from the Care Association Alliance
Migratory Advisory Committee

CAA response to the MAC call for evidence

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  1. The Care Association Alliance is a not for profit entity that promotes and represents local care associations across the country. Our aim is to provide resources and information to care associations to enable them to become more effective and to represent their views at a national level. We have therefore prepared the following response to the Migration Advisory Committee’s call for evidence.
  2. When looking at migration trends we have split the social care workforce into four primary jobs, that have varying dependencies on migration and differing levels of skill requirement. These four key roles are; care assistants, senior carers, nurses and registered managers. These roles comprise the majority of the workforce for adult social care. Each answer will contain data from each of these different roles to highlight how leaving the EU could impact the different jobs within social care. Below is a brief description of the roles and their importance. The majority of the data presented is sourced from the Skills for Care NMDS database and resources on their website will contain a full description of all of the roles used in this analysis, however a brief description is contained below.
  3. Care Assistants – This role is the most common within the sector and these individuals provide the personal care services that we offer. Care Assistants require no qualifications for entry to the role, although they are often offered an NVQ/QCF level 2 qualification funded by the UK government when in post.
  4. Senior Care Assistants – This role is the second most numerous within the adult social care sector and is a group of staff that take on additional responsibilities above that of care assistant. These can range from carrying out difficult tasks, such as running a medication round, through to managing a team of staff. This role requires an NVQ/QCF level 3 qualification in the majority of organisations, although in some cases this is carried out once the person is in post. This group of staff were previously on the Shortage Occupation list before their removal in 2011. Prior to 2011 it was extremely common to have individuals from outside the EEA come to work in the UK as a senior carer that were a nurse in their home country. They would then work on improving their English until they were competent enough to pass the IELTs requirements for the NMC. Removal of this role from the shortage occupation list may have contributed to the dramatic drop in the number of nurses entering the UK from over-seas.
  5. Nurses – These individuals play a key role within the nursing home segment of Adult Social Care, where registered nurses are required to be on shift to deal with the higher level of healthcare tasks covered within this setting. There is a requirement for a degree level nursing qualification and formal registration to the Nursing and Midwifery Council, meaning that the barriers to entry for this role are extremely high. This role is currently on the Shortage Occupation list. Being on the Shortage occupation list was an interim measure that was introduced by Theresa May in response to the overwhelming evidence of a severe shortage of nurses in the UK. Being on the Shortage occupation list confers a number of benefits when recruiting staff members, namely:
    • Being on the shortage occupation list removes nurses from the wage lottery currently used to allocate work permits. [There are a limited number of work permits allocated each month and these are given to the highest earners first. Ie. if there are 1,000 allocations in April and 1,000 applicants are paid more than your application it will be refused and you will have to re-apply]
    • The Shortage occupation list should remove the need to carry out a labour market test [this is the requirement to advertise a job for 28 days in 2 recognised formats before being able to offer the job to a foreign applicant]. Although read below regarding this.
    • Most importantly however is that being on the shortage occupation list means that you do not need to earn over £35,000 per year to apply to stay in the country indefinitely. [Under current visa rules any individual that does not earn more than £35,000 per annum must leave the country at the end of a maximum of 5 years in the UK]. This was particularly important in nursing because £35,000 is the basic pay level of a band 8 nurse. Meaning that anyone paid below this and recruited after 2011 would have to leave the country after 5 years. Without the option to stay in the country indefinitely this was the single biggest deterrent for any foreign nurses wanting to come to the UK over the past 6 years.
  6. Since Theresa May insisted that the home office included nurses on the Shortage Occupation List they have removed many of the benefits of being on the shortage occupation list for this role in a rules change in April 2017[i], namely they have re-introduced the requirement to carry out a Labour Market Test before employing from overseas. This is not to say that being on the list is un-important as it still means that nurses are able to attain residency within the UK without having to earn over £35,000 per year.
  7. Registered Managers – These individuals are responsible for managing care establishments across the UK and in many cases are more legally accountable than business owners for what happens within a care setting. These individuals must be registered with the Care Quality Commission and are legally responsible for what happens within any care provider. Individuals within this role require an NVQ/QCF level 5 to carry out the role, and will usually require many years of experience within the sector.
  8. The majority of the data presented here is taken from the National Minimum Data-Set. This data set is held by Skills for Care and data is provided by social care providers across the sector. This includes care homes, domiciliary care providers and learning disability providers.

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