New immigration rules set to disrupt recruitment within the care sector

The UK care sector faced renewed recruitment challenges as of 9 April this year, when the Home Office imposed further changes to the Immigration Rules seeking to restrain the recruitment of overseas care workers. These changes include a requirement to attempt to recruit from the sponsored worker pool within the UK first before looking outside the UK as well as new salary requirements.

On 12 May, the Home Secretary published an immigration white paper which announced the end of overseas recruitment using the care worker visa.

The Home Office justifies these changes, particularly the recruitment requirement, as a means to “restore order to our broken immigration system”, citing its aims of tackling exploitation of workers, ending reliance on overseas workers, and boosting domestic skills and economic growth. However, the potential impact of these changes is significant, not only for sponsoring employers within the healthcare sector – which is already feeling the pressure of skills shortages – but also for overseas workers seeking sponsorship in the UK as a carer for the first time.

Recruiting care workers outside of the UK

The overseas care worker visa route will close imminently; the Government has not said when the cut off will be, but we anticipate that it will be weeks rather than months.

It seems that care workers are being targeted to bring down the number of ‘low-skilled’ workers entering the UK.

Recruiting care workers inside the UK

Where does this leave sponsored care workers already working in the UK? The white paper suggests that there will be a transition period until 2028 where workers will be able to extend their existing visas.

Under the new immigration rules, employers looking to recruit care workers (occupation code 6135) or senior care workers (occupation code 6136) in England will be required to prioritise recruiting from the pool of skilled workers already within the UK who require new sponsorship under these job codes or those who are in need of new sponsorship due to their sponsor losing its licence or not providing sufficient work.

This new requirement on employers to consider the internal market first is reminiscent of the Resident Labour Market Test (RLMT), which required employers to demonstrate that they were unable to recruit a suitably skilled worker from within the UK before being able to sponsor a migrant worker from outside the UK under the Tier 2 (General) visa route (now the Skilled Worker visa route). It came as a relief to many licensed sponsors when the RLMT was abolished in January 2021 on the basis that it created needless burdens on employers and made overseas recruitment particularly difficult.

The new rules are narrower than the RLMT, as they focus on recruiting displaced migrant workers rather than British workers. However, the new rules do require employers to contact the relevant regional or sub-regional partnership in the area they are located or recruiting in to check if any suitable skilled workers based in the UK already are available to fill the vacancy, before looking outside the UK. If no one suitable is available, the employer must have a letter from the relevant partnership confirming the same before they seek to recruit from overseas.

The Home Office claims that these changes are a result of an increasing number of care workers becoming displaced when non-compliant sponsors have their sponsor licence revoked. They have stated in the explanatory notes that “these changes are aimed at helping those already in the UK who have been affected back into work within the care sector before new international workers are recruited”.

The new rules do not apply to care workers already sponsored before 9 April 2025, any workers switching employers within the UK, or where a provider is seeking to sponsor someone switching from another immigration route who has already been working for them for at least 3 months.

Check that paycheck

The usual annual increase to keep overseas workers’ pay in line with the National Living Wage for UK workers means that the minimum salary threshold for Skilled Workers on discounted rates, including therefore health and care workers, will rise from £23,200 to £25,000 per year (equivalent hourly rate increase from £11.90 to £12.82 per hour). The new rate will apply where a Certificate of Sponsorship (“CoS”) is assigned to a worker after 9 April 2025, including not only newly sponsored care workers but also when an employer is issuing a new CoS to existing sponsored care workers as part of a visa renewal.

The Home Office has also introduced unprecedented rules regarding salary deductions. These rules state that certain payments, such as deductions from salary, loan repayments or investments, will be subtracted from a sponsored worker’s salary for the purposes of sponsorship. Sponsors must therefore ensure that the skilled worker still meets the minimum salary requirement after any relevant deductions are taken into account. This will exclude any payment which is not related to business costs, immigration costs or investment, but rather an additional benefit which the applicant has made a “genuine choice” to take up, such as salary sacrifice arrangements.

Impact on the health and social care sector

The abolition of the care worker visa and these new rules won’t come as welcome news to sponsoring employers within the healthcare sector. The changes couple coupled with the recent National Insurance contribution changes and local authority fee squeezes. Care providers should consider swift action to review their workforce planning options to ensure they have the right workers in the right roles.

We are still missing much of the detail on how these changes will be implemented in practice, so providers should stay alert to further information.

In the meantime, consider the changes to salary thresholds when calculating your recruitment costs (including whether the proposed salary is subject to any deductions) and expect ongoing scrutiny from the Home Office in this area. If you have a vacancy for a care worker or senior care worker role, contact your local regional partnership and collaborate with them to attempt to hire from the pool of displaced sponsored workers first, but also to seek any support you may want with ethical international recruitment.

Those who are heavily reliant on local authority funded care placements should also review their contracts and seek expert advice on possible uplift options.

If you have a query about recruiting within the health and social care sector, get in touch with our specialist team.