The Government’s consultation on the proposed “Earned Settlement” reforms closed on 12 February 2026.

However, engagement must not stop.

What We Said in Our Consultation Response

Our position is clear: extending the route to settlement for care workers on the Health and Care visa to 15 years risks destabilising an already fragile system.

1. Workforce Destabilisation

385,000 international workers currently fill critical gaps in social care.
International recruitment has already fallen sharply following previous immigration changes.
There were still 111,000 vacancies in 2024/25.
The sector is projected to require 470,000 additional roles by 2040.

Extending settlement to 15 years will force international workers to leave social care — or the UK altogether.

2. Structural Imbalance with the NHS

The consultation proposes a shorter settlement pathway for certain public service roles (RQF Level 6+), but excludes most social care roles.

This creates a serious imbalance:

NHS roles may benefit from greater immigration security.
Equivalent social care roles do not.
Staff may be incentivised to move into NHS employment purely for settlement certainty.

The likely consequence is worsening shortages in social care and increased pressure on hospitals.

3. Impact on NHS Capacity

Social care is essential to:

Hospital discharge
Preventing avoidable admissions
Supporting people safely in the community

A lack of social care capacity already accounts for a significant proportion of delayed discharges. Workforce loss in social care will inevitably increase NHS waiting times and bed pressures.

4. Economic and Social Consequences

Adult social care contributes £77.8 billion annually to England’s economy.
Every £1 invested in care generates up to £2.35 in wider economic benefit.
Workforce disruption will increase reliance on unpaid carers — already, around 600 people leave work every day to care for a loved one.

Settlement reform is therefore not simply an immigration issue — it is an economic and societal risk.

5. Ethical and Integration Concerns

Care workers already “earn” settlement daily through their contribution to:

Disabled people
Older people
Those with long-term conditions

Extending the settlement route to 15 years signals that their contribution is valued less than other skilled workers, undermining dignity, retention and public confidence.

Independent evaluation of the SESCA International Recruitment Programme demonstrates measurable benefits in workforce stability, provider capability and retention. Structured engagement leads to stable employment — not dependency.

What We Are Asking Providers to Do

Political engagement now moves into a critical phase.

We are asking providers to:

Write to your local constituency MP – 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.
Request face-to-face or virtual meetings to explain the local impact on services, workforce stability and vulnerable people
Copy SESCA into any responses you receive so we can coordinate regional intelligence

Template Letter for MPs and Council Leaders

To support you, SESCA has published a template letter that can be adapted and sent to MPs and local council leaders outlining concerns about the proposed settlement reforms and their local impact.

The template includes:

A suggested Parliamentary Question
Evidence on workforce and NHS impact
Clear policy recommendations

The template letter and full briefing materials are available here.

Real Stories Matter

Personal testimony is one of the most powerful tools in influencing policymakers.

We are seeking:

Employers willing to explain the operational impact of these proposals
Sponsored overseas workers willing to share (confidentially if preferred) how changes to settlement routes would affect their lives

If you are willing to share your experience — as a provider or a worker — please contact us at: hello@sesca.org.uk

A Defining Moment for Social Care

The consultation may have closed, but the reforms have not been finalised.

Sustained, coordinated advocacy over the coming weeks will determine whether social care is further marginalised by immigration policy.

We urge all providers to remain engaged.

SESCA will continue to provide timely updates, practical resources and coordinated advocacy as the Government moves towards a final decision.