Health and Care Visa Reforms Boost Adult Social Care Workforce

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By Sanwar Ali:

The NHS has been grappling with substantial staffing shortages in the adult care sector. In a bid to counteract this issue, the UK government introduced further amendments to the Health and Care Worker Visa system in February 2022 part of the Skilled Worker visa system, thereby facilitating the recruitment of care workers from overseas for employers with a sponsor licence. This report delves into the implications of these adjustments on the adult social care workforce within England.

Table of Contents

  1. Understanding the Visa Reforms
  2. Impact on International Recruitment
  3. Influence on Quality of Care
  4. Recommendations for Further Improvement
  5. Conclusion

Understanding the Visa Reforms

In response to the protracted health and care worker shortage in the UK and other countries, the UK government implemented several modifications to the Immigration Rules. Namely, Senior care workers became eligible for the skilled worker route on December 1, 2020, and were added to the shortage occupation list on January 27, 2021.

Subsequently, based on the Migration Advisory Committee's (MAC) advice, the role of care workers was incorporated into the shortage occupation list (Shortage Occupation Code 6145), rendering the position eligible for the Skilled Worker route. This was an alteration to the usual requirement that a role on the list must be skilled to Regulated Qualifications Framework (RQF) level 3 at a minimum (roughly equivalent to A-levels).

This change, which took effect on February 15, 2022, allowed individuals from other countries to work with a licensed UK employer as a care worker, marking a significant step in the government's effort to mitigate staffing shortages in the adult social care workforce.

Impact on International Recruitment

In the wake of these adjustments to the Health and Care Visa system, there has been a steady rise in visas granted to care workers. Data from King's College London (KCL) reveals that as of June 2023, about half of the visas granted within the 'Health and Care Worker' category were allotted to care workers.

The KCL report, Understanding the impact of changes to the UK Health and Care Visa System on the adult social care workforce in England, Phase 1: The Visa Study, provides an in-depth analysis of the impact of the February 2022 visa changes on the adult social care workforce in the UK. The research is based on interviews with 74 individuals conducted between Spring 2022 and Spring 2023, encompassing social care providers, recruitment agencies, internationally recruited social care workers, and experts in the sector.

The report sheds light on the visa application process from both the care provider and the care worker perspective. Over half of the care providers recruiting internationally who were interviewed for the study revealed that they had availed legal advice to meet their sponsor requirements. The complexity of the application process was underscored by one care provider who stated, "The process of application is so difficult that you need to virtually engage a solicitor or some legal professional or somebody that knows what they're doing to get that process right. And if you get it wrong, it gets rejected and it's disheartening and it can take months."

Influence on Quality of Care

While the visa reforms have had a positive impact on international recruitment, concerns have been raised about the potential exploitation of migrant care workers. According to an article published by the House of Commons Library, almost 78,000 people secured long-term visas to work in UK social care between June 2022 and June 2023, following the relaxation of immigration rules for the sector. However, some reports suggest that these workers may be at risk of exploitation.

Recommendations for Further Improvement

The UK government can implement several measures to further enhance the recruitment and retention of care workers. These include:

  1. Offering language support to internationally recruited workers to ensure they can communicate effectively with service users and other staff members.
  2. Providing cultural awareness training to help workers understand the values and expectations of service users in the UK.
  3. Establishing robust supervision and mentoring processes to support workers in their roles and help them develop their skills and knowledge.
  4. Ensuring that internationally recruited workers have their qualifications and experience recognised in the UK.
  5. Prioritising the well-being of the workforce by addressing issues such as workload pressure, stress, and burnout.
  6. Raising public awareness about the value of care work and its contribution to society.
  7. Investing in long-term reform of the social care sector, including sustainable government funding.


The recent changes to the Health and Care Visa system have had a significant impact on the adult social care workforce in England. They have facilitated the recruitment of care workers from overseas, helping to address staffing shortages in the sector. However, more needs to be done to ensure that these workers are adequately supported and that their rights are protected. The UK government should consider implementing further measures to improve the recruitment and retention of care workers, such as providing language support and cultural awareness training, ensuring professional recognition, and prioritising workforce well-being.

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