Locked Out: How UK Immigration Rules Are Breaking the Care Sector - While Ireland Thrives

Introduction

The care sector across the British Isles has long relied on international labour to sustain its workforce. With aging populations and increasing demand for long-term care, providers have leaned heavily on overseas recruitment to fill chronic staff shortages. However, in recent months, the UK government has imposed sweeping restrictions on the recruitment of care workers from abroad. These changes are having a profound and immediate impact on care delivery across the UK.

In a straw poll carried out by Harley Medical of 100 nurses in the Kerala region India, asking the question “Would you prepare for your OSCE exam to help you secure a job in the UK?”, more than 70% said they felt there was no point as there were no opportunities in the UK to prepare for.

In contrast, the Republic of Ireland has retained a more open and pragmatic policy, continuing to welcome international care workers through accessible visa pathways. As a result, care providers in Ireland are now enjoying a major competitive advantage, with easier access to talent, reduced dependency on agency labour, and more stable staffing.

This blog explores the divergence between UK and Irish policy, the impact on care services, and why Irish providers must act now to capitalise on their current position before the winds shift.

The UK's Policy Shift: Restricting Overseas Recruitment

In late 2023 and into 2024, the UK government implemented significant changes to its visa rules affecting the Health and Care Worker visa route. These included:

• Banning care workers from bringing dependants to the UK

• Raising the minimum salary thresholds for sponsored roles

• Increasing the administrative burden and compliance costs on sponsoring employers

These moves, framed as part of a broader effort to reduce net migration, sent shockwaves through the care sector. Providers that were already struggling to fill vacancies now found their recruitment pipelines severely constrained.

UK Net Migration is clearly on the decline. But is it healthy in the longer term?

The results have been swift and severe:

• Vacancy rates in adult social care in England rose by over 15% in early 2024

• Providers have reported a sharp decline in international applicants

• Increased reliance on expensive agency staff has pushed many care homes into financial distress

• Some providers have been forced to close services due to lack of staff

  
  

While these measures may appeal to certain political narratives, they have created a dangerous staffing crisis that risks undermining care quality and accessibility.

The Republic of Ireland: A More Open Approach

Ireland, by contrast, has adopted a far more practical stance. Recognising the essential role international workers play in healthcare and social care, the Irish government continues to include care workers on its General Employment Permit list. This allows care providers to sponsor overseas staff with relative ease.

In Ireland:

• There are no bans on dependants for care workers

• Salary thresholds remain more accessible for social care roles

• Processing times for work permits have improved in recent years

This policy stability has made Ireland an increasingly attractive destination for overseas applicants who might have previously looked to the UK. Indian, Filipino, and African care workers are now redirecting their applications to Irish employers, fuelling a more robust and sustainable staffing model.

Comparative Impact on the Care Sector

The difference in policy has produced starkly contrasting outcomes in each country:

UK:

• Escalating vacancies and burnout among existing staff

• Rising use of agency labour, pushing up operational costs

• Increased turnover and disrupted continuity of care

• Declining morale among managers and frontline carers

Ireland:

• Steady influx of qualified international care workers

• Greater workforce stability

• Improved ability to scale services and open new facilities

• More time and resources to invest in training and service improvement

In effect, while the UK scrambles to fill growing gaps with diminishing options, Ireland is consolidating a workforce advantage that could reshape the sector in the years ahead.

Will Ireland Follow the UK? Why the Window to Recruit Overseas May Narrow

While the Republic of Ireland currently maintains a more open and practical approach to overseas healthcare recruitment, it would be naïve to assume this freedom will last indefinitely. As political, economic, and public pressures mount in both countries over immigration, there is growing speculation within the care industry that Ireland may eventually begin to mirror some of the UK’s more restrictive stances—particularly if workforce inflows continue to climb rapidly.

Political Signals and Policy Caution

So far, the Irish government has been relatively pragmatic in recognising the acute and growing shortage of healthcare workers. The inclusion of care workers and healthcare assistants on Ireland’s Critical Skills and General Employment permit lists has been a lifeline for care home operators. However, recent debates around housing shortages, integration challenges, and public services strain could place immigration policy under review—especially in the run-up to elections or in response to populist pressures.

There is precedent for tightening but just not yet. For example, in late 2023 the Irish government reviewed its work permit regime, and while no drastic changes were made for the care sector, adjustments were made in other sectors, signalling that ongoing scrutiny is real. If the UK model is held up, however controversially, as a benchmark by certain political factions, the Irish government could be tempted to introduce caps, quotas, or salary thresholds, especially if public sentiment shifts.

Why Irish Care Providers Must Act Now

Ireland is currently in a unique and advantageous position compared to its UK counterparts. While UK care homes are scrambling to fill vacancies under tougher visa conditions and dwindling supply, Irish providers still have full access to experienced, English-speaking care workers from regions like India, the Philippines, and parts of Africa.

This gives Irish operators a critical first-mover advantage—but only if they act quickly and strategically.

• Secure long-term staffing before demand and competition surge: The UK restrictions are already forcing some care workers to explore Ireland as an alternative. Irish providers can tap into this talent pool now, before it becomes oversaturated or regulated.

  
  

• Build a stable, loyal workforce while it’s still affordable: The longer companies wait, the more likely it is that future restrictions—or simple demand pressures—will drive up competition, wages, and onboarding complexity.

  
  

• Avoid the boom-bust recruitment cycles: The UK care sector is a cautionary tale in how reactive policymaking can destabilise staffing. Irish care providers can avoid this by establishing a strong overseas recruitment pipeline now, with trusted partners and scalable strategies.

The Strategic Imperative

If Ireland eventually tightens its overseas recruitment policy, the care providers who already have staff in place—and the infrastructure to support them—will be far ahead of the curve. Those who delay risk being caught short-handed in an increasingly competitive and constrained labour market.

Care organisation in Ireland have a clear strategic imperative. But how long will it last?

The message to Irish care groups is simple: don’t wait for policy to change—act now while the window is open. Invest in overseas talent before that advantage disappears, and position your organisation for long-term workforce stability.

Conclusion

The divergence in immigration policy between the UK and Ireland has created two very different realities for care providers. In the UK, new visa restrictions are exacerbating an already critical workforce crisis. In Ireland, a more flexible and open approach is enabling providers to grow and stabilise their services.

But this advantage may not last forever. Political winds can shift quickly. For Irish care groups, the time to build, invest, and recruit is now. By acting decisively, they can not only meet current workforce needs but insulate themselves from future uncertainty.

In the battle for care sector resilience, the winners will be those who recognise opportunity before it becomes necessity.

Harley Medical

Harley Medical and our team of experts welcome the opportunity to speak to you about your overseas recruitment plans and we can offer free advice on the best way forward. Just reach out to us on the contact details below for a chat at any time.

To start a dialogue or request more information please email: info@harleymed.com or call 0203 488 4776