New hiring requirements for care agencies will not solve the Health and Care Worker visa crisis

When the government announced changes to the Immigration Rules last month to require care sector employers to prioritise recruiting from a local pool of migrant care workers seeking a new sponsor before sponsoring new workers from overseas, it seemed to some like a beacon of hope. This pool of workers have been left in desperate situations after their sponsors failed to offer sufficient work, and/or have lost their sponsor licences. Finding a new sponsor to provide them work and status to remain in the UK is their top priority. 

However, these changes - though well-intentioned - are a sticking plaster on a much wider issue of migrant worker precarity under the work-sponsorship system, a point which we have highlighted on many occasions to the government. 

As a result, we wrote to the Secondary Legislation Scrutiny Committee on 18 March arguing for greater scrutiny of these changes and a much broader package of reform. In this blog post, we evidence why the changes are insufficient, the government’s response and the Committee’s position on the new changes.

Our submission

Our evidence argues that the changes would not be sufficient in and of themselves to provide assistance to the tens of thousands of migrant workers who have been exploited by their visa sponsors, or who have been affected by Home Office sponsor enforcement activities. By now, the figures here are shocking - the government admitted that it has revoked more than 470 sponsor licences in the care sector and that more than 39,000 workers have been affected by licence revocation action. Considering that tens of thousands of dependent family members also joined carers on the route prior to last year’s changes, which prohibited family members from accompanying new applicants to the UK, the affected cohort is likely to be many thousands higher.

The government’s plan to help these affected workers has not taken off. A recent survey we conducted found that out of the 141 respondents who had experienced sponsor licence revocation or non-provision of contractual work hours, 103 respondents (73%) had not heard about the Department for Health and Social Care's (DHSC) rematching scheme. On the ground, other charities and organisations supporting migrant workers are reporting that even where workers are aware of the service, very few have been successfully rematched into new sponsored employment.

The government’s policy change suggested by implication that the lack of engagement from sponsors with this scheme was responsible for this low take-up, but other evidence points to a more complex picture. For example, in January 2025, an interim report evaluating the use of the DHSC International Recruitment Fund in the West Midlands found that there are practical barriers to recruitment from those accessing the Rematching Scheme, including not having a UK driving licence or access to a vehicle for work purposes, experiencing health issues and not having the right care skills or experience. Similarly, it appears that not all workers have been signposted to the Rematching Scheme, “mainly due to a break in contact between UKVI and some workers”.

The government’s response

There were a number of interesting takeaways from the Government’s response to our submission.  Surprisingly, in its response to the Committee’s follow-up questions, the Home Office admitted that “these changes will not entirely solve the challenges facing displaced care workers” and that the Government continues to “explore further ways of supporting them”. 

The government also admitted that the figures for existing take-up of rematching support had been “disappointing” and agreed that some of the barriers workers face are “unavoidable”, but that the care sector “needs to play its part too” in overcoming these barriers.

It remains to be seen how much further care providers can support the pool of displaced workers without additional support from the government. As recently highlighted, many care providers have been vocal in their criticism of the government’s recent national insurance changes for employers and the lack of an exemption for care providers, who have been facing systemic pressures for many years now. It may be that funds allocated to regional and sub-regional partnerships have to be used in a more creative way, such as partially covering the costs of sponsoring workers from this pool - indeed, we understand that this has been started to be piloted across some partnerships.

Worryingly, the Home Office also admitted that it does not have an estimate of the current size of the pool of displaced care workers in England. We know from our own casework that many workers have been in this position for months, with many at risk of or currently suffering in circumstances of destitution. Without an agenda to help these workers, including the potential to regularise their immigration status where this has been negatively affected, there is a growing risk that these workers will be forced further underground with the very real possibility of re-exploitation and more sinister conditions amounting to modern slavery.

The Committee’s conclusion

The Committee’s conclusion on the changes recognised the government’s intention to resolve this issue, but also noted our concerns about the actual impact and monitoring of the support provided to displaced workers:

“We are not in a position to pre-judge the impact of the policy. However, we welcome that the Government recognises the changes “will not entirely solve the challenges facing displaced care workers”, and that there are barriers to the operation of the matching scheme. It is also encouraging that the Home Office has committed to “continue to explore further ways” of supporting those in the pool. The House may wish to question the Minister on how the Home Office will monitor and report on the success of the scheme; and what further steps it is considering, or taking, to establish how many care workers no longer have employment and to increase the number of them being supported into new employment.”

Ultimately, as we requested, the Committee has drawn the Statement of Changes to the special attention of the House of Lords on the grounds that it is politically or legally important or gives rise to issues of public policy likely to be of interest to the House.

As the Committee has noted, we welcome the government’s willingness to assist workers who have been affected by exploitation from rogue sponsors. However, given the scale of the issue at hand and the need to avoid a situation where thousands of people are unnecessarily forced underground and into more precarious conditions, the Home Secretary must consider a much more ambitious range of proposals to resolve the issues on the Health and Care Worker visa and the wider work-sponsorship system. We urge the government to heed the recommendations from our submission and from our previous report into England’s social care sector.