“Earned Settlement” & Immigration System Reform

The Government’s proposed “Earned Settlement” reforms are expected to be implemented from Spring 2026.

If enacted, adult social care workers on the Health and Care visa would move from a 5-year to a 15-year settlement route, leaving tens of thousands of overseas care workers facing an additional decade of uncertainty and extended reliance on employer sponsorship.

The consultation has closed — but the reforms are not yet finalised. With implementation anticipated from Spring 2026, providers must act now to protect workforce stability and existing staff.

Background

The Health and Care Worker Visa Route – Policy and Context

The Health and Care Worker visa route has undergone dramatic shifts between 2022 and 2025 — moving from rapid expansion to sharp contraction, and now operating at significantly lower levels as a result of tighter government policy controls.

SESCA has produced a detailed policy briefing and workforce analysis examining these changes and their implications for adult social care. The document draws on Home Office visa statistics and Skills for Care workforce data, analysed by SESCA, to track trends in international recruitment and assess the impact of tightening immigration rules.

It also sets out the wider policy context, including proposed “Earned Settlement” reforms that would extend the pathway to indefinite leave to remain (ILR) for care workers. The briefing explains why these reforms risk further destabilising the social care workforce at a time of sustained vacancies and rising demand.

“Earned Settlement” Consultation

The Government’s “Earned Settlement” consultation closed on 12 February 2026. Current policy direction indicates implementation from Spring 2026.

Under the proposals, adult social care roles would move to a 15-year settlement pathway. Anyone who has not secured Indefinite Leave to Remain (ILR) before implementation would transition onto the longer route.

This affects thousands of overseas care workers who arrived from 2022 onwards, expecting to qualify for ILR from 2027.

Without ILR, migrant care staff remain tied to their sponsoring employer, limiting mobility and increasing vulnerability. Workers would face prolonged visa renewals, significant cumulative costs and continued restrictions on access to public funds.

For employers, this means extended sponsorship obligations, continued Immigration Skills Charge payments, and increased compliance and administrative burden.

Read the full Government proposals here.

SESCA’s Response

Recognising the scale of risk to the sector, SESCA commissioned Victoria Buyer, specialist public affairs consultant, to support development of our formal consultation response and advocacy strategy.

We:

Encouraged and supported provider consultation submissions
Issued detailed sector guidance
Facilitated direct engagement with MPs across the South East

Provider Briefing Webinar

On 22 January 2026, over 100 providers attended SESCA’s Earned Settlement briefing webinar.

Led by Erica Lockhart MBE and Victoria Buyer, the session:

Explained the proposed reforms
Assessed workforce and NHS implications
Provided practical guidance on engagement

Watch the webinar recording here.

Consultation Closed — Implementation Approaching

The consultation period has ended. Implementation is expected from Spring 2026.

There is a limited window for political engagement before policy is finalised.

Key Risks Identified by SESCA

Workforce Destabilisation

385,000 international workers currently fill critical gaps
111,000 vacancies remained in 2024/25
Recruitment has already fallen sharply
470,000 additional roles will be required by 2040

A 15-year route risks pushing international workers out of social care — or out of the UK entirely.

Structural Imbalance with the NHS

Shorter settlement routes are proposed for certain RQF Level 6+ public service roles, excluding most social care roles.

This risks incentivising movement into NHS roles, worsening social care shortages and increasing hospital pressure.

NHS Capacity Impact

Social care underpins hospital discharge, prevents avoidable admissions and supports people safely at home.

Workforce loss in social care will increase NHS waiting times and bed pressures.

Economic & Social Risk

Adult social care contributes £77.8bn annually
Every £1 invested generates up to £2.35 in wider benefit
600 people leave work daily to provide unpaid care

This is not solely an immigration issue — it is a workforce, economic and societal risk.

What Providers Should Do Now

With implementation anticipated from Spring 2026, engagement must happen immediately.

We urge providers to:

Write to your local constituency MP and council leaders – particularly Labour MPs — to explain the local workforce impact and press for safeguards for social care. Your staff and service users are all constituents whose voices matter in this debate. You can use the template “proforma letter” in the Resources section below
Request meetings to explain local workforce impact
Copy SESCA into responses so that we can coordinate regional intelligence

Real Stories Matter

We are seeking:

Employers willing to outline operational impact
Sponsored overseas workers willing to share their experience (confidentially if preferred)

Please contact: hello@sesca.org.uk

Resources

SESCA has produced the following resources to help providers and partners understand and respond to the proposed changes.

Earned Settlement – Briefing Note
An overview of the proposed changes and their potential impact.

Framework Consultation – SESCA Response
SESCA’s formal response outlining sector concerns, risks and recommendations.

Advocate for equal treatment of social care within the settlement framework

Extend public service concessions to relevant social care roles

Protect international care workers already in the UK from retrospective changes

Recognise the essential contribution of international staff to the health and care system

Immigration reform must strengthen, not undermine, workforce stability across social care and the NHS.