New research from the Homecare Association shows nearly one in three homecare providers cannot meet current demand despite improvements in staff retention, whilst others cannot give their careworkers enough hours of work.
The 2025 Workforce Survey, covering 450 homecare providers, over 186,000 people and 135,000 careworkers, exposes the impact of government decisions on immigration, commissioning and NHS funding.
Immigration clampdown leaves providers without options
The Government closed overseas recruitment in July 2025 despite having no credible plan to fill vacancies. The Association’s research shows:
- A majority of providers (59%) employed sponsored workers in 2025, and in almost one in ten organisations they made up three-quarters or more of the workforce.
- Nearly nine in ten providers said overseas careworkers contacted them this year because their primary sponsor failed to give them enough hours. This is a direct consequence of poor commissioning practices by local authorities and the NHS. This leads to fragmentation of the market and not enough hours per provider, leaving workers underemployed and families without vital support.
- Proposals to extend settlement from five to ten years and political rhetoric on deportation of people living in the UK from overseas has further damaged morale, with 72% of providers reporting concern among overseas staff, with one in five reporting workers are now considering leaving the UK.
NHS cost-shunting without payment
At the same time, the Government announced plans to increase duties on careworkers to deliver NHS healthcare activities. The Association’s research shows:
- Seven in ten providers said their careworkers deliver NHS tasks such as catheter care, wound care and diabetes management, yet only 26% receive extra funding. Commissioners continue to expect homecare providers to absorb NHS responsibilities without training or payment.
- 65% of providers said NHS staff do not provide appropriate ongoing clinical support, and 80% said it was difficult to secure NHS sign-off for competencies.
- Families face more risk, and careworkers shoulder more responsibility without reward.
Dr Jane Townson OBE, Chief Executive of the Homecare Association, said:
“Families across Britain are waiting for care that simply isn’t available in some places. Government underfunding and penny-pinching contracts have already driven carers away. Now they’ve pulled the plug on overseas recruitment too. It’s reckless, and people will suffer. The result is predictable: people go without support, deteriorate and end up in hospital, and then hospitals struggle to discharge them. Providers face impossible choices.”
She added:
“There is no other business in the economy where government would expect vital, skilled services to be delivered for free. It is unacceptable and unsustainable.”
The Association warns that poor commissioning practices remain the root cause of workforce instability. Local authorities and NHS bodies continue to purchase care by the minute, at the lowest possible price, and from too many providers, driving insecure contracts, low pay and high turnover. These systemic failings make the sector unattractive to domestic workers and leave it exposed to immigration decisions.
Dr Townson said:
“The Government says it wants to improve pay and conditions through a Fair Pay Agreement and new employment rights. It’s no good promising careworkers a better deal while starving the system of cash. Without a statutory National Contract for Care to end underfunding and enforce fair commissioning, these policies are undeliverable. We cannot legislate our way to fair pay if the money and contracts don’t stack up.”
The Association is calling for urgent action:
- Ring-fence social care budgets and invest at least £1.6bn to address historic underfunding in homecare.
- Legislate for a National Contract for Care, with sustainable minimum fee rates.
- Embed homecare providers as core partners in integrated Neighbourhood Teams so that careworkers are recognised as part of the community health and care workforce, not just “add-ons” contracted at arm’s length.
- Develop a statutory workforce plan to ensure enough careworkers for an ageing population.
- Expand Regional Partnerships to cover sponsored workers with insufficient hours and other employment issues, not just those displaced by licence revocations.
Without these reforms, the Homecare Association warns, millions risk going without vital care - not because providers don’t want to deliver it, but because government policy has made it impossible.
ENDS
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