Hiring International Workers For The Care Industry

By Sacha Wooldridge, Senior Associate, Birketts’ Immigration Team (www.birketts.co.uk)

The crisis in Social Care staffing is well documented and the sector now has an estimated 165,000 job vacancies.

The recruitment challenges felt after Brexit, exacerbated by the pandemic, have resulted in the hiring of international workers no longer being exclusive to large multi-centre care groups, but increasingly independently owned care homes and services – with many now reporting that the benefits outweigh the additional costs.

What you need to know:

Red-List countries
UK social care providers are subject to the Code of practice for the international recruitment of health and social care personnel in England to ensure ‘international health and care workers [are recruited]… in an ethically responsible manner ’. This code includes a restriction to ensure that there is “no active international recruitment from countries on the red list, unless there is an explicit government-to-government agreement”. Countries that businesses can freely recruit from however include Malaysia, Philippines, India and Sri Lanka.

The red list includes Nigeria, Pakistan, Bangladesh, Ghana and Nepal. Kenya is on the Amber list meaning no active recruitment should take place there either.

Exit visas
Even if a UK visa can be secured for an applicant from a Green-list country, you need to be aware that some countries e.g. the Philippines, have an additional Exit Visa processes for their citizens.

This process has been implemented to ensure the protection of workers and that the overseas employment contracts meet minimum standards. Securing an Exit visa can take months and require that you’ve recruited the worker via a Government approved recruitment agency, or your UK business and employment contract have been vetted and approved with their Embassy. This might mean writing additional terms into your employment contracts e.g. the provision of return flights back to their home country of nationality.

Debt Bondage
Many are alarmed at the cost of UK visas – the UK visa system is one of (if not the) most expensive immigration systems in the world with visas costing up to £9,000 per worker. Visas for the relocation of a family of four to the UK (worker and dependent spouse and two children) could cost nearly £20,000 in visa fees alone. Relocation flights, accommodation etc. would all be payable in addition.

Debt bondage in the care sector has been widely reported and it’s therefore vital that businesses undertake their due diligence when working with agencies to avoid falling foul of the regulations.

Visa fees are payable in full, up-front, prior to the individual moving to the UK – business are therefore often concerned to ensure that the recruit is fully invested in the process, with some seeking to split the costs of the visa and relocation with the individual. Where businesses are recruiting from less economically developed countries, many applicants won’t have the funds to pay for visa costs in advance and it’s not uncommon for businesses to enter in to a clawback arrangement with workers. In theory there is no problem with this. However, advice should be taken to ensure organisations aren’t falling foul of legal restrictions and agreements are carefully drafted.

Businesses can also be reassured that an employee on a sponsored work visa in the UK is only permitted to work for their sponsoring employer, and there are restrictions on self-employment or any secondary employment.

Visa pathways
Many businesses will assume that they have to sponsor a work visa for the individual to enable them to work in the UK, however applicants may be eligible for alternative visa routes. These include:
– EU Settlement status (EU nationals resident in the UK prior to the end of the Brexit transition period)
– Youth Mobility visa (a 2 year visa, enabling work for individuals under the age of 30 of certain nationalities e.g. Australia, New Zealand, Canada)
– Dependent visa (if they have a British partner or their partner holds their own visa to be in the UK)
– Student visa – for those working part time hours
– Graduate visa
These are great options to explore before proceeding with an employer sponsored visa, and will significantly save on costs, as they can be obtained by the individual without company support or investment.

Roles eligible for sponsorship
If the candidate doesn’t have any alternative visa route, sponsorship of a Skilled Work or a Health and Care visa may be the only appropriate option.
To be eligible for visa sponsorship the role must be:
• working for a UK health and care sector employer that’s been approved by the Home Office (i.e. an approved Home Office immigration sponsor licence holder) and
• a NHS Foundation trust; or
• Local Health Board; or
• A person providing regulated activities per the Health and Social Care Regulations 2014; or
• CQC registered; and be paid the minimum salary or the ‘going rate’ for the type of work.

The individual must also be able to meet and evidence a minimum English language proficiency requirement (reading, writing, speaking and listening).
Previously only Senior Care Workers were eligible for sponsorship but in February 2022 the list of eligible roles was expanded to include; nurses, residential, day and domiciliary care managers, care workers and home carers and senior care workers. In February 2022 – Care Workers were added to the UK’s Shortage Occupation List.

Compliance
Businesses are reminded that if they recruit international workers and sponsor work visas that they will be undertaking to the Home Office to maintain certain records and ensure reporting standards are kept throughout the contract of employment. Failure to meet sponsor duties could see the licence revoked and any sponsored workers returned to their home country.
A common issue is that many businesses don’t appreciate that a change in business ownership triggers Home Office reporting and that could inadvertently leave them with illegal workers and open to hefty financial penalties.

Conclusion
Overall, whilst the UK visa system is now seeing far broader engagement from care sector organisations of all sizes, the process undeniably requires substantive investment both financially and, to an extent, in resource to ensure compliance and longevity.