International recruitment into adult social care has been identified by West Midlands ADASS, through its 2023 Future Thinking project, as an important factor in the resilience of the sector in the years ahead. This remains true even as national policy shifts toward reducing new overseas recruitment.
“I wouldn't want international recruitment to end tomorrow because there are some good people coming over and who we can support. A lot of international recruits are trained nurses and midwives and physiotherapists.
They're providing great skills as they are in some of our organisations...and it's quite unusual to be able to recruit staff with a lot of experience.”
Local Authority Commissioning Manager
The Context
Workforce Pressures in Adult Social Care
Local authorities commission adult social care mainly from independent providers, many of them with fewer than 250 employees.
In 2022, one third of these small and medium enterprise providers were considering exiting the adult social care market due to workforce issues and cost pressures, moves which would significantly impact increasing population needs for adult social care.
International Recruitment Policy Background
In February 2022, care workers were added to the Shortage Occupation List and the Health and Care Worker visa route. This meant that providing international care workers met the salary thresholds and had a licensed sponsor, they could be recruited to care worker roles in the UK.
Since then, the evidence showed care providers were able to recruit care workers internationally to reduce vacancy rates. However, the policy landscape has changed significantly since 2024–25, and the sector now faces new challenges.
Challenges and Risks
There have been some concerns about international recruitment in adult social care, including:
- The administrative cost and burden of becoming or operating as a sponsoring employer
- Reported incidences of unethical recruitment and exploitation by agencies and providers, resulting in some employers having their sponsor licence revoked. This has had a significant impact on international recruits, many of whom have been left without employment and feeling vulnerable
- In 2025, the Government introduced new requirements for providers to prioritise displaced international care workers already in the UK before issuing new Certificates of Sponsorship. It also confirmed its intention to phase out new overseas recruitment into adult social care – this made it even more important to support and safeguard the international workforce already in the UK
- Placement barriers for displaced international care workers, such as, challenges not having a UK driving licence/being able to book a driving test and challenges for providers in securing Certificate of Sponsorships
West Midlands International Recruitment Programme
2023–24: Building Foundations
- Funding from the Department of Health and Social Care (DHSC) supported the development of regional solutions to local challenges around international recruitment.
- Activities focused on strengthening safeguards against exploitation and creating a resilient support infrastructure for employers and recruits.
2024–25: Strengthening Safeguarding and Responding to Exploitation
- Additional DHSC funding enabled continued investment in safeguarding and ethical practice.
- Support was provided for international care workers displaced by sponsor licence revocations
Work continued to prevent and respond to exploitative employment practices.
2025–26: Supporting Transition and Retention
- The 2025–26 IR Programme supports local authorities, providers, and partners as the government transitions away from new international recruitment into social care
- The programme focuses on supporting international care workers already in the UK, impacted by sponsor non-compliance or unethical practice, including pathways back into employment and to reduce poor employment practices.
- Efforts are being made to embed long-term safeguarding and ethical recruitment practices.
- Partnerships are being strengthened to ensure international workers are retained, valued, and integrated into the West Midlands care sector.
- Sharing learnings from the programme to help strengthen recruitment, retention, and workforce development practices across the wider adult social care workforce.
Find more information about the West Midlands International Recruitment Programmes from the links opposite.