Bridging the care gap: can the UK meet demand without overseas recruitment?

Blog posts

2 Jun 2025

Seemanti Ghosh, Principal Research Fellow (Economist)

The UK government's new Restoring control over the immigration system white paper outlines a comprehensive overhaul aimed at reducing net migration and prioritising high-skilled workers who contribute most to economic growth. One of the eight proposals is to end the existing exemption for social care workers so that employers are no longer able to recruit them from abroad. This blog explores what this means for the UK’s care sector, whether the labour market is prepared to absorb these changes without deepening existing workforce shortages and what this would mean for the people who depend on the system.

The government proposes to close overseas recruitment for Health and Care Worker visas, with no new applications accepted. A transition period until 2028 will allow existing visa holders to extend or switch within the UK. Meanwhile, employers will be required to invest in domestic training to end dependency on international recruitment. These changes aim to reduce dependency on migration and align immigration policy with the government’s long-term labour market and economic goals.

To understand the care sector’s reliance on migrant workers and potential implications of ending this visa route, we analysed migration data from the Home Office alongside Adzuna intelligence data on job postings in the care sector. We focus specifically on visas issued within the Human Health and Social Work Activities sector. This sector includes 26 minor occupational groups, but our focus is limited to group 613-Caring Personal Services. Notably, our analysis excludes group 223-Nursing Professionals. We looked at this data against the backdrop of new postings in SOC 6135 (care workers) and SOC 6136 (senior care workers).

Figure 1: Visas and vacancies

Source: graph created by author using Home Office data on Monthly Entry Clearance Visa Applications & data from Adzuna intelligence

Figure 1 above shows that the demand for jobs in this sector peaked in Q1 2022 and Q1 2023 and has been steadily declining since then. In total, between 2022 and 2023, 470,000 care worker jobs have been posted, with the highest number of jobs being in the South and North West of England. In terms of educational requirements, 98.5% of these jobs did not require RQF Level 6 and above. Excluding the peak demand period between 2022-2023, approximately 170,000 jobs were posted in 2024 alone.

With a high number of vacancies, the social care sector continued to be a significant driver of demand for overseas workers during 2022 and 2023, with over 140,000 Health and Care visas being issued to care workers. The total number of visas granted for care workers increased sharply between Q1 2022 and peaked in Q3 2023. The number of care worker visas has declined sharply since: quarterly visas granted in 2024 were less than a tenth of those granted in the peak quarter of 2023.

Visas granted as a percentage of job postings in the care sector reached a peak of 60% in Q1 2023 and a second peak of 52% in Q3 2023 but has been on a sharp decline since then. These peaks can be explained by the change brought around in Q1 2022 when the Health and Care visa and Shortage Occupation List were expanded to include care workers and home carers temporarily due to increasing demand in the sector, and Q4 2023 when restrictions on work and family migration were announced at the end of 2023, which saw a significant reduction in care workers visas granted as a proportion of vacancies - and brought it down to around 5%.

The sharp decline in international recruitment, without an equivalent scaling of domestic workforce development, could exacerbate staffing shortages in an already strained sector, may strain the NHS, and undermine the stability of the adult social care system. Part of the issue is that the impacts of changes to visas are fairly immediate, therefore there is a risk of possible mismatch in timing between immigration policy changes and workforce readiness. The government’s decision to rapidly restrict care worker visas has immediate effects on recruitment pipelines, while efforts to improve the domestic workforce will take years to materialise. Without a transitional plan, this may create a critical shortfall leaving providers struggling to fill essential roles and risking a deeper crisis in care delivery.

Given the UK’s ageing population and increasing demand for care services, a long-term workforce strategy including investment in training, pay, and career progression for UK workers is urgently needed to avoid destabilising the sector and placing further pressure on the NHS.

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Any views expressed are those of the author and not necessarily those of the Institute as a whole.