The care worker visa introduced under Boris Johnson’s government is now widely-recognised as a failure, and their potential settlement under Indefinite Leave to Remain as a looming disaster. What has been less well-understood is precisely why the care worker visa route failed, and the extent to which the state lost control. Those are the questions Charles Talbot and I have sought to answer in The Care Worker Visa Disaster, a new paper from Cambridge Circus Research (CCR). Drawing together published Home Office immigration statistics, Freedom of Information requests, public data on visa sponsors and the care system, and Companies House records, we believe the report will help policymakers avoid such disasters in the future. Because of imperfect matching between these different datasets, some of our findings are less certain than others, but we are confident that our findings represent a reasonable base-case scenario, and a significant improvement on the data available to date.
At the launch of the Health and Care visa in February 2022, then Home Secretary Priti Patel said: ‘This is our New Plan for Immigration in action, delivering our commitment to support the NHS and the wider health and care sector by making it easier for health professionals to live and work in the UK.’ As is now well known, while initial Home Office modelling expected between 6,000 and 40,000 applications a year, 132,452 care worker visa decisions (not quite the same as applications) were taken in the 12 months to October 2023, and in total 157,940 visas were issued to care workers between 2021 and 2025, and 48,328 people already in the country switched from student visas to social care. As a result of this, the Home Office estimates that 117,000 care workers and 79,000 of their adult dependants will settle between now and 2030.
The visa was conceived as a route to fill vacancies in the health and social care sectors, but what we have discovered is that in the care system, the state created an uncontrolled market. For the first two years of the visa, companies sponsoring care workers were not even required to be registered with the sector’s regulator, the Care Quality Commission, reflecting the government’s total disinterest in controlling the route. That lack of control was everywhere. There was no link between visa issuance and actual vacancies, no demand model and no automatic brake. Sponsors registered and generated certificates of sponsorship, and the Home Office processed those requests. The system was so permissive that only 1.5% of sponsor applications were substantively refused.
The results were predictable. When the Independent Chief Inspector of Borders inspected the system, they found the misuse of a genuine care home’s identity, forged evidence, fake jobs and a sponsor, Efficiency-for-Care that reported four employees, but generated 1,234 Certificates of Sponsorship, of which the Home Office later said 1,014 had been used in visa applications which are ‘referred for cancellation’ (although when we asked the Home Office for comment as to whether these visas had actually been sponsored, they did not respond). The compliance system was not worthy of the name because it had neither the staff nor the data to understand or test the market the state had created: there was only one compliance officer per 1,600 sponsors.
Furthermore, there are around 500 companies which assigned 22,000 visa sponsorship certificates for care workers in 2023 alone which are now dissolved or have entered insolvency procedures. According to the Home Office guidance on the matter, this should result in loss of sponsorship licence and the employees then have 60 days to find a new sponsor. In practice, this did not happen. The Home Office quietly relaxed its guidance on notifying employees that their visas were due for cancellation. As a result, it is unlikely that many — if any — ‘care workers’ have been deported due to their visas no longer being valid.
Many organisations portray these workers as entirely innocent victims of exploitation. While there are undoubtedly cases of this, there are equally numerous documented cases of fraud. It is known that the selling of sponsorships and even outright fake jobs was rife during this period, and it is likely a non-trivial number were knowingly participating in these schemes.
The lack of controls also extended to disappearing sponsors. As of July 2026, 748 companies who had registered to sponsor these visas could not be found on the register. They accounted for 48,874 certificates of sponsorship – 41% of the total. Despite this, 55 of the 75 largest companies are still active on Companies House. This points to another huge weakness in state oversight: we simply don’t know why sponsorship licences end. This must change.
Domiciliary care, in which care is provided in people’s homes, is the least auditable part of the care sector, as the absence of physical care homes makes it very difficult to judge whether the c.115,000 certificates of sponsorship issued were genuine or not.
The visa also drove a significant shift in the care workforce. Non-EU care workers increased by c.300,000, EU-worker numbers stayed flat, and c.105,000 Brits left the care sector. For context, there are around 1.7 million people working as carers. Given the importance of high-quality communication in care, and the strong anecdotal evidence of language barriers between carers and the people they are caring for, this likely represents a meaningful decline in the quality of care, albeit one which is not captured in official data.
Ultimately, 260,000 new people were recruited, with only 185,000 jobs being filled. The scale of recruitment reveals how little the visa route achieved in terms of resolving social care’s underlying retention problem. International recruitment was operating as a replacement system for a high-churn labour market, rather than simply adding workers to an otherwise stable workforce. Social care already had severe vacancy and retention problems, and this visa only perpetuated this system with workers from abroad.
The very design of the visa also served to obscure its harms. Reporting ‘health and care’ workers as a single category means combining clinicians earning an average of £58,000 per year, nurses earning an average of £35,400 per year, and care workers earning merely an average of £23,100 per year. Naturally the fiscal contribution or drain of these groups is markedly different, with the Migration Advisory Committee estimating that the typical care worker will cost British taxpayers £36,000 over their lifetime, with the health workers contributing an average of £168,000 over their lifetimes.
The warning signs were visible well before any changes were made to the route. As we have noted above, Home Office planning had envisaged between 6,000 to 40,000 care worker applications per year. Yet even in just the twelve months to October 2023, 132,452 decisions on care worker applications had been made. Despite an extraordinary and obvious overshoot, there was no cap on visas or any brake applied to the route. Additionally, there was no system for testing whether rising sponsorship reflected genuine expansion, replacement hiring, or churn. When the Home Office eventually tightened the route, applications fell sharply and refusal rates rose. The scale of the boom was not inevitable. Once the state began to exercise control, the route responded quickly. The greatest failure was that meaningful control came nearly two years too late.
When those changes were finally introduced by Home Secretary Suella Braverman, the change was rapid. On 7 August 2023, ‘genuineness interviews’ were introduced, and further sponsor-compliance and contract-evidence checks were tightened throughout the autumn. As a result, main-applicant applications collapsed from 47,560 in Q3 2023 to 30,637 in Q4 to 10,238 in Q1 2024. Meanwhile, the refusal rate increased significantly from 5.8% to 13.9% and 24.8% over the same time periods. Subsequent dependant and CQC restrictions were announced on 4th December 2023, and did not take effect until 11th March 2024.
When we spoke to Braverman, she said:
When I became Home Secretary, Rishi Sunak promised me he would do “whatever it takes” to get migration under control. Once in power, however, he set about refusing my every measure to curb the blatant abuse of our visa system, from ending the dependents scam to increasing the salary threshold for entry. Robert Jenrick and I had to fight tooth and nail, and all we got was measly crumbs to try and fob us off, all the while the number of foreign caseworkers skyrocketed. It was our skilled worker genuineness requirement and other measures that managed to reduce the tsunami, however slightly, but when we wanted more stringent measures and tried to put the British people first, our own Conservative cabinet colleagues blocked us. Cambridge Circus Research has shown how the British people were once again deceived by the Conservatives’ great betrayal on migration and how those who would claim credit for stopping the fire were the same people who lit the fuse.’
We also understand that the additional restrictions announced by James Cleverly in December 2023, shortly after he became Home Secretary, were in fact policies which had been developed and advocated for by Braverman, and resisted by Sunak.
Recognising, then, that the care visa route was disastrous — ‘Between July 2022 and December 2024, the government has revoked more than 470 sponsor licences in the care sector to clampdown on abuse and exploitation… more than 39,000 workers have been associated with these sponsors since October 2020’ — uncontrolled — ‘We are unable to provide an answer concerning lost sponsor licences as this information is not centrally held and could only be collected and verified for the purpose of answering this question at disproportionate cost’ — and rife with fraud — ‘We have revoked the licenses of more than 1000 care providers who are now no longer able to sponsor migrant workers’ — and that the costs of allowing this group to settle would be very high, it is critical that the government’s proposed ILR reforms are implemented as soon as possible. While this is often characterised on the pro-migration left of the Labour party as a ‘retrospective’ change of rights, it is actually just a change to the terms on which this cohort might be allowed to settle.
It is also crucial that policymakers learn from the failures of the care visa route and ensure that future work visa routes are properly overseen, capped, and constructed so that there is friction and inefficiency in the process. This is important because the ease of certificate of sponsorship generation undoubtedly reduced the barriers to entry for those seeking to conduct large-scale visa fraud.
This article was written by Charles Talbot and David Shipley. Have a pitch? Send it to submissions@pimlicojournal.co.uk.
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It has worked well at suppressing pay and conditions for our OWN people.