This browser is not actively supported anymore. For the best passle experience, we strongly recommend you upgrade your browser.


| 3 minutes read

New measures announced to slash net immigration - How it affects the health and social care sector

New Home Secretary James Cleverly has just announced a five-point plan in a bid to reduce abuse in the immigration system and cut the country's net migration figures which have increased sharply in recent months and years. Net migration is the difference in number of people arriving in the UK and those leaving. 

The five-point plan includes: 

  1. Measures to end the alleged abuse of the health and social care visa - workers will be stopped from bringing dependents. The Government say this is because the vast proportion of whom are not in work and contribute nothing to the economy. Employers will require regulation with the CQC to be able to sponsor employees on health and care visas. 
  2. An increase in the annual immigration health surcharge from £624 to £1,035. Given the recruitment crisis, we are aware of some employers offering to pay this for migrant workers. 
  3. A significant increase in the minimum annual salary required for employees applying for a skilled worker visa in the UK - this will increase from £26,000 to £38,700 so that it is in line with the median full-time wage in those jobs. However, those on health and care visas will be exempt.  
  4. The shortage occupation list will be overhauled. This will end the ability of employers to pay 20% of the going rate for skilled workers. The list of occupations on the shortage occupation list will be reviewed and reformed and a new immigration-reduced salary or discounted salary list will be created. This is in line with the recommendations of the Migration Advisory Committee (MAC) report. 
  5. The graduate route will be reviewed to prevent abuse and the right for international students to bring dependents to the UK will be removed. 

Observations and reflections

A cap on the number of health and care visas that will be issued to workers in the NHS and health and social care sector had been anticipated. However, the Government has not introduced one stating that in practical terms managing a cap would be difficult.  

Home Secretary James Cleverly says changes to the health and care visa will not lead to a staff shortage. BBC News reported that there are between 7 and 10% vacancies in the health and care sector that are filled by overseas workers and the turnover of care workers is between 30 and 40%. In its report on the state of the adult social care sector and workforce in England, Skills for Care reported 152,000 vacancies in the sector in October. In its response to the Government's plans to limit immigration, the National Care Forum has commented that ‘this is unsustainable for any sector, never mind one upon which millions of people rely for care.' While the Government states that vacancies can be filled by workers in the UK, health and care sector, health and social care employers will recognise that this can not be done imminently because salaries are nowhere near the level where the skill and expertise of care workers are recognised. According to BBC live reporting, care workers can earn £3-4 more per hour at a supermarket. The MAC has advised that in order to properly address shortages in the care workforce, it is essential to enhance the pay, terms and conditions of those staff. 

While we have been told that those on health and care visas will be exempt from the increase in minimum salary, another measure is to overhaul the shortage occupation list so social care employers will no longer have the benefit of paying care workers a minimum salary of £20,960. If care workers and senior care workers are retained on the proposed replacement immigration salary discounted list, it is not yet clear what ‘discounted salaries’ will look like for these roles. Given the direction of travel, it is possible that the minimum salary is significantly increased beyond the shortage occupation level care providers are required to pay at present. This would have financial ramifications for care businesses and could impact the ability of some to continue operating. It will also adversely impact the ability of people in their later years to receive care in their own homes if the staff are not there. The Government has for a long time now failed to fund and resource the sector appropriately. 

What action do you need to take?

While the shortage occupation list is being reviewed and reformed, we believe that it is likely that care workers and senior care workers will feature on the new immigration discounted salary list proposed as per the recommendations of the MAC report. However, we don't yet know for certain. 

The new measures are due to take effect in Spring 2024. Therefore, employers in the process of applying for sponsorship licences or looking to assign more certificates of sponsorship should look to do this sooner rather than later. 

We are aware of a recent step up in pre-sponsorship licence compliance visits and requests for information which demonstrates an increased level of scrutiny by the Home Office for employer sponsorship licence applications. 

How we can help:

If you require any support or have any further questions on this please contact either Katherine Sinclair or Hazel Findlay in our employment and pensions team.  

Home Secretary James Cleverly says changes to the health and care visa will not lead to a staff shortage.


discrimination, employment, employment and pensions, housing, health and social care, immigration, migration