While the majority of Britain feels seized by joblessness, with the unemployment rate rising to 4.7% and genuine vacancies few and far between, one sector is still crying out for employees: social care.
Social care is one of the most critically understaffed sectors in the country. The latest available study by The King’s Fund shows that the overall social care vacancy rate was 9.9% in 2022/23. That’s compared to the UK’s much lower overall rate of 3.4%.
It’s also a sector with a high proportion of first-generation immigrants and workers recruited from abroad. 25% of employees in the Health and Care economic sector are migrants, and this number is only higher in Hospitality and Admin & Support Services. Specifically, 16% of care staff in residential, nursing and domiciliary care settings are migrant workers.
In contrast to popular political myth-making, we now know that net migration is at its lowest level in five years. Dropping from 649,000 in the year ending June 2024 to 204,000 in the year ending June 2025, it’s fallen by over two-thirds. A plummeting number of total arrivals is the biggest contributor to the fall in net migration: fewer people are coming to work or study in the UK, although asylum seeker figures have remained consistent.
One of the government’s contributions to this drop, despite what we know about the makeup and the strain that currently characterises the care sector workforce, has been an abrupt halt in the issuing of Health and Care Worker visas.
These visas are for qualified medical professionals from abroad who are then sponsored to work in the NHS, but also apply to adult social care workers. In 2023, the total number of these visas issued to care workers was 107.8k. In 2024, that number was 9.5k: a dramatic drop. On July 22nd 2025, new international recruitment on the Health and Social Care visa, at Starmer’s behest, was banned outright.
At first glance, the decision seems utterly counterintuitive. Announced in the May 2025 Immigration White Paper, it’s a drastic measure amid extraordinary pressure on the social care industry. An overstretched social care sector has knock-on effects for the country’s wider healthcare system too: NHS performance figures released for September 2025 indicate that 292,726 ‘bed days’ were lost due to the delayed discharge of patients. Those are days in NHS beds that could be made available for new patients, which the Royal College of Physicians claims could be relieved by a more efficient social care system.
The government’s explanation is that the visa ban is a move to tackle the exploitation of migrant workers in care. The Health and Care Worker visa is what’s called a restrictive visa: this means that the visa-holder’s right to remain in the UK is beholden to a specific job and a specific sponsor. If the worker is dismissed, regardless of whether this dismissal is fair, and cannot find another sponsor within 60 days, they’ll no longer be eligible to stay in the country.
This results in care sector employees suffering inhumane hours, low pay and little support through fear of being fired for raising concerns with employers. They become trapped in exploitative situations because to leave would mean losing sponsorship, and likely their place in the country.
A research report by the Work Rights Centre found that workers on the Health and Care Worker visa were more likely to feel at risk when considering raising grievances or reporting employment rights breaches at work. Several were explicitly threatened by employers with visa curtailment, and many faced inhumane work schedules, pressure to cover their own costs and other workplace abuses.
That being said, the knee-jerk solution of halting Health and Social Care visas altogether betrays the government’s lack of confidence in their own ability to protect migrant workers. The government’s move to tackle migrant exploitation has also seen 470 rogue care agencies abusing the visa system have their sponsorship licenses revoked, with International Recruitment Partnership ‘hubs’ set up to find those working at these agencies new sponsors in the UK.
But just 3.4% of migrant workers invited to use the government’s International Recruitment Partnership hubs managed to secure new care sector sponsors, according to a Freedom of Information Request by the Work Rights Centre. In context, that’s 941 reinstated care sector workers amid 39,000 affected by their employers’ revoked sponsorship licenses.
Solutions could include investing more in these hubs, expanding the time limit for migrants working in understaffed sectors to find new sponsors, or guaranteeing unrestricted work for migrant victims of exploitation. Instead, the government has chosen a rash, but perhaps politically convenient policy – given growing anti-immigrant sentiment in the UK. In reality, not only does it leave the exploitation and subsequent reinstatement of migrant workers already in the UK largely unaddressed, but it places the whole care sector under further strain by cutting off its international lifeline.
Halting the visa also operates on the assumption that ‘UK-born’ workers will flood in to fill the gap. Again, this ignores systemic issues within the care sector that the government has not moved quickly enough to correct. A survey of CQC-registered residential and domiciliary adult social care settings observed that 71% of provider locations found workforce recruitment challenging. Better pay outside the sector was cited as the biggest challenge to both recruitment and retention. As highlighted by the King’s Fund, there were no announcements in the Autumn budget pertaining to adult social care. This comes amid reports that the NHS’s discretionary contribution towards the fund for integrating health and social care was cut by £400m. Many care workers will be affected by an increase in the National Minimum Wage, but this will not solve issues of retention or encourage workers to choose the intense emotional and physical labour necessary for social care over other low-paid jobs.
Care England has responded to the government’s cited measures to fill the migrant-worker vacuum with more ‘UK-born’ workers, such as the Fair Pay Agreement, as being underfunded and years away from implementation. And cultural perceptions of care work as ‘low-skilled’, reflected in the government’s very own white paper, are yet to be tackled in any meaningful way.
Faced with a sector that needs urgent reform, both to protect migrants on restricted visas and to encourage domestic influx into a chronically understaffed industry, the government has responded with a blanket policy that fails to understand the nuances, or the dire state, of social care recruitment. There will be an estimated 540,000 more care posts required to meet rising demand in the next 15 years. We may yet be heading towards the social care sector’s most acute crisis point.
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