, many British workers have opted for a career change, with 85,000 British nationals leaving adult social care between March 2021 and March 2025, a 7% decrease in just four years (see Fig. 2). Chronically low wages and poor terms of employment had led workers to seek opportunities elsewhere, particularly within entry-level NHS roles.
Figure 2. Year-on-year change in the number of filled posts in adult social care, by worker nationality, 2021/22-2024/25
In these conditions, work migration has been instrumental to ensuring the viability of adult social care. Nevertheless, largely due to restrictions on the Health and Care Worker visa route, the number of recent migrants (who arrived in the UK and started a care job within 12 months) joining the workforce has plummeted. In just one year, this figure fell from 105,000 individuals in 2023/24 to 44,000 in 2024/25. We can reasonably expect a further drop in 2025/26, now that the 22 July ban has come into effect.
Poor decision making
In the absence of other interventions, service users, workers and care providers alike are likely to feel the pinch of restrictions on the Health and Care Worker visa route. As the president of the Association of Directors of Adult Social Services (ADASS) Jess McGregor explained: “A shortage of care workers leads to a triple whammy of more reliance on agency staff who the person drawing on care won’t know and who the provider will need to pay much more for, more people – especially women – giving up paid work to care for their loved ones, and many people potentially missing out on care altogether.”
Yet, with the risk to the sector’s viability in mind and contrary to standard practice, the Home Office failed to conduct an Impact Assessment before banning the international recruitment of care workers. In its report, the Secondary Legislation Scrutiny Committee decried this as “a suboptimal way to make policy,” noting that scrutiny of the changes to the Immigration Rules was impossible “without a fuller understanding of the impacts across the economy, and perhaps most significantly, on the care sector.” Industry leaders we spoke to as part of our research similarly bemoaned a lack of consultation going into the decision-making.
The government offers no real alternatives
Perhaps what is worse is that the government does not have an alternative plan to prop up adult social care in the short or medium term. Regulations to establish the Fair Pay Agreement negotiating body will only come into force in October 2026, and the first pay increases for carers (which hope to draw people into the sector) are expected no earlier than in 2028. It is yet to be determined who will foot that bill, which may delay rollout or impact on the efficiency of the Fair Pay Agreement. In its long-awaited 10 Year Health Plan for England, the government also failed to offer any sense of direction.
As a temporary measure, care providers could still rely on some migrant labour. Notably, international students (and graduates) have a history of working in the sector. Tens of thousands joined the care workforce to support themselves during term time and then switched to Health and Care Worker visas, in order to extend their leave. Relative to the scale of the staffing issue, this is hardly a strong fallback option. Falling numbers of students coming to the UK, their ability to only work up to 20 hours per week during term-time, and an impending cut to the duration of the Graduate visa announced in the White Paper down to 18 months (from two years) make this a relatively small and unreliable labour pool to draw upon.
Recruitment from the pool of displaced workers is also lacklustre, with just 3.4% of around 28,000 displaced workers rematched to a new visa sponsor between July 2024 and April 2025.
Exploitation risks remain for migrant carers already here
The changes to the Health and Care Worker route were purportedly a response to exploitation, but stopping care workers from moving to the UK will do little to achieve even this aim. While new entrants may be prevented from coming to the UK, there are still thousands of care workers already in the country, their right to work strictly tied to their employer. Even more will join their ranks.
Until no later than 22 July 2028, migrant care and senior care workers employed for three months continuously for a prospective visa sponsor (e.g. Student or Graduate visa holders) would be eligible to switch to a Health and Care worker visa. A recent report by the Public Accounts Committee emphasises that “this reliance [on a sponsor] makes migrant workers vulnerable to exploitation,” and the 22 July changes did nothing to address it.
By ending new international recruitment into care the government will achieve a political aim - reducing immigration. But to believe that it can contemporaneously not harm the adult social care sector is at best naive. In this context, Prof Martin Green, chief executive of Care England, sums the sector’s sentiment up best: “International recruitment wasn’t a silver bullet, but it was a lifeline. Taking it away now, with no warning, no funding, and no alternative, is not just shortsighted – it’s cruel.”
Read more on the migrant care worker exploitation crisis