UK migration policy and the Welsh NHS and social care workforce

25 / 09 / 2020

This report analyses the likely impacts of the proposed new immigration rules on the Welsh NHS and social care workforce. The UK Government has proposed a new, points-based immigration system to come into effect once the European Union (EU) Transition Period ends on the 31 December 2020. The main effect of the new system will be to create equal status for EU and non-EU immigrants, and to end the free movement of labour to and from the EU.

To acquire a Skilled Worker visa the new rules require all non-UK migrants to have an appropriately skilled job, usually paying at least £25,600 a year. A new Health and Care Visa (HCV) has been proposed, which means that for certain occupations the salary threshold will be set at the appropriate NHS pay scale – in other words, for such roles the NHS can hire non-UK workers without meeting the general salary threshold.

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 the HCV or Skilled Worker 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 HCV 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.

The Welsh NHS appears well placed to support future migrant workers through the new system, with good relations and shared views across NHS Wales organisations in terms of support for migrant workers and seamless systems. This system has coped well during the implementation of the EU Settled Status Scheme and it is crucial that it copes well during the EU transition.

To facilitate future recruitment, the priority should be to expand eligibility of the HCV to include occupations that are of importance within the social care sector; or failing that, to broaden Shortage Occupational Lists

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