3rd November 2026
Britain faces a growing problem in recruiting enough people to look after its elderly, disabled and vulnerable citizens. Care homes, home-care providers and local authorities all need a reliable workforce, yet recruitment and staff retention have become persistent difficulties.
The obvious question is why a country with a substantial working-age population struggles to recruit people into an occupation that is becoming increasingly important as the population ages.
Is the problem really a shortage of people willing to work in care, or have wages and working conditions made the occupation insufficiently attractive?
There is also a wider economic question. Has Britain relied too heavily on overseas recruitment instead of making care work a properly paid and attractive career for people already living here?
Low wages are part of the problem
There is considerable evidence that pay is a major obstacle.
A UK Government survey of adult social care employers in England found that 60.7% identified pay compared with other sectors as one of the main barriers to recruitment and retention. Other concerns included childcare, transport and the time taken to complete recruitment checks.
Research published by the Joseph Rowntree Foundation in February 2026 also highlighted the hidden financial cost of low wages.
Its research estimated that recruiting and training a replacement care worker, including the associated agency costs and lost productivity, could cost providers a median of approximately £7,870.
This is important because paying workers more is often presented as an additional expense, while the costs of failing to retain them receive less attention.
Care work involves considerable responsibility. Workers may be helping people wash, dress, eat and manage everyday activities. Home-care staff can also spend much of their day travelling between clients.
Yet the pay has frequently compared poorly with other occupations offering more predictable hours and less demanding responsibilities.
If someone can earn similar money in retail, hospitality or another occupation without the emotional and physical demands of care work, it is hardly surprising that employers struggle to attract applicants.
Overseas recruitment filled the gap
The UK increasingly turned to overseas workers to help address shortages.
This provided an important source of labour, particularly when domestic recruitment was insufficient. However, it also created questions about the country's longer-term approach to staffing essential services.
Skills for Care reported that international recruitment into adult social care in England reached approximately 105,000 in 2023/24. That figure subsequently fell to around 50,000 in 2024/25.
Analysis published by the King's Fund on 2 November 2026 suggests that overseas recruitment could fall to just 10,000 during 2026/27 if current trends continue.
More concerningly, the number of new British starters is also falling, while departures are exceeding new domestic entrants.
The result is that Britain cannot simply assume that overseas recruitment will continue to fill the gaps.
The additional cost of family migration
Another aspect deserves examination: the wider implications when overseas workers are permitted to bring family members.
Under the previous immigration arrangements, partners and children could accompany eligible care workers. Government figures published in March 2024 indicated that approximately 120,000 dependants had accompanied 100,000 care workers on the relevant visa route during the preceding year.
This potentially increased demand for schools, healthcare, housing, transport and other public services.
Children attending state schools require funding. Families may also use NHS services and other facilities provided by local authorities.
However, it is important to recognise that this is not a straightforward calculation of cost against benefit. Family members may work, pay taxes, rent or buy homes and contribute to their communities.
Furthermore, care workers and their dependants have generally been subject to immigration conditions restricting access to most public funds, including Universal Credit and Housing Benefit.
The Government subsequently changed the rules. From March 2024, newly recruited care workers were generally prevented from bringing dependants. In July 2025, the overseas recruitment route for new care workers was closed.
There are transitional arrangements for certain people already in Britain, but the previous system has effectively ended for new overseas applicants.
Nevertheless, the experience raises a legitimate question about whether immigration policy has always adequately considered the wider demands placed on public services.
Would higher wages attract more British workers?
This is perhaps the most important question.
Instead of continually looking overseas to fill vacancies, should governments invest more in making care work attractive to people already living in Britain?
That would require more than simply increasing the National Minimum Wage.
A serious recruitment strategy might include:
Better basic wages reflecting the responsibility involved.
Guaranteed minimum working hours.
Payment for travelling time between home-care appointments.
Proper mileage allowances, particularly in rural communities.
Better training and opportunities for career progression.
More predictable shifts and improved working conditions.
Scotland has already introduced a minimum hourly rate of £13.45 from April 2026 for eligible adult social care workers delivering direct care in commissioned services in the independent and third sectors.
That is a step towards improving pay, but questions remain about whether it is sufficiently competitive and whether funding arrangements allow providers to offer better conditions more widely.
Who pays for better care?
There is an obvious difficulty. Many care providers depend on contracts with local authorities, which determine how much they receive for delivering services.
If councils pay insufficient rates, providers cannot simply increase wages without threatening their financial position.
This means governments must consider the full cost of social care rather than expecting providers to solve recruitment problems themselves.
There may also be savings from better wages. Lower staff turnover means fewer recruitment and training costs, less reliance on expensive agency workers and greater continuity for people receiving care.
The Joseph Rowntree Foundation's research suggests that the financial losses associated with repeated recruitment and staff shortages are substantial.
It is therefore possible that investing in better wages could reduce some of the longer-term costs of running the care system.
A problem that will not disappear
Britain's ageing population means demand for care is unlikely to diminish. More people will require assistance, while the working-age population will have to support an increasing number of older citizens.
This is not simply an immigration issue, nor is it just a question of wages. It involves workforce planning, public finances, local authority funding, housing and the way society values care.
But governments should be prepared to answer a straightforward question.
If Britain needs more care workers, why has it not done more to make these jobs attractive to British workers?
Overseas recruitment helped fill an immediate gap, but it was never a substitute for developing a sustainable domestic workforce.
Paying care workers properly should not be viewed simply as another demand on public spending. It may be an investment that reduces recruitment costs, improves care and prevents more expensive problems elsewhere in the health and social care system.
There is also a wider lesson about immigration. Governments should consider not only the immediate benefit of filling a vacancy but also the longer-term implications for housing, education, healthcare and local services.
The real test of a successful care policy should be whether Britain can provide the people it needs to look after its ageing population without continually finding itself short of staff.
That requires a workforce that is properly valued, properly paid and given a reason to stay.
2 Novemmber 2026
The King's Fund's analysis of the growing social care workforce challenge