Changes to the immigration rules laid by government will mean that people with a Health and Care Worker visa who have lost their employment due to sponsorship breakdown, could be given more opportunities to re-enter employment. As some health and care workers have been approaching councils for accommodation and financial support after losing their employment, it is important to be aware of these changes in order to help displaced workers access support to re-enter employment.
Background
The Skilled Worker route was expanded in 2022 to enable medical professionals to come to the UK and work in the health and care sector via a Health and Care Worker visa. To obtain a visa, a person must be employed in an eligible job with an employer who is an approved sponsor. Visas are granted on the condition that the sponsor, applicant, and job conditions all meet the necessary requirements for the route. Since its launch in 2022, the route has experienced a high number of sponsorship breakdowns due to employers failing to meet the scheme's requirements, such as when the job role no longer exists or no longer meets the conditions of the visa. A government inspection in 2023 found that some health and care workers had been left in precarious situations as a result of sponsorship breakdowns. It reported that some workers had experienced financial insecurity and destitution, modern slavery, and in some cases, had lost their right to live and work in the UK.
The government has undertaken a series of steps and policy changes to address issues with the Health and Care Worker visa, including changes to the Immigration Rules in 2024 imposing tougher conditions on employers to register as sponsors. Additionally, funding from the Department of Health and Social Care has been made available to through the international recruitment regional fund to develop regional partnership hubs to support displaced care workers in finding new employment. Further developments were announced in March 2025.
Changes to the Immigration Rules in 2025
A statement of changes to the Immigration Rules was laid in March 2025, and these new rules are in force from 9 April 2025. These changes include:
- A new process requiring employers to attempt to recruit via a pool of registered displaced workers before sponsoring new international health and care workers.
- Raising the minimum salary threshold from £23,200 to £25,000 to keep the route in line with inflation and reflect the findings from the Office of National Statistics’ Annual Survey of Hours and Earnings.
- Restrictions regarding circumstances in which employers can make deductions from a person’s salary, and this is being brought in to tackle instances of exploitation of health and care workers.
- Reducing the working hours for full-time salaries from 40 hours to 37.5 hours per week.
Of significance are the changes instructing employers to demonstrate that they cannot recruit from a pool of registered skilled workers who were previously sponsored on the route, before sponsoring another overseas worker to fill a vacancy. This will prioritise the employment needs of displaced health and care workers and may help some avoid visa cancellations while in the UK. This process only applies to workers who are based in England.
When a person on the Health and Care Worker visa experiences a breakdown in their sponsorship, they are given 60 days to find alternative employment with an approved sponsor. During this period, they are encouraged to register with their regional hub for support and assistance in finding employment. Regional hubs will maintain a database of this pool of workers within their region, and employers recruiting health and care workers will need to contact the regional hubs initially to establish whether they can match a post with a displaced worker before they can obtain a certificate of sponsorship for a vacancy. They must provide evidence that they have utilised this resource before undergoing further international recruitment from outside this pool.
What this means for local authorities
The new protections could safeguard some displaced health and care workers from the effects of destitution by facilitating their return to employment within the 60-day grace period. While this could help alleviate labour shortages in the care sector, the changes could also minimise the need for local authority intervention where displaced workers and their families are experiencing financial insecurity and complications regarding their immigration status in the UK.
The Health and Care Worker visa is issued with a no recourse to public funds (NRPF) condition, and so a person on this route cannot access the safety net of welfare benefits or local authority homelessness assistance. Local authorities across the UK have informed us that they have seen an increased number of destitute health and care workers and their families seeking assistance following sponsorship breakdowns. In such cases, councils may be required to meet their statutory duties under section 17 of the Children Act 1989 when there is a ‘child in need’, or under the Care Act 2014 when an adult has care and support needs. This includes meeting urgent needs like accommodation and financial support to alleviate homelessness or financial insecurity.
Going forward, these new protections could reduce the instances in which displaced workers require assistance or shorten the period of insecurity. However, with only 60 days for a person to find a new sponsorship before the Home Office can take action to cancel a visa, these new rules will only be effective if displaced workers are able to quickly register with their regional hub. It is therefore essential that local authorities, voluntary and community sector groups, and any other organisations supporting health and care workers are signposting into the service.
Increasing the salary threshold could also benefit some workers who are struggling to meet their needs where their income is insufficient to safeguard them from poverty such as because of rises in the cost-of-living, inflation, or a reduction in working hours. However, as health and care workers cannot top their income up with benefits like Universal Credit or Child Benefit, some may continue to be reliant on charities like food banks or in some cases support from children’s social care to meet their needs.
Local authority social care services and other frontline council services will need to familiarise themselves with their local hub and refer displaced workers to ensure they register for further employment opportunities and can access any other support provided through the hubs. See the government webpage for more information on support for international health and care workers and for details on regional international recruitment hubs.