The UK government has continued its legislative refinement of the Health and Care Worker visa route with new rules introduced in March 2025. These measures specifically target the adult social care sector in England, mandating a strict “domestic first” recruitment policy. This follows the major policy shift in 2024 which banned care workers from bringing dependants, a move that has already significantly reshaped the demographic of new arrivals.
The latest changes aim to address concerns about ethical recruitment and the over-reliance on international labour, while attempting to balance the critical staffing shortages in the sector.
The “Domestic First” Evidence Requirement
The core of the new rule is an enhanced evidence requirement for sponsors. Care Qualified Care (CQC) registered providers must now provide robust, documented proof that they have genuinely attempted to recruit domestic workers before a Certificate of Sponsorship (CoS) can be assigned to an overseas national.
While the “Resident Labour Market Test” was technically abolished post-Brexit to streamline hiring, this new sector-specific requirement essentially reintroduces it for care homes. Sponsors must demonstrate:
- Active advertising of the specific vacancy on compliant platforms for a minimum period.
- Engagement with local Jobcentre Plus schemes.
- Clear justification for why domestic applicants were unsuitable.
Failure to provide this evidence upon request can lead to the refusal of the CoS allocation and potential compliance action against the sponsor licence.
Impact of the Dependant Ban (Review)
The rule comes one year after the implementation of the ban on dependants for care workers (SOC code 6135) and senior care workers (SOC code 6136). Government data indicates this has led to a sharp contraction in total visa issuances for the sector.
While this has achieved the political goal of reducing “net migration” numbers—as a single care worker often brought a spouse and children—it has created retention challenges. Care providers report that experienced staff are increasingly looking to move to jurisdictions like Canada or Germany where family reunification rights remain intact, or are attempting to upskill into the standard Skilled Worker route (e.g., as nurses) which still permits dependants.
CQC Registration Loophole Closed
Another critical aspect of the evolving rules is the tightening of the CQC requirement in England. Previously, some agencies operating in a grey area of the “care” definition managed to sponsor workers without full regulatory oversight. The Home Office now strictly enforces that only CQC-registered activities entice sponsorship. Workers found to be effectively “contracted out” to non-regulated environments face visa curtailment, and the sponsor faces revocation.
Ethical Recruitment and Red Lists
The UK continues to align strictly with the World Health Organization (WHO) Code of Practice on the international recruitment of health personnel. The “Red List” of countries—developing nations with critical healthcare workforce shortages of their own—remains in force.
Employers cannot actively recruit from Red List countries (such as Nigeria, Ghana, or Pakistan) unless there is a direct government-to-government agreement in place. Direct applications from individuals in these countries are permitted, but agencies and employers must ensure they do not market directly to these populations.
Challenges for the Sector
The combination of the dependants ban and the new “domestic first” hurdles has placed care home operators in a precarious position.
- Rising Costs: To attract domestic workers, wages must inevitably rise, squeezing margins in a sector heavily reliant on fixed Local Authority funding rates.
- Admin Burden: The administrative cost of proving domestic recruitment efforts adds time and expense to an already stretched HR function.
- Vacancy Gaps: Despite government initiatives to fund domestic training (such as the “Made with Care” campaign), the gap between demand for care slots and available staff remains wide.
Conclusion
The “New Deal for Care Workers” represents a fundamental shift in the UK’s approach to social care staffing. The government’s clear intent is to wean the sector off its “addiction” to overseas labour. For providers, this means the era of easy, quick-access international recruitment is ending. The focus for 2026 and beyond must pivot towards aggressive domestic retention strategies, apprenticeship schemes, and automation, with international sponsorship reserved for critical, evidence-backed shortages only.