Social care organisations in Wales face an impending workforce crisis under the new immigration laws set out by the UK Government when free movement ends on 1st January 2021.

If the proposed immigration policies were in place now, nearly one fifth of nurses currently working in social care in Wales are EU nationals and would not qualify under the proposed new immigration system.  

This could place further pressure on the health and social care system. It is estimated that a further 20,000 social care staff will be needed in Wales by the year 2030.

Recent research has shown that 58% of registered social care providers reported difficulties recruiting to vacancies, with 28% indicating that it had become ‘very difficult’.

Meanwhile the proposed immigration laws stand to affect about 1% of new starters within the NHS in Wales, many of whom have played essential roles during the Coronavirus pandemic. These roles include ambulance drivers, dental surgery assistants, social care support workers, health care support workers/healthcare assistants, patient care assistants, emergency care assistants, and pharmacy assistants. 

The report finds that under the new immigration system it could be easier, and in some cases with the introduction of the Health and Care Visa also cheaper, to employ non-EU nationals compared to the current immigration system. While this is a positive development, it also means that the NHS and new starters from the EU could face significantly greater bureaucratic processes before they can take up a position working in the NHS.

Nesta Lloyd - Jones, Assistant Director of the Welsh NHS Confederation said:

“The NHS and social care are intrinsically linked. This research highlights that the UK Government’s proposed immigration laws will have a significant impact on the social care sectors ability to recruit the staff they need.

“If social care cannot fill vacancies, then ultimately we may see a knock-on effect on the pressure and demand placed on the NHS. This won’t be the fault of those working in social care, such as those managing care homes in Wales, but it will be the result of additional barriers put in front of them.

“While staff within the NHS appear to be less affected, this would nonetheless impact recruitment into essential roles who have gone above and beyond when responding to Coronavirus. Anything which makes Wales a less attractive place to train, live and work will have a significant impact on our ability to recruit and provide the level of care we can deliver.”

Jonathan Griffiths, Vice-President and Workforce Lead for the Association for Directors for Social Services Cymru said:

“We know that there are long-standing recruitment and retention challenges within the social care sector, and this fragility will certainly have been exacerbated by the direct impact of COVID – particularly for frontline care staff who have had to bear the risks of greater exposure to the virus.

“Yet what has also become apparent particularly as a result of the pandemic is the high-public value that has been attributed to social care workers, who continue to play an essential role in sustaining our healthcare system, for example by ensuring that individuals can be safely discharged from hospital to their home supported by domiciliary care or to residential care.

“ADSS Cymru and its partners are working hard to support employers to address ongoing recruitment and retention challenges and to make the sector a more attractive career opportunity for our home-grown talent in the long term, through actions to improve the status of social care workers and to improve the wider terms and conditions of the workforce; however we also need an immigration system that supports our current needs.

“We are concerned that with the new immigration thresholds set high, no reference to social care on a UK Shortage Occupation List and with no indication, at this stage, of a Wales specific Shortage Occupation List –– the challenges for the health and social care system, as we continue to deal with these shortages and the ongoing effects of the pandemic, will be profound.”

Dr Craig Johnson, of the Wales Centre for Public Policy said:

“Our analysis finds that most non-UK nationals currently working in NHS Wales would qualify for a Skilled Worker and/or Health and Care Visa under the proposed rules. However, some EU nationals would be ineligible, and it suggests a small but not insignificant impact on future recruitment is likely.

“The implications for social care are more severe. Fewer roles will qualify for either visa, and the greater turnover of staff in the sector presents particular challenges; with likely knock-on impacts for the NHS.

“Many essential social care roles have been excluded from the Health and Care Visa and the Shortage Occupation List because they have been labelled ‘low skilled’. These roles are essential to service provision and should not be forgotten when considering the new rules and their coverage.”

  • Author: Welsh NHS Confederation
  • Date: 28/09/2020