In a year marked by sweeping changes to the United Kingdom’s immigration rules and mounting scrutiny of social care delivery, the impact has been felt acutely across the country—with Lancashire standing as a telling example of both the challenges and the resilience within the system. As policymakers tighten visa requirements and local authorities scramble to meet regulatory expectations, the fate of vulnerable residents and the workforce that supports them hangs in the balance.
According to The Economic Times, July 2025 saw a dramatic drop in UK Health and Care Worker visa applications, a shift attributed to more rigorous employer checks and new restrictions on overseas recruitment. The numbers paint a stark picture: main applicant submissions plummeted from 18,300 in August 2023 to just 1,300 in July 2025. Dependants followed a similar trend, with applications falling from a peak of 23,300 in August 2023 to 4,900 in July 2025. The root cause? A raft of new immigration rules introduced in July 2025, raising the bar for both skill and salary requirements.
For Skilled Worker visas, the minimum skill threshold was bumped up to RQF level 6—essentially, graduate-level roles—while the minimum annual salary leapt from £38,700 to £41,700. The Health and Care Worker visa, though, kept its £25,000 salary floor. Most significantly, the door was slammed shut on new overseas applicants for care jobs, though those already in the UK can switch visa categories until July 2028. The Home Office’s move to ramp up compliance checks in March 2024, coupled with targeted action against non-compliant health and social care employers, triggered an early decline in applications that only accelerated with the spring’s policy measures.
Elsewhere in the visa landscape, the Youth Mobility Scheme saw a 10% year-on-year dip, with 22,200 applications in the year ending July 2025. Study visas, on the other hand, held steady—sponsored applications from main applicants totaled 428,900, down just 3% from the previous year. Family visa applications experienced a rollercoaster: they surged to 12,700 in April 2024 after income requirements changed, dropped sharply to 5,100 in June, then rebounded to 8,100 by July 2025.
While these national figures illustrate the broad consequences of policy shifts, the ground-level realities are perhaps best captured in Lancashire’s recent experience. The Care Quality Commission (CQC) inspected Lancashire County Council’s adult social care services between October 2024 and February 2025, culminating in an on-site visit and a sobering assessment. As reported by Lancashire Post, the council received a 50 percent overall score and a ‘requires improvement’ rating. The inspection found shortfalls across all nine measured categories, from assessing people’s needs to integration and continuity of care.
The numbers are daunting. In the 2023/24 period, Lancashire provided long-term support to nearly 23,000 people and short-term help to over 5,500, at a cost of £496 million—nearly half the council’s net annual budget. At the time of the inspection, almost 2,100 people were waiting for an initial assessment, with a median wait time of 27 days (down from 34 days in October 2024), and the longest wait stretching to 226 days. More than 3,800 residents were waiting for their annual review, with a median wait of 441 days and a jaw-dropping maximum of 2,760 days—over seven years. The backlog for occupational therapy assessments was similarly troubling, with nearly 1,100 people waiting a median of 40 days.
Despite these challenges, CQC inspectors acknowledged the commitment and compassion of Lancashire’s staff. “While people using services spoke positively with us about committed and compassionate staff, we had concerns about how quickly the authority was able to assess their needs. We saw staff capacity issues making these problems worse,” said James Bullion, the CQC’s chief inspector of adult social care and integrated care. He added, “Lancashire County Council’s got strong foundations to build on. While the waiting times and capacity issues need urgent attention, their committed staff provide a solid platform for addressing these challenges – and there was a clear drive and desire to make improvements.”
The report also highlighted the toll on staff morale. Many practitioners felt overwhelmed by high workloads and constant system changes. Yet, as inspectors noted, “Many had worked at the local authority for a long time and felt a strong sense of pride, loyalty and determination to keep going and deliver services for people they support.” Staff supported each other, even as major system changes and leadership turnover eroded trust and confidence.
On the positive side, once assessments were completed, they were found to be thorough and holistic. The council’s approach to safeguarding was praised as everyone’s responsibility, and the speed of providing equipment—over 10,000 pieces issued monthly, with no wait for low-level kit—was singled out as exemplary. Most people and carers interviewed felt listened to and supported, though the process of accessing practitioners and navigating the council’s website remained difficult for many.
The CQC also recognized improvements already underway. Since the inspection, Lancashire County Council has recruited over 50 social workers, 14 occupational therapists, and 18 social care support officers. Between April and July 2025, the number of older people waiting for care assessments was cut from about 1,850 to 1,075, slashing the number waiting over 28 days by 48%. Care assessment reviews increased by 8% compared to the previous year, and the backlog for occupational therapy assessment was halved.
Helen Coombes, executive director of adult services, responded to the findings with measured optimism. “While the result…is disappointing, we fully accept the inspectors’ findings,” she said. “Significant progress to solve many of the issues identified in this report has been made over the last six months and we will continue to drive forward these improvements. Staff are driving our change – and we are making sure that they are supported to deliver improvement.”
Political leaders were quick to weigh in. Reform UK’s Stephen Atkinson, who took over leadership after the inspection period, stressed that the CQC’s findings related to the previous Conservative administration but promised continued focus on improvement. “We accept the inspectors’ findings and want to assure residents that significant work is continuing to ensure that the people we support every day receive the best service possible,” he said. Former Conservative cabinet member Aidy Riggott echoed the sentiment, acknowledging disappointment but emphasizing the dedication of staff and the council’s determination to build on highlighted areas of good practice.
The broader context is impossible to ignore. The end of overseas recruitment for care workers, stricter visa rules, and a sector already grappling with staff shortages and rising demand have put immense strain on local services. As one former cabinet member candidly remarked, occupational therapists were “rarer than rocking horse dung”—a quip that underscores the recruitment crisis facing the sector nationwide.
Yet, as Lancashire’s experience shows, the story is not just one of struggle but of adaptation and incremental progress. With new staff, a renewed focus on staff wellbeing, and ongoing process improvements, the county is striving to turn a difficult chapter into a foundation for better care. For those waiting for help—and for the professionals determined to provide it—the hope is that these efforts will soon translate into tangible, lasting change.
