- The Royal College of Nursing warns that visa sponsorship enables grotesque exploitation of international care staff.
- Repayment clauses are being weaponized, with some workers facing illegal demands up to £25,000.
- The RCN advocates for universal 180-day grace periods and moving sponsorship to umbrella organizations.
The Royal College of Nursing warned that the visa sponsorship system is leaving migrant nursing and care staff open to “grotesque” exploitation, and it called for immigration-rule changes that would let workers move between employers without threats of deportation. The report was published on 7 August 2026.
Its findings came from 383 cases. They covered health and care staff in adult social care who sought RCN support for exploitation and extortion between 2023 and 2025, with wider coverage describing almost 400 cases. They asked for help.
Professor Nicola Ranger, the college’s general secretary and chief executive, said the sponsorship setup hands too much control to bosses. She was direct.
“unscrupulous employers” use withdrawal of sponsorship as leverage to extort money, alter contracts, reduce pay, or bully and harass staff.
The report says that control creates a dangerous power imbalance. Employers can use the sponsorship threat to pressure workers over money, contracts, pay, and conduct. The link is tight.
Repayment clauses were part of that pressure. More than half of the cases used them to recover costs from workers who wanted to leave before contract end. Many of those demands went beyond the NHS Employers recommended maximum of £3,000. One cited demand reached £25,000. Wages also slipped. One in five cases raised pay issues, especially workers being paid less than their agreed hourly wage.
The abuse was not only financial. More than half of respondents reported substandard workplace practices, and a third of those involved severe bullying and harassment, including racist discrimination. Racism appeared too.
The proposed fixes are more structural than cosmetic.
| Measure | What the report found | What the RCN wants |
|---|---|---|
| Visa administration | Tied so tightly to a single employer | Handed to an umbrella organisation or industry body |
| Repayment demands | Many above £3,000; one reached £25,000 | Curb the use of repayment demands against workers who want to leave |
| Job-change window | 60 days | Extend it to 180 days to reduce deportation risk when workers change jobs |
Visas should not depend on one employer
The RCN says visas should be administered by an umbrella organisation or industry body instead of being anchored to a single employer. It also wants the new Fair Work Agency to monitor employers, investigate unethical practices, and enforce standards. It would add oversight.
The warning lands after UK Government changes in July 2025 closed off routes for new overseas care workers entering social care. Existing visa holders remain covered by transitional arrangements expected to continue until around 2028. The RCN’s Northern Ireland director, Professor Rita Devlin, also called for policy changes to better protect international staff. Around 2028 is the end point.
