International Care Workers in the UK: Demand, Visas and Pay

The demand for care services continues to grow as England's population ages and more people require ongoing support. In 2025/26, the adult social care sector employed around 1.59 million people across 1.69 million available roles, highlighting the scale of the workforce needed to meet demand. Forecasts put the additional requirement at 410,000 posts by 2040, driven by a growing older population. Earlier Skills for Care estimate, however, were higher, at 470,000.

Councils carry statutory responsibilities here. Section 5 of the Care Act 2014 obliges them to weigh the sustainability of the care market, and to consider how a workforce with relevant skills and suitable working conditions can deliver high-quality services. The statutory guidance expects councils to support workforce development and fair remuneration.

While vacancy rates have improved in recent years, recruitment and retention remain major concerns. Vacancy levels have fallen from their 2021/22 peak, but turnover remains high, with more than one in five care workers leaving their role each year. For many providers, attracting new staff is only part of the challenge. Retaining experienced workers is just as important.

According to the CQC's latest report, both measures are edging down but still warrant attention.
The sector also draws heavily on non-British staff, with non-British nationals holding roughly one in three posts, and among care workers the proportion reaches 42%. Since 2020/21, the British share of filled roles has shrunk by 18 percentage points, from 85% to 67%, which equates to roughly 130,000 posts.

Filled posts grew by roughly 22,000 last year, a pace that the previous year more than doubled. Professor Oonagh Smyth, Chief Executive of Skills for Care, has framed the priority as making care careers attractive enough for people to join, progress in and remain in over time.

Overseas workers have long contributed to health and care in the UK. Health and care posts were open to EU, EEA and Swiss workers without any visa requirement until, however, free movement came to an end. The Code of Practice for ethical overseas recruitment dates back to 2001.

The Health and Care Worker visa launched in August 2020 on the Skilled Worker route, although many adult social care roles were initially ineligible. For example, senior care roles became eligible in early 2021, and care workers and home carers were brought into scope in February 2022.

International recruitment accelerated rapidly, with around 70,000 overseas workers joining the sector in 2022/23, compared with approximately 20,000 the previous year. For many providers struggling with persistent vacancies, international recruitment became a vital workforce strategy.

Over the twelve months from June 2022, the Home Office issued about 60,000 care worker visas, and senior care workers received another 18,000. The government's approach shifted in 2024 when new rules prevented care workers from bringing dependants to the UK, while sponsorship requirements were tightened so that only CQC-registered providers in England could recruit through the route. These changes reduced the number of new overseas recruits entering the sector.

Since 22 July 2025, new overseas applications under the care worker and senior care worker occupation codes have been refused. Existing workers in the UK keep access to switching and extension routes through a transitional window ending on 22 July 2028.

Settlement rules have also changed. The National Care Association describes the revised route as allowing eligible care workers who arrived before May 2025, have complied with their visa conditions and earn at least £25,000 a year to apply for settlement after five years, but also that that the announcement leaves uncertainty and that it is still awaiting the detail. Reaching five years does not by itself secure permanent residence, as applicants must also satisfy the salary, sponsor and employment tests.

A ten-year route, rather than five, typically applies to people who joined or switched onto the route after May 2025. Applicants will also face a higher English test, moving from B1 to B2 for standard settlement. Separate proposals reportedly could lengthen the period before settlement to 15 years, though SESCA says official detail has yet to appear.

Workers aged 21 and over have been entitled to at least £12.71 an hour since April 2026. The voluntary Real Living Wage rose to £14.10 across the UK and £15.45 in London, with the figures confirmed in mid-October 2026.

Working 37.5 hours a week at the statutory rate produces an annual gross figure of roughly £24,785, which sits just below the £25,000 settlement threshold. The calculation shows that a 40-hour week at the same rate comes to around £26,437, which is above the threshold. Part-time and variable-hours staff are therefore more likely to fall short, which is the group the NCA has asked government to consider.

The salary figure linked to the visa has moved over time, as Commons Library analysis cites an earlier salary floor of £20,960, the Local Government Association quotes £23,200 for social care, and the settlement requirement is now £25,000. Pay concerns predate these changes, with providers reporting difficulty keeping wages in line with inflation.

The revised Code of Practice, published on 27 March 2025, asks employers to follow benchmarks that put internationally recruited staff on the same legal footing as colleagues trained in the UK. Its benchmarks also rule out charging candidates fees for recruitment services.

Despite the safeguards in place, concerns remain around unethical recruitment practices. Investigations have uncovered cases where workers were charged substantial recruitment fees before arriving in the UK, leaving some in significant debt and vulnerable to exploitation. Work Rights Centre described clients who had handed over up to £20,000 in fees.

Since November 2023, the CQC's assessment framework has covered how providers handle modern slavery risks and the wellbeing of overseas recruits. Mistreatment risks rise when workforce gaps and visa rule changes arrive together. Anyone worried about welfare or employment rights is directed to the agency responsible for investigating them.

Concerns about modern slavery or exploitation can be raised by calling 08000 121 700.

Domestic training expansion is important for the NHS Long Term Workforce Plan, with the aim of lessening dependence on overseas and temporary staff. A 10% ceiling on overseas hires by 2035 is the government's stated ambition for the NHS. 

International care workers have become an essential part of the UK's adult social care workforce. Their contribution has helped providers address staffing shortages, maintain services and support people to live independently.

While recruitment pathways have changed significantly in recent years, the sector's reliance on overseas talent has not disappeared, as providers, representative bodies and care leaders continue to call for greater clarity around settlement, fair pay and workforce planning.

As demand for care continues to rise, creating a sustainable workforce will depend on supporting both domestic and international talent. Ensuring fair treatment, ethical recruitment practices and clear career pathways will be critical to retaining the skilled professionals the sector depends on.