Overseas recruitment: the ‘short-term fix’ for the social care workforce that is now at an end

In a different universe, this week’s Skills for Care report on the size and structure of the adult social care workforce would be seen as testimony to the success of the last government’s policy on adult social care. The report shows a fall in the headline rate of vacancies in the sector – and it was the last government's policy that brought it about.

Of course, it's not quite that simple. We can all remember it: as the UK emerged from the Covid-19 pandemic, and the wider economy opened back up, vacancies in social care accelerated to record levels. Providers were desperate for staff – there were 152,000 vacancies – and couldn't offer the services that people needed. Hospitals said they couldn't discharge patients because homecare agencies didn't have the workforce. In a sector used to chronic problems, it was a genuine crisis.

The then Conservative government responded. In February 2022, it opened up a new health and social care visa route, allowing overseas workers to take up care posts on relatively low salaries. It was immediately successful. In 2022/23, 75,000 people arrived in the UK from overseas and started work in care. In 2023/24, that number grew to 105,000, and in 2024/25, even after changes to the rules and implementation, it was still 50,000. As a result, vacancies fell and have continued to fall. They are now back to where they were before Covid-19.

No one will be showering the previous government with praise, however, and for at least four good reasons.

1. The health and care visa route was initially recommended by the government’s Migration Advisory Committee as a short-term fix for social care, while the substantive issue of underfunding in social care was addressed. But that did not happen – the sector continued to be under-funded. Almost three-quarters of councils in England overspent their adult social care budgets in 2023/24.

2. Overseas recruitment did nothing to tackle the underlying workforce problem: the unattractiveness of working in social care. In fact, if anything this has gotten worse. In 2024/25, despite the overall fall in vacancies, the number of British workers in adult social care actually fell by 30,000. There are now 55,000 fewer British workers in social care than before Covid-19, making up 71% of the workforce, compared with 85% in 2019/20.

3. The policy was poorly implemented, allowing for abuse of the system and exploitation of migrant workers. In July 2023, the chair of the Migration Advisory Committee said: ‘There are clear problems, in terms of exploitation, both in the home country and when they get here, really bad employers doing quite dreadful things.’

4. The policy ran headlong into voter concerns about increasing immigration. For some voters, overseas workers may have been a solution to the crisis in social care, but they were the wrong solution.

It's also worth saying that the policy has only been a success up to a point. The scale of the problem may have fallen, but there are still 111,000 vacancies in social care and the vacancy rate (7%) remains three times as high as the wider economy (2.3%). Returning a crisis to a chronic state was only ever half the battle.

The current government put a stop to the health and social care visa route earlier in July. Its own policy to tackle recruitment in social care – a fair pay agreement – is going through parliament at the moment. That has the potential to tackle the underlying problem by boosting pay and thereby attracting more staff. In principle, it should be welcomed.

However, it's not without difficulties. It’s a major intervention in a complex marketplace and needs to be properly thought through and joined up with other workforce measures and wider social care reforms. Even more fundamentally, though, on the current timetable it won't be implemented before 2027.

At the moment, vacancies are at a familiar level, not low enough to relieve the pressure but not high enough to cause the widescale alarm of 2022. What if they begin to climb again, though? The government appears to have ruled out a return to overseas recruitment: it would be good to know what it plans to do if it needs a new ‘short-term’ fix.