The UK’s adult social care sector is facing an acute workforce crisis, exacerbated by severe immigration restrictions, higher sponsorship costs and the absence of a comprehensive domestic workforce strategy. With care providers already struggling to fill vacancies, recent changes to the Skilled Worker visa route and the Certificate of Sponsorship (CoS) fee increase are placing further financial strain on an industry that is heavily reliant on international recruitment, leaving care providers feeling like they are going round in circles.
For years, overseas workers have played a crucial role in filling workforce gaps in adult social care, a sector that faces 152,000 vacancies at any given time. While the UK Government aims to reduce dependency on international recruitment, it has failed to implement a viable alternative strategy to meet demand domestically. Without urgent intervention, these policies risk pushing care providers to breaking point, increasing costs for service users and leaving vulnerable people without adequate care.
Stricter immigration policies and their impact on the care sector
In 2024, the UK Government introduced a series of immigration reforms designed to reduce the country’s reliance on overseas workers. However, for the care sector, an industry already struggling with critical workforce shortages, these changes have only exacerbated an already difficult situation.
One of the most significant obstacles is the increase in the minimum salary threshold for Skilled Worker visas to £38,700, making it harder for care providers to recruit internationally. While care workers remain on the Shortage Occupation List (SOL), the increased threshold for other roles within the sector, such as senior care workers, team leaders and registered managers, creates additional financial barriers and makes recruitment increasingly challenging.
Further worsening the issue is the new restriction on dependent visas, meaning that care workers can no longer bring family members with them to the UK. For many prospective recruits, particularly those from countries where extended family networks play a crucial role in caregiving, this significantly reduces the appeal of working in the UK, making it even more difficult for care providers to attract skilled workers from overseas. As a result, care providers will face even greater difficulties in attracting skilled workers from overseas, leading to higher vacancy rates and a greater reliance on agency staff, with overstretched staff struggling to meet individuals’ needs, ultimately leading to poorer outcomes for people drawing on care and support.
CoS fee increase: A financial strain on care providers
One of the most pressing financial challenges for care providers in 2025 is the potential substantial increase in the CoS fee, which may more than double from £199 per worker to £525. For care homes that rely heavily on international recruitment, this increase represents a significant financial burden. For example, a provider sponsoring 50 overseas care workers annual sponsorship costs will rise from £9,950 in 2024 to £26,250 in 2025. This £16,300 increase is substantial for an industry where profit margins are already often slim.
This increase in sponsorship costs does not exist in isolation. Care providers must also factor in additional expenses, including the Immigration Skills Charge, visa application fees and the NHS Health and Care Visa surcharge. When all of these costs are combined, the price of recruiting international workers becomes prohibitively expensive for many care providers, especially smaller, independent homes that do not have the financial resources of larger care groups.
For many care providers, there will be no choice but to offset these rising costs by increased fees for people drawing on care and support. Many families are already facing significant financial pressures and may struggle to afford rising care costs, leading to greater inequality in access to quality care. Local authorities, which provide funding for social care placements subject to eligibility, may also struggle to keep up with the rising costs, potentially resulting in fewer publicly funded care options.
If no action is taken to mitigate these expenses, closures within the sector will inevitably increase, further exacerbating the workforce crisis and leaving vulnerable individuals without adequate care services.
The lack of a domestic workforce plan: A major policy gap
The Government’s justification for these immigration restrictions has been to encourage greater domestic recruitment into the care sector. However, there is currently no comprehensive workforce plan in place to achieve this goal. Without a long-term, structured plan to recruit, train and retain UK workers, the care sector remains heavily reliant on overseas professionals, making restrictive immigration policies even more damaging.
One of the main barriers to recruiting UK workers into the care sector is low wages and high workloads. Compared to other industries such as retail or hospitality, social care jobs often offer lower salaries with significantly more demanding responsibilities. Many UK workers do not see social care as a viable long-term career, leading to high turnover rates and poor retention of staff which is another major concern. Nearly 40% of care workers leave their roles within a year, often due to burnout, poor working conditions and a lack of long-term career prospects.
Another significant challenge is the ageing workforce. Many experienced care workers are nearing retirement age, meaning that unless new talent is actively brought into the sector, vacancy rates will continue to rise. Additionally, the sector can lack structured career progression pathways, making it difficult for workers to see a long-term future in the industry. Without investment in training and professional development, the sector will struggle to attract and retain the workforce it needs.
The absence of a domestic workforce plan means that vacancy rates will remain high, placing even more pressure on the remaining workforce and the need for international recruitment. Staff will be expected to take on heavier workloads, increasing the risk of burnout and high turnover rates, which in turn negatively impacts patient outcomes and leads to more people leaving the industry for other roles.
The consequences of immigration restrictions on the care sector
The combined effect of immigration restrictions, rising sponsorship costs and the failure to implement a domestic workforce strategy is putting the care sector under unprecedented strain. The direct impact of these policies is already being felt across the industry, with staff shortages worsening, costs increasing and providers struggling to recruit internationally while also unable to attract domestic workers in sufficient numbers.
Financially, these challenges are driving up costs for care providers, forcing many to increase fees for people drawing on care and support or, in extreme cases, close their doors altogether, making care less accessible overall. Local authorities, which are already facing budget constraints, may struggle to fund care placements, leading to a shortfall in available services.
Perhaps one of the most alarming consequences is the knock-on effect on the NHS. With fewer care workers available to provide home-based and residential care, more patients are ending up in hospitals, creating a ripple effect that will place additional strain on the NHS. Delayed hospital discharges will lead to bed shortages, longer waiting times and rising healthcare costs, further overwhelming an already stretched system.
Potential solutions: What needs to change?
To prevent further decline in the care sector, urgent Government intervention is required. The most pressing priority should be to provide financial support for care providers, either through Government grants or subsidies to help offset rising sponsorship costs. Without financial relief, smaller care providers will continue to struggle to recruit internationally and bolster the workforce.
A long-term workforce strategy is also essential. Raising wages, improving working conditions and investing in career progression opportunities will help attract and retain UK-based workers. Investing in training and professional development, such as structured apprenticeship programmes and education incentives, could provide a clearer pathway into the care sector and make it a more attractive profession, ensuring a sustainable workforce for the future.
Finally, there is an urgent need to revise the current visa system and create a more flexible route for care professionals. Reinstating dependent visas for care workers could make UK-based care jobs more appealing to international workers, while reducing visa costs and administrative barriers could help ease the recruitment process.
Without these changes, the care sector may continue to struggle under the weight of rising costs, workforce shortages and increasing pressure on services. The Government must act now to ensure that providers can continue to deliver high-quality care to those who need it most.
Urgent intervention is required
The 2025 visa reforms risk crippling a care sector already on its knees. With staffing shortages at critical levels and financial pressures mounting, the Government’s approach risks harming vulnerable individuals and overwhelming the NHS. A dual focus of financial relief for providers and a credible domestic workforce plan is essential. Without urgent intervention, the sector’s ability to deliver safe, compassionate care is at risk.
Will your organisation be deterred from recruiting internationally due to the recent CoS fee increase? If not, how will the additional cost be offset? Leave a comment on this feature or join the conversation to share your thoughts.
Michelle Holmes is Managing Director at Holmes & Partners Ltd. Email: [email protected] Linkedin: Holmes & Partners Ltd