Adult social care has become one of the most frequently discussed yet persistently misunderstood parts of England’s public services. It sits beneath the NHS, alongside local government and within communities, quietly holding together a system that would otherwise fracture.
Despite this, policy decisions affecting the sector are too often made at a distance from the realities of care delivery. Nowhere is this more evident than in the current approach to international recruitment.
The Home Office’s recent proposal to extend settlement routes for care workers to up to 15 years is not occurring in isolation. It follows a series of changes over the past two years that have steadily narrowed the path for overseas care workers to live and work in the UK with security.
The removal of dependants, rising visa costs (120%), heightened employer compliance requirements and increased licence suspensions have collectively reshaped international recruitment into something far less stable and far less attractive. When viewed together, these measures do not resemble a carefully managed transition strategy. They look like attrition by policy.
Progress remains aspirational
International recruitment has never been a convenience for adult social care. It has been a necessity. At its peak, the sector carried vacancy rates exceeding 150,000 roles. Even as headline figures fluctuate, many providers report that reductions in vacancies are being driven not by successful recruitment, but by service contraction.
Providers are handing back contracts, closing services or reducing capacity because they cannot staff them safely. This is particularly visible in domiciliary care, rural services, specialist provision and support for people with complex needs areas where international workers make up a substantial proportion of the workforce.
The idea that tightening immigration rules will naturally lead to a strengthened domestic workforce assumes that the infrastructure to support that workforce already exists. It does not. England still lacks a fully funded, long term social care workforce strategy.
Pay remains largely dictated by local authority commissioning rates that do not reflect the true cost of delivery. Career progression is inconsistent and parity with NHS roles remains aspirational rather than real. Recruitment campaigns alone cannot resolve these structural issues, and they certainly cannot do so at the pace required to meet rising demand.
A troubling message
Against this backdrop, proposing a 15-year settlement route sends a troubling message. It asks care workers to commit a significant portion of their working lives to a sector characterised by high emotional and physical demands, limited progression and comparatively low pay, while offering prolonged uncertainty about their future.
From a workforce retention perspective, this is counterintuitive. From a moral standpoint, it raises questions about fairness and proportionality. From a system sustainability perspective, it risks accelerating the very instability policymakers claim to want to avoid.
Providers are already feeling the consequences. Many report increased anxiety among international staff about long-term security, reluctance from new applicants who perceive the UK care sector as politically precarious and higher turnover as workers seek alternatives in countries offering clearer settlement pathways.
These are not abstract concerns. They translate directly into missed care visits, delayed discharges, increased pressure on hospitals and greater reliance on unpaid family carers. The costs do not disappear; they are simply shifted elsewhere in the system.
Reframing recruitment and retention
Adult social care providers are not passive recipients of policy. They are statutory partners delivering essential services on behalf of the country. Yet each restrictive workforce decision transfers risk further downstream.
Providers are expected to absorb the operational, financial and ethical consequences of policy choices over which they have little control. When staffing becomes unsafe, providers face impossible decisions, continue delivering care at risk or withdraw services and leave unmet need behind.
This pattern exposes a deeper issue. Social care is still not treated as critical national infrastructure. It is approached as a flexible system that can absorb shock indefinitely, rather than one that requires stability to function. International care workers are framed as a temporary solution rather than as long-term contributors, despite their central role in sustaining services. This framing undermines retention, damages morale and erodes trust.
Risk displacement
If Government is serious about reform, realism must replace rhetoric. Workforce policy cannot be separated from commissioning reality. Pay reform without fee reform is not reform. Reducing reliance on international recruitment without first stabilising domestic supply is not transition it is risk displacement. The sector needs immediate, evidence-led decisions that reflect how care is actually delivered today.
Care workers, whether recruited domestically or internationally, are not interchangeable units of labour. They build relationships, hold continuity and provide care that is deeply human. A system that praises compassion while withholding security will eventually exhaust both. International recruitment should not be treated as a loophole to be closed, but as a vital component of a workforce that needs support, stability and respect.
A shared social responsibility
Any conversation about the future of the social care workforce must begin with honesty and respect. International care workers are not a temporary solution, nor a gap to be closed. They are colleagues, leaders, mentors and friends. They are embedded in communities across the UK and are integral to the care system as it exists today. Providers Unite understands the sector does not function without them, and nor should policy ever imply otherwise.
At the same time, it would be disingenuous to ignore the broader social and generational shifts affecting workforce supply. This is not about a lack of compassion among younger people, nor a failure of work ethic. It is about a labour market that has changed fundamentally. Many younger workers are drawn to flexible, digital and creative careers, often enabled by technology in ways previous generations did not have access to. The idea of long hours, emotionally demanding work and limited progression is increasingly out of step with what younger people are told success should look like.
In other countries, care is culturally embedded as a shared social responsibility. Caring for elders and disabled family members is visible, valued and supported from an early age. In the UK, care has too often been framed as low status work rather than skilled, relational labour. That cultural positioning matters. If society does not visibly value care, it cannot expect future generations to choose it.
The path forward
This is not a problem that can be solved by workforce policy alone. It requires a shift in how care is understood, funded and respected. Technology and innovation can and should play a role not to replace care, but to support it. Digital tools that reduce paperwork, improve co-ordination and enable smarter working can make care roles more sustainable and attractive. But technology cannot replace human connection, and it should never be used as an excuse to reduce investment in people.
For Providers Unite, the path forward is not an ‘either/or’ choice between international and domestic workers. It is a both/and approach. We must protect and value our international workforce while creating the conditions that make care a viable, respected and supported career for those who wish to enter it domestically. That means realistic funding, visible progression, professional recognition and a cultural shift that acknowledges care as essential social infrastructure.
The danger lies in pretending there is a quick fix. Restrictive immigration measures without corresponding reform elsewhere do not build a domestic workforce, they simply destabilise the existing one. A sustainable future for social care depends on honesty about who is doing the work today, respect for why others may not yet choose it, and a long-term commitment to changing the conditions that shape those choices.
Voices Across Care
The future of adult social care will not be secured by restricting those who currently hold it together. It will be secured by funding it properly, valuing its workforce’s honesty and aligning policy with lived and operational reality. Anything less risks weakening a system that millions of people rely on.
Working in partnership with The Care Workers’ Charity, Providers Unite supports Voices Across Care as a platform to help bring the lived experience of the frontline closer to policymakers, ensuring those most affected by decisions have a clearer route to be heard.
How has your organisation been impacted by Government’s restrictive immigration measures? Comment on this feature or join the conversation to share your thoughts.
Katrina Hall is Project Lead at Providers Unite. Email: [email protected] X: @Providers_Unite