The United Kingdom government is considering exempting hundreds of thousands of care workers from upcoming immigration restrictions as part of broader efforts to address strains in the social care sector. Prime Minister Andy Burnham plans to outline his commitment next week to establishing a national care service before the next general election, accelerating reforms initiated under his predecessor, Keir Starmer.

Burnham, who has spoken publicly about his personal experience caring for his father Roy, who has Alzheimer’s disease, is pushing forward Louise Casey’s review of social care, originally slated to conclude in 2028. The review may now be expedited, with an interim report expected this year and a final report potentially published by the end of the year.

One of the key issues under consideration is the potential exemption of existing social care workers from new rules proposed by Home Secretary Shabana Mahmood, which would increase the qualifying period for migrants to obtain indefinite leave to remain (ILR) in the UK. The current plans aim to tighten immigration rules, doubling the time required for settled status, a move critics warn could disproportionately impact the care workforce, which relies heavily on migrant labor.

Andrea Egan, general secretary of Unison, the country’s largest union, emphasized the importance of migrant workers in the sector, stating that vulnerable individuals may suffer if recruitment and retention fail due to the immigration changes. Mahmood has indicated she is open to considering exemptions for migrant care workers, but implementing such carve-outs could reduce the overall impact of her proposed policies.

Burnham’s contemplated approach reportedly involves exempting care workers already residing in the country from the stricter immigration measures, while applying the new rules to incoming workers. These exemptions are unlikely to feature in his forthcoming speech but may be formalized later this year after public consultation and Home Office review.

Alongside immigration considerations, the prime minister is expected to propose short-term measures including increased funding to the £9 billion Better Care Fund. This ringfenced fund supports social care initiatives that alleviate pressure on the National Health Service (NHS), with one possible enhancement being free, short-term care for patients discharged from hospitals to reduce readmissions.

Burnham has also reiterated openness to exploring funding mechanisms for a sustainable care system. Previous proposals, including replacing inheritance tax with a 10% levy on all estates to fund universal care, were withdrawn following criticism and political opposition.

The current social care system in England provides state-funded care only to those with assets below £23,250, forcing individuals with greater means to cover their own costs. Providers have reported increasing financial pressures, partly due to the low value of contracts given by local authorities, which impacts their ability to meet service demands.

Louise Casey’s review has highlighted a “moment of reckoning” for social care in the UK, pointing to a long-standing failure to adequately resource services for a growing frail and disabled population. Casey has criticized the ongoing institutional disputes that hinder timely access to NHS-funded care for patients with dementia and Alzheimer’s, reflecting broader systemic challenges the government aims to address through upcoming reforms.