International recruitment continues to play a significant role in helping to fill vacancies in adult social care in England, which remain high. The International Recruitment Fund (IRF) 2023-24 was introduced to address barriers to international recruitment in adult social care and promote ethical recruitment and employment practices at a local level by the distribution of £15million to 15 regional and sub-regional partnerships across England.

The IRF 2023-24 coincided with a time of sharp increase in Health and Care visas granted and care provider sponsor licences being revoked by UK Visas and Immigration, the latter resulting in care providers being closed down and internationally recruited workers being displaced.

In our new report, lead-authored by Kalpa Kharicha, we present findings from a process evaluation of the introduction and use of the IRF 2023-24 across England, drawing on interviews with 70 stakeholders (partnerships, care providers and internationally recruited care workers) and analysis of Fund application and monitoring documents. This report is Phase 2 of an on-going programme of work on international recruitment in adult social care.

Key findings

Dedicated funding enabled essential capacity, development of networks and knowledge of international recruitment, particularly in regions and sub-regions with less experience and fewer internationally recruited care workers. The Fund also allowed partnerships to respond to national events related to license revocations, displaced workers and cases of exploitation.

Partnerships convened in different arrangements for the Fund based on existing, modified or new organisational structures. Partnerships used IRF to implement initiatives in four key areas: ethical recruitment and retention, shared recruitment and training activities, onboarding / settlement support and pastoral support / training for international workers. Two overarching approaches were used: i) infrastructure for additional staff, commissioned services and resource development, and ii) grants, primarily for care providers, and for international recruits in a few cases. Grant eligibility criteria and value varied across partnerships. Over time and in response to national circumstances, IRF activities shifted from recruitment to retention within the ASC sector as a whole.

Successful implementation of the IRF required time and infrastructure investment. The time needed to establish staffing, engage stakeholders, and commission services was significant and essential. Additionally, most partnerships needed to establish bespoke governance arrangements, such as legally binding agreements or Memoranda of Understanding (MoU), to disperse the funding, which was a barrier to progress for most. A few partnerships were able to proceed more quickly due to existing governance or trusted working agreements with ADASS and care provider representatives.

National guidance and coordination were critical to accelerating partnership working and avoiding duplication. The absence of national guidance on best practice for ethical international recruitment at the outset of the funding period meant that partnerships had to create their own resources, leading to duplication of effort and delays, particularly for partnerships new to international recruitment. Partnerships felt future guidance should be centrally produced.

Access to national and regional data on care provider sponsors and internationally recruited care workers was essential for delivering the IRF’s objectives. Partnerships were frustrated by the lack of accessible and co-ordinated national and regional data on international recruitment (sponsor licenses, Certificates of Sponsorship, and internationally recruited care workers), care provider locations, and up-to-date information on care provider quality. This lack of information hindered their ability to target IRF initiatives, evaluate impact and respond quickly to crises. Partnerships which carried out pre-planned, independent evaluations were better placed to assess impact.

Engaging with ASC market requires working with sector representatives with established networks. Partnerships highlighted the challenge of engaging private care providers (the majority of providers), particularly in local authority led partnerships via their commissioning teams. Working with care alliances / umbrella bodies representing the care workforce, with established communication networks and trust with members, facilitated reach with the ASC market and implementation of Fund activities.

Support from DHSC and ADASS was crucial, but partnerships called for sustainable, long-term funding from the outset. Partnerships valued the support from the Department of Health and Social Care (DHSC) and national and regional members of Association of Directors of Adult Social Services (ADASS) to navigate complex international recruitment processes, managing the IRF and to respond to changing national events. Partnership plans were able to evolve because of features of the IRF grant and monitoring processes with DHSC which promoted a ‘test and learn’ approach and enabled partnerships to be responsive to changing circumstances. DHSC-hosted webinars were helpful, but partnerships reported a missed opportunity to fully share and learn from IRF implementation, due to limited coordinated learning beyond these webinars, and partnerships lacked time to build these networks independently.

Future evaluations need to focus more on capturing the views and experiences of care providers and internationally recruited care workers. There was variable awareness of the IRF within the stakeholder groups involved in this evaluation. Most care providers used grants to reimburse immigration and recruitment costs rather than fund new activities, which limited impact of the Fund. Internationally recruited care workers were generally unaware of the IRF, their suggestions for funding allocation mirrored partnership proposals with a focus on accommodation, travel, immigration, and pastoral support.

This publication (Phase 2 report, January 2025)

Kharicha, K., Kessler, I., Steils, N., Samsi, K., & Brown, J. (2025) Evaluation of the International Recruitment Fund for adult social care for 2023-24, London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King's College London. https://doi.org/10.18742/pub01-202

The Visa Study (Phase 1 report, October 2023)

Kharicha, K., Manthorpe, J., Kessler, I., & Moriarty, J. (2023) Understanding the impact of changes to the UK Health and Care Visa System on the adult social care workforce in England, Phase 1: The Visa Study. London: NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King's College London. https://doi.org/10.18742/pub01-145

King's project pages

International Recruitment Fund 2023-24 (Phase 2) | The Visa Study (Phase 1)

Acknowledgement and disclaimer

This research is funded by the National Institute for Health and Care Research (NIHR) Policy Research Programme, through the NIHR Policy Research Unit in Health and Social Care Workforce, PR-PRU-1217-21002. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

Margaret Butterworth Care Home Forum February 2025

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Dr Olivia Luijnenburg

Dr Kritika Samsi

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