Migration Advisory Committee Call for evidence - impact of ending freedom of movement on the adult social care sector: Scottish Government response

Section 2: Current Routes into Social Care

Points based immigration system

The UK Government's 'points-based' immigration system launched on 1 January 2021. However, the changes are, in the main, adjustments to the previous main route for skilled workers sponsored by an employer, the 'Tier 2' visa, to introduce a small points-based element. With the ending of free movement EU/EEA citizens entering the social care system in Scotland now need to comply with the immigration rules.

Like the previous Tier 2 visa, the new points-based 'Skilled Worker' route requires an offer of employment by a sponsoring employer licensed by the Home Office; the job being at an appropriate skill level (RQF 3 and above – the equivalent of A-levels or highers); and the applicant speaking English to a minimum standard.

Although these are described as attracting points, they are not 'tradeable' in the points-based system (a shortfall in one of these characteristics cannot be 'made up' by gaining more points in other characteristics) and so are more properly described as mandatory criteria.

The points available in the new route are described in the table below. Applicants must reach 70 points overall, with 50 of those points being attained through the three mandatory requirements.

Salary is a tradeable characteristic in this route. The general salary threshold is set at £25,600 as recommended by the MAC, but lower-earning roles can still be eligible. Although salaries between £20,480 and £23,039 do not attract any points, this can be made up by either the role being on the SoL (or the additional lists for Scotland, Wales and Northern Ireland, where appropriate); or by the applicant having a PhD in a STEM subject relevant to the role, both of which attract 20 points. Further to the MAC's recommended in their 2020 review, senior social workers were added to the SoL, in March 2021. Table 1 illustrates the criteria required for the skilled worker route.

Health and Care Visa

On 4 August 2020, applications opened for a new Health and Social Care Visa to create a new fast-track visa route for eligible health and care professionals. The route is an expansion of the Tier 2 (Skilled Worker) route and will have a reduced visa application fee, including exemption from the Immigration Health Surcharge, and individuals can expect a decision within three weeks (or pay for a priority service for 2 – 5 working days).

Individuals must have a job offer from the NHS, an organisation providing medical services to the NHS or an organisation providing adult social care. The job offer must be from a licensed sponsor who must assign a certificate of sponsorship to prove the job is eligible for the visa.

Individuals must also be a qualified doctor, nurse, health professional or adult social care professional: only the following list of roles (and associated Standard Occupational Classification codes) are eligible:

1181: health services and public health managers and directors
1242: residential, day and domiciliary care managers and proprietors
2112: biological scientists and biochemists
2113: physical scientists
2211: medical practitioners
2212: psychologists
2213: pharmacists
2214: ophthalmic opticians
2215: dental practitioners
2217: medical radiographers
2218: podiatrists
2219: health professionals that are 'not elsewhere classified', such as audiologists and occupational health advisers
2221: physiotherapists
2222: occupational therapists
2223: speech and language therapists
2229: therapy professionals that are 'not elsewhere classified', such as osteopaths and psychotherapists
2231: nurses
2232: midwives
2442: social workers
3111: laboratory technicians
3213: paramedics
3216: dispensing opticians
3217: pharmaceutical technicians
3218: medical and dental technicians
3219: health associate professionals not elsewhere classified
6141: nursing auxiliaries and assistants
6143: dental nurses
6146: senior care workers

Notably this visa excludes many social care roles which do not meet the qualification thresholds. Individuals must also meet all other relevant criteria for a Tier 2 (General) migrant including being able to support themselves; sufficient knowledge of the English language; meet the salary threshold; and have a valid Certificate of Sponsorship.

Whilst the addition of senior care workers to the SoL is welcome, it disregards the majority of Social Care roles which fall short of the requirement for RQF 3. Similarly, the introduction of the 'Health and Care visa' continues to disregard the huge contribution of social care workers. 53% of roles in Scotland earn less than £25,000, and up to 90% in the care sector, according to analysis from our Expert Advisory Group on Migration^[6].

Fees

It currently costs the individual £610 to apply for a three-year visa or £1220 for over three years plus and annual £624 NHS surcharge. Employers pay a licence fee of £1,476 and annual immigration surcharge of £1,000

Whilst the health and care visa route is exempt from the Immigration Health Surcharge and has reduced associated fees, these costs are still notable. A visa for up to 3 years costs £232 and more than 3 years £464 (for a maximum stay of 5 years 14 days). Dependents will also pay this same amount. Employers must still pay the licence fee and immigration surcharge.

This visa does not exempt everyone in the sector who has paid the IHS – notably it excludes the thousands of overseas staff working as direct care workers in social care, or as cleaners, porters or other healthcare support staff throughout the NHS (and are key workers in our response to Covid-19). All employees in the sector who have paid the charge on or after the 31^st March 2020 will however be eligible for reimbursement(launched from 1 October 2020).