The Coming Crisis: How the UK Government’s Crackdown on Immigration Could Break Health and Social Care

Over the past year, the UK Government has launched a sweeping crackdown on immigration in a bid to reduce overall migrant numbers and “ease pressure on public services.” Among the sectors most immediately affected is health and social care—an industry already under significant strain from chronic understaffing, burnout, and rising demand.

One of the most contentious changes has been the restriction on overseas care workers coming to the UK. Previously, a large proportion of frontline care staff were recruited from abroad, including a steady influx of qualified international nurses who chose to work temporarily in the care sector while improving their English language skills and transitioning to NHS roles.

Whilst the social care vacancy rate is falling, it remains higher than the overall unemployment rate.

A Sudden Stop

The recruitment of overseas care workers has ceased. Visa eligibility has been severely tightened, minimum salary thresholds raised, and family visa restrictions have made the UK a much less attractive option for overseas talent.

At the same time, nurse migration to the UK—whether to care homes or the NHS—has plummeted. Application rates from international nurses are down sharply, and several recruitment pipelines have stalled entirely.

Yet, on paper, the sector appears to be carrying on. This raises an urgent question:

Where Did the Shortfall Go?

According to pre-2024 data, the UK health and social care sector faced well over 150,000 unfilled roles across adult social care and nursing. Has that vacancy gap simply vanished?

The answer is: almost certainly not.

While employers in both the NHS and private care sectors may currently be experiencing a temporary surge in domestic applicants—possibly due to a weaker economy and a more competitive job market—there is little evidence to suggest this is a sustainable long-term solution. Domestic workers often lack formal training, tend to view care roles as temporary, and are far more likely to exit the sector within a year.

So while it may feel like the workforce crisis has eased, the foundations remain brittle.

A False Sense of Security?

Employers who were previously reliant on overseas care workers are now scrambling to onboard from the local market, offering recruitment bonuses, fast-tracked training, and flexible hours. But is this a new normal—or simply a blip?

Given the traditionally high turnover rate in care and the demanding nature of the job, it’s hard to believe that domestic recruitment alone can plug the structural gaps left by the departure of migrant workers. The economic reality is that many British workers will move on as soon as better-paid or less demanding jobs become available.

It also appears that employers are currently benefitting from increased domestic recruitment, perhaps due to economic uncertainty or surplus labour. But these applicants are often younger, less trained, and far more likely to exit the sector within a year—historically driving turnover rates of up to 41% among British recruits, versus 30% for international recruits.

Is this sustainable?

Highly unlikely. Without fresh international intake:

·         Within 12–18 months, vacancy rates are likely to rebound.

·         Turnover will soar as inexperienced domestic hires leave for other opportunities.

·         Care quality risks declining, due to staff shortages and reliance on agency or temporary workers.

·         NHS pressures will intensify, with fewer beds available for discharge and more patients stuck waiting for social care packages.

·         The sector may revert to costly agency staffing, eroding continuity and inflating budgets.

Turnover rates in care homes with nursing are at their lowest since 2017 - but is it sustainable? Source: Skills for Care estimates

Moreover, the care sector is not static. The UK’s ageing population is growing. The number of people requiring care is rising—not falling. Without access to a global workforce, how can we expect to meet this demand?

Finally, the question remains as to whether, with a significant reduction in overseas recruitment, its positive impact on the quality and stability of the UK workforce will evaporate.

The Evaporation of the Positive Impact of Migrant Nurses

The quiet but impactful migration pattern—where nurses arriving from countries such as the Philippines, India, Nigeria, and Ghana took on care worker roles as a stepping stone—had a profoundly stabilising effect on the UK’s care workforce. These individuals brought with them professional training, clinical experience, and a strong work ethic that elevated the standard of care and helped plug serious workforce gaps.

Care professionals recruited from abroad—including many qualified nurses—brought clinical training, multilingual communication skills, and cultural diversity that enhanced care quality. Their presence helped deliver smoother transitions and mentoring of less experienced staff.

It wasn't just a matter of numbers—it was about quality. Families and service users alike benefitted from the presence of skilled practitioners who, even when working in lower-paid care roles, delivered care with insight, compassion, and clinical awareness that is difficult to train into an overstretched domestic workforce overnight.

But today, that stream has all but dried up.

The Long-Term Outlook

The current policy approach appears to be based on the hope that domestic recruitment will permanently fill the gaps. But this overlooks decades of evidence suggesting that UK-based recruitment cannot, by itself, meet the sector’s needs.

As mentioned above, if these immigration restrictions remain in place, we are likely to see:

• A resurgence in vacancy rates within the next 12–18 months

• Increased pressure on existing staff, leading to burnout and poor retention

• Lower quality of care as inexperienced or untrained staff are rushed into frontline roles

• Delays in hospital discharges, with the NHS unable to offload patients into the community

• A renewed reliance on agency staff, inflating costs and undermining continuity of care

  
  

Time for a Rethink?

The health and care sector doesn’t just need more workers—it needs qualified, dedicated professionals who see the UK as a viable long-term destination. By slamming the door shut on overseas recruitment, we are not solving a problem—we are deferring a crisis.

The Government must urgently revisit its immigration strategy, particularly for health and social care. Without a pragmatic, needs-based approach to workforce planning, we risk undoing the fragile gains of recent years and plunging the sector into a deeper, more dangerous shortfall.

Because while policies can change overnight, rebuilding a shattered workforce takes years.

Conclusion: Ignoring reality won’t fix the problem

While improving pay and investing in domestic training is laudable, the decision to abruptly halt new overseas recruitment ignores the hard truth:

The gaps didn't simply vanish - they've been temporarily filled by a domestically recruited short term labour resource.

Now, with the visa tap effectively turned off, these hidden pressures are set to re-emerge. Unless the Government revisits its policy and implements workforce planning rooted in social care realities, the sector risks spiralling back into crisis.

The care sector needs time—and people—to rebuild. Relying on a temporary domestic bump without a robust plan is not sustainable.

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