What are the experiences, motivations and plans of Health and Care Visa holders and their dependants?

Dr Kalpa Kharicha is Senior Research Fellow at the NIHR Policy Research Unit in Health and Social Care Workforce in the Policy Institute at King’s College London. She led the Unit’s Visa Study, the report from which was published in October 2023. (679 words)

Internationally recruited care workers made the biggest contribution to reducing vacancies in frontline adult social care in England during 2022-3; 70,000 people came to the UK to work in a direct social care role. During this time the number of domestic recruits to care work fell. Vacancies in social care are currently at 152,000.

The increase in international care workers follows changes to government immigration policy in recent years. In particular, the addition of ‘Senior care workers’ and ‘Care workers’ to the shortage occupation list (on 27 January 2021 and 15 February 2022, respectively) allows people from other countries to apply for these jobs, with a licensed UK employer and if eligible for a Health and Care Visa.

Recent announcements on immigration policy mean that from early 2024 (exact date to be confirmed at time of writing), Health and Care Visa holders arriving in the UK after that time will no longer be able to bring their dependants with them Health and Care Visa holders who are already in the UK can bring dependants whilst on their current visa.

As part of our recent research to understand the impact of the Health and Care visa system on the adult social care workforce in England, we spoke to 29 internationally recruited care workers and dependants, as well as 22 social care providers, 8 brokerage agencies and 15 sector skills experts, who shared their views and experiences with us. Continue reading

The view from here

Karl Womack is a disability activist and poet who lives in a care home. (544 words)

Karl about Karl

My name is Karl Jonathan Womack. I was born in 1966. I was born with acute paralysis, epilepsy and a learning disability. The day I was born I had a testicle removed because it was strangulated and 6 months later I had an abscess. I couldn’t walk until I was 4 years old.

I was in and out of GP surgeries. They told my parents I was lazy and retarded. Through my early childhood I had intense physiotherapy, throughout my life I’ve had psychiatry and psychology. I was bullied from the age of 8 – 40 by able bodied and disabled because I went to mainstream school despite my disabilities. I was transferred to a special school for disabled and was bullied by the disabled for looking able bodied. I have a file full of certificates. And use a pseudonym called Blaze Burnstar.

I’m 56 and from the age of 23 I lived in residential care. Continue reading

Martin Stevens

Our colleague Martin Stevens, who has died aged 57, was Senior Research Fellow here at the NIHR Policy Research Unit in Health and Social Care Workforce. Martin joined our Unit’s predecessor at King’s, the Social Care Workforce Research Unit in 2004, and for 18 years he was a central figure within the team.

Martin’s first research post was at Hampshire Social Services Department, where he undertook work on community care, child protection and learning disability services, and completed his PhD (University of Portsmouth) on family group conferences. His BA had been in philosophy at the University of Southampton, following which he had worked for five years in a residential service for people with learning disabilities. He also gained an MSc in social research.

At King’s, Martin developed his research expertise in adult safeguarding, personalisation and learning disability services – and is widely published in these fields. His interest in learning disabilities services and their workforces led to his convening our popular seminar series on the topic – this has been running since 2014 and will continue, with three more webinars already planned for 2022.

During his research career he chaired the UK Social Services Research Group and led on social care for the Local Area Research and Intelligence Association. And since 2019 he had been advising other researchers, both new and old to research, in the setting up of studies at the NIHR Research Design Service.

He was, until recently, chair of the Health Research Authority Social Care Research Ethics Committee. As colleagues we benefited hugely from his expertise in this area. Whether seeking initial ethical approval for projects or dealing with problems as studies unfolded, Martin was always humane and empathic. One felt his interest in philosophy at these times. He was also a union member and encouraged others to value the union, as part of a wider commitment to social justice.

Latterly, Martin’s research had a focus on mental health, leading two projects on the professionals who work with the Mental Health Act, both commissioned by the Department of Health and Social Care. He remained the chair of the Good Mental Health Co-operative Committee up until his death.

We will all miss Martin greatly as a funny, talented and generous colleague.

Martin Stevens, 18 April 1964 – 21 March 2022

If you wish to share your memories of Martin, please add them below (comments are moderated, so will not publish immediately).

And, on Twitter, see the replies to tweets by: this Research Unit | NIHR School for Social Care Research | Prof Jill Manthorpe. See also: Other Lives (by John Woolham in The Guardian, 21 April 2022).

Remembering Darren O’Shea (1977-2021), ‘Expert by Experience’ member of the HSCWRU Homeless Research Programme

Darren O’Shea in London, February 2019

It is with great sadness that we share the news that Darren O’Shea passed away in hospital in London on 17 January 2021. Darren was a long-standing and much valued member of our Homeless Research Programme here at HSCWRU. He worked on the National Institute for Health Research (NIHR) study about improving hospital discharge arrangements for people who are homeless, sharing his lived experiences and giving presentations at many conferences and events. He was also a member of the Department of Health and Social Care’s Rough Sleeping Advisory Group, and advised the Healthy London Partnership based at City Hall. He was influential in campaigning for ‘step-down’ care so that people who are homeless have somewhere to stay when they leave hospital and it is now government policy that these services are developed across England. We are grateful for all Darren did to improve homeless health services and to contribute to our research at HSCWRU.

Stan Burridge, an Involvement specialist and another member of HSCWRU’s Homeless Research Programme, writes:

‘I was fortunate to work with Darren on many occasions over the past few years, and the value he brought to the work is almost beyond measure. We can forget that researching homelessness and social exclusion issues is dependent on capturing the harsh reality of people’s lives. Darren, who was often floating in and out of his own chaos, was a stark reminder that we were working to make a difference to real people with real lives and that our work goes beyond datasets. Darren had an incredibly valuable skill in that he was able to step out of his own difficult world and focus on the plight of others around him, and this brought a richness to the work we did together. His ability to talk openly, often when the rawness of his own journey was very evident, brought vividness to the research from a rich life, sadly now cut short. Darren’s death leaves a void and although we are saddened we are also enriched by the time he gave us. We will ensure his legacy lives on.’


Darren O’Shea (1977-2021)