Immigration Rules changes – Care workers

The UK’s changes and proposed changes to the health and care sector in 2025 represents a significant, albeit cautious, step toward long-term reform. These initiatives aim to address challenges such as workforce shortages while introducing stricter regulations on overseas recruitment and sponsorship practices. 

In February 2022 the Skilled Worker visa route was expanded to include care workers, initially on a temporary basis.  This triggered a sharp increase in the number of people arriving via this route to work in below degree-level jobs, from 37,000 in 2022 to 108,000 in 2023.

The Home Office executed a crackdown on sponsor licence holders in the care sector throughout 2024, which led to an exceptional number of sponsor licence suspensions and revocations. The has seen around 40,000 workers displaced, many of whom are ready to rejoin the workforce. The past year has seen numerous changes focusing on the Care Worker visa and sponsors in this industry.

Key Reforms Implemented

Restrictions on care worker dependants

New rules were introduced from 11 March 2024 to restrict care workers from bringing dependent family members to the UK. This change was brought into effect to address the disproportionate number of dependants accompanying care workers - 120,000 dependants accompanied 100,000 workers on the route during 2023. 

Enhanced Protection Against Exploitation 

Also effective from 11 March 2024, in efforts to combat unethical recruitment practices, care providers are required to register the Care Quality Commission (CQC) – the industry regulator for Health and Social Care – to crack down on worker exploitation and abuse within the sector. 

The Home Office has taken action to identify and remove the licenses of unethical and exploitative sponsors, revoking 1,494 Skilled Worker (including Health and Care) sponsor licenses in 2024, up from 337 in 2023.

Prioritising domestic recruitment

Effective from 9 April 2025, care providers are required to demonstrate that they have attempted to recruit from the pool of international care workers already residing in the UK before sponsoring new overseas recruits. The restriction of dependants for care worker and senior care workers has already reduced the numbers of migrants on these visas. The requirement to prioritise domestic recruitment may limit care providers’ ability to fill vacancies promptly in areas with high demand and low local applicant pools. 

Increased Minimum Salary Thresholds

The minimum salary threshold for skilled workers under a Health and Care Visa is now at least £25,000 per year, up from £23,200. This increase ensures that wage requirements remain competitive and reflect current UK labour market conditions.

Increase in Sponsorship costs

From 9 April 2025, Certificate of Sponsorship fees increased from £239 to £525. The fee must be paid by the sponsor and not passed on to the individual. 

On the same day, fees across immigration categories increased, including Skilled Worker application fees, ILR fees, sponsor licence and naturalisation fees.

Key Reforms – White Paper proposals 

Removal of care worker route for overseas applicants

The white paper outlines an end to overseas recruitment for care worker visas. This is likely to impact the sector’s ability to recruit essential staff. In an industry that continues to face significant labour shortages, this is of grave concern. Under the proposed changes, care providers will no longer be able to meet their staffing needs by recruiting migrant workers from overseas.

International care workers in the UK

International workers who are already sponsored to work legally in the sector will be able to continue to extend their stay, change sponsors and apply to settle, including those who need to switch employers following a sponsor licence revocation. There will be a three-year transition period to extend or switch in-country, but this will be kept under review.

Extension of Settlement Eligibility

The eligibility period for indefinite leave to remain will be extended from five to ten years for many migrants, including those in the health and care sector. This change will affect long-term planning of the work force.

Our recommendations 

• Review your sponsorship process, audit current systems to ensure accurate record-keeping, reporting duties and monitoring of sponsored workers. 
• Provide staff training for HR and recruitment teams on compliance with the new requirements, prepare for the requirement to develop domestic training plans to boost British skills and recruitment levels before hiring from overseas.
• Review your salary structures to ensure they meet the new minimum salary requirements. 
• Keep up to date with new developments on immigration rules and policies, you should also keep staff informed on any changes.
• Speak to your staff who are currently sponsored or who may be seeking sponsorship, conduct a review of current staff and roles that may be sponsored and seek to sponsor them at the earliest opportunity. 

Concerns 

These proposals are not without concern.  The policies implemented and suggested are aimed to cut net migration further and tackle visa abuse. The government has been clear that immigration is not the long-term answer to health and social care needs and care providers should hire more British workers. 

These policy changes present several challenges and considerations for health care sector: recruitment challenges, administrative burden, financial implications, compliance risks. Stricter requirements limit the pool of eligible candidates, especially for roles that are already facing staffing shortages.

Conclusion

The UK’s proposed reforms to the health and social care sector represent a serious attempt to stabilise the sector. While initiatives to raise pay, improve working conditions and better integrate services are move in the right direction, the ambiguity could undermine the effectiveness. A balanced approach would support both domestic workforce development and controlled international recruitment.

Note from Citypress

Carolyn Bowie, immigration law specialist at national law firm, Weightmans, said:

“A blanket ban on overseas care worker recruitment would be yet another blow to a sector already under severe strain. Care providers are still adjusting to sweeping changes to the Skilled Worker visa regime; from higher salary thresholds to stricter compliance and a renewed push to prioritise domestic recruitment. In removing international routes altogether, without a robust alternative in place, the government risks triggering an immediate staffing crisis for the sector.

“The care sector needs time to adapt to any new rules- it needs both certainty and practical support. Without that, this policy risks undermining care services across the country at a time when they are needed the most.”