8 March 2023

Recruiting Social Care Workers from Overseas

Anne Morris

Under current rules, UK care providers are permitted to sponsor care workers from overseas under the Health & Care Worker visa.

In this guide for employers we explain the current rules on hiring care workers from abroad and what you need to do to be able to recruit internationally.

In a further boost to support international recruitment within the adult social care sector, the Government announced in February 2023 it is allocating £15 million over the course of 2023 to 2024 to help reduce barriers, such as administrative complexity and cost, when recruiting staff from overseas.

The fund was launched by the Department of Health and Social Care. It applies to providers in England only, who can use the funding in areas such as:

Finding and attracting overseas candidates
Assisting with sponsor licence applications and visa applications
Helping new overseas workers access affordable housing

Care roles on Shortage Occupation List

As part of temporary measures to address the workforce challenges faced by the health and social care sector in the UK, a number of care sector roles were added to the UK Shortage Occupation List (SOL) for 12 months on 15 February 2022, making them eligible for Health and Care Worker visas.

Under the rules, care providers can employ non-UK workers from overseas through the visa sponsorship process in a range of care roles. While the measures are in place, workers in eligible roles can apply to come to the UK to work under the Health and Care visa, which makes them exempt from the Immigration Health Surcharge, provided they met the visa eligibility requirements and that their employer holds a valid sponsorship licence.

The SOL, as set out under ‘Appendix Shortage Occupation List’ of the UK’s Immigration Rules, comprises those roles deemed to be in short supply within the UK resident labour market, with such roles afforded more relaxed eligibility requirements for sponsored work visa applications. The list is designed to help facilitate migrants in successfully obtaining work visas to fill jobs where there are shortages — but what does this all mean in practice for UK social care providers looking to recruit migrant workers from overseas?

Prior to the change announced in December 2021, Senior Care Workers, under SOC Code 6146, and Social Workers, under Code 2442, and Residential, day and domiciliary care managers and proprietors under code 1242 were already featured on the SOL.

But in response to labour shortages in the sector, additional care roles with SOC code 6145 have been added to the list of eligible occupations on the SOL, covering roles such as care assistants, care workers, carers, home care assistants, home carers and support workers in nursing homes.

This means care worker applicants may only need to meet a minimum annual salary requirement of just £20,480 to apply for the work visa.

Sponsor requirements to hire social care workers

The Health and Care Worker visa allows medical professionals to work in the UK with the NHS, an NHS-supplier or in adult social care. The benefits for eligible workers are fast-track entry, reduced visa fees and dedicated support from UK Visas and Immigration (UKVI) to enable such workers to easily come to the UK with their families. It also provides a pathway to settlement for those looking to make the UK their permanent home.

Equally, by easing the process by which much-needed doctors, nurses, and other health and social care professionals can obtain permission to work in the UK within their qualified field, UK care providers have at least been able to address some of the workforce challenges that they’ve faced during the pandemic, and continue to face post-Brexit.

Specific requirements must be met when recruiting social care workers from overseas, including being an eligible employer with a valid sponsor licence in place. Eligible employers include the NHS, organisations providing medical services to the NHS, or those providing adult social care.

Care workers cannot be sponsored by private households or individuals, other than sole traders sponsoring someone to work for their business.

UK-based care providers who do not already hold a sponsor licence will need to apply for a licence under the Worker category. The sooner your organisation has in place Home Office approval for recruiting social care workers from overseas, the quicker you’ll be able to meet any skills gaps.

To apply for a licence you will need to pay a fee. This will be £536 for small businesses and charities, or £1,476 for medium and large organisations. It usually takes UKVI around 8 weeks to process a sponsor licence application, although processing times are subject to delay depending in Home Office caseload and in some cases, applicants may be able to apply for fast-tracked priority application processing for an additional fee.

Health & Care Worker visa requirements

Care workers will have to meet the following Health and Care Worker visa requirements:

Have a valid Certificate of Sponsorship (CoS) for an eligible job role issued by a Home Office approved employer authorised to sponsor the job in question. Under SOC Code 6145, the applicant must be hired to attend to the personal care needs and comforts of service users within residential and daycare establishments, or in their own homes, including the elderly and infirm. There are no academic entry requirements for these jobs, although workers must typically be 18 years old and have some experience of working in a care environment;
Be paid a minimum of £20,480 or the ‘going rate’ for their job, whichever is the higher, where the going rates for these types of jobs are based on national pay scales. Once updated, you should be able to check how much a new recruit will need to be paid in the table of “national pay scales for eligible healthcare occupations codes” that can be found online at GOV.UK. However, social care worker job roles are being placed on the shortage occupation list. This therefore means that a new recruit can be paid 80% of the job’s usual ‘going rate’, or 70% if the applicant is under 26 on the date they apply;
Meet the maintenance requirement, where they must be able to support themselves on their arrival in the UK. This requires proof of funds of £1,270, where the applicant will need to have had the money available in their bank account for at least 28 days in a row, and day 28 must be within 31 days of applying for the visa. Alternatively, the applicant must have confirmation from you, on their CoS, that you’ll cover their costs during their first month;
Meet the English language requirement, where they must be able to speak, understand, read and write English to a minimum level.

As background checks, including a DBS check, are likely to be required for care staff roles, your prospective new recruit will need a criminal record certificate from their current country of residence. They may also need tuberculosis test results if they’re from a listed country.

English Language requirement for social care workers

In practice, the ability to speak English to the required minimum level, and providing proof of that ability where required, can often pose the biggest challenge for applicants under the Health and Care Worker visa route. Unless the applicant is a national from a majority English-speaking country, prospective social care recruits from overseas must be able to prove that they can speak, understand, read and write English to level B1 on the CEFR scale, otherwise known as the Common European Framework of Reference for Language scale.

However, an applicant can prove their knowledge of English by either:

passing a SELT, or Secure English Language Test, from an approved provider
obtaining a GCSE, A level, Scottish National Qualification (either level 4 or 5), Scottish Higher or Advanced Higher in English, gained through study at a UK school when aged under 18
having an academic degree-level qualification that was taught in English, although if they studied abroad, they’ll need to apply through Ecctis (formerly UK NARIC) for confirmation that their qualification is equivalent to a UK bachelor’s or master’s degree, or a PhD.

The applicant will not need to prove their knowledge of English if they’re a national from a majority English-speaking country, including Antigua and Barbuda; Australia; the Bahamas; Barbados; Belize; Canada; Dominica; Grenada; Guyana; Jamaica; Malta; New Zealand; St Kitts and Nevis; St Lucia; St Vincent and the Grenadines; Trinidad and Tobago; and the USA.

Health & Care Worker visa application process

Individuals applying for the Health and Care Worker visa will need to apply using the normal Skilled Worker application form and, checking the box to confirm they’re applying for this subcategory of visa. They’ll need to apply online, and within 3 months of getting their CoS. A CoS is a unique reference number that must be submitted as part of the visa application, along with proof of identity and other relevant supporting documentation.

Skilled Worker visa applicants whose job is in a shortage occupation benefit from reduced application fees. The Health and Care Worker subcategory offers a further 50% fee reduction. The standard fee to apply for this category of visa is £232 for those wishing to work in the UK for up to 3 years, and £464 for those staying for more than 3 years.

Health and Care Worker visa applicants also benefit from an exemption from the Immigration Health Surcharge — the fee to use the NHS — as well as a speedier decision following submission of their application. Most decisions will be processed within 3 weeks from the date that the applicant’s biometrics are taken or identity is scanned.

If the application is successful, as with other applicants under the Health and Care Worker visa, social care workers will be able to move to the UK with dependants, including any partner and children, provided these individuals are also eligible. For example, they must be able to show proof of funds to support themselves on their arrival. The applicant would need £285 for their partner, £315 for one child and £200 for each additional child, in addition to their own maintenance funds unless you, as the UK sponsor, will also cover the family’s costs.

The visa fee reduction applies to partners and dependants of Health and Care visa applicants.

Taking on additional work or a second job

Under the latest guidance, Health and Care Worker visa holders can take on a second, or additional, work or employment while in the UK, provided they continue to work in their sponsored role for their sponsor, but may in some circumstances have to apply to update their visa to account for this change in status. Health and Care Workers will not need to update their visa if:

Their additional job also qualifies under the Health and Care Worker route – in which case, there are no restrictions on the hours they can work in this role.
Their additional job is on the Shortage Occupation List – in which case, they can work up to 20 hours a week without having to update their visa.
Their additional job is an unpaid, voluntary role.

As such, Health and Care Workers will need to apply to the Home Office to update their visa if the additional role is not a Health and Care Worker or Shortage Occupation List role, or if they intend to work more than 20 hours a week in an additional role which is on the Shortage Occupation List.

The worker will need to be assigned a new Certificate of Sponsorship from their second employer and provide supplementary information to the Home Ofice detailing the reasons why they want to change their current working status and permission.

New rules on secondary employment from 27 August 2023

From 27 August 2023, Health and Care Workers will only be allowed to work up to 20 hours of additional paid work without the requirement to update their visa, provided the second role is either in the same occupation code and at the same level as their primary job or is on the Shortage Occupation List.

Need assistance?

DavidsonMorris’ team of immigration lawyers have specialist experience in advising UK social care providers on the immigration aspects of international recruitment. We work with employers to provide guidance through the sponsor licence application and Health and Care visa processes. We have particular expertise in complex applications involving group organisations and taking on previously refused licence applications. Contact us for advice.