Research and analysis

Estimated lifetime net fiscal costs for care workers and their adult dependants

Published 5 March 2026

This note produces an estimate of the lifetime net fiscal costs of care workers and their adult dependants who are expected to settle between 2026 and 2030 using a combination of Home Office published statistics, the published Home Office settlement forecast and the published Migration Advisory Committee estimates on the lifetime fiscal cost of care workers and adult dependants. 

1. Background 

Published Home Office visa data^{[footnote 1]} suggests that between 2022 and 2024, 616,266 visas were issued on the Health and Care route. Of this, 249,594 were issued to main applicants and 366,672 were issued to dependants.  

Published Home Office visa data^{[footnote 2]} also suggests that over the same period, of the visas issued on the Health and Care route, 154,342 visas were issued for people working in “Caring Personal Services” (SOC 613).  

In “A Fairer Pathway to Settlement: statement and accompanying consultation on earned settlement”^{[footnote 3]}, the Home Office published a forecast that between 1.3 million and 2.2 million people will settle in the UK between 2026 and 2030 (central estimate 1.6 million). 462,000 people were estimated to have originally come on the Health and Care route, 189,000 as main applicants and 274,000 as dependants. 

Internal Home Office data consistent with the published statistics above suggests that of the visas issued to dependants on the Health and Care route between 2022 and 2024, 47% were issued to adults aged 18 and above. 

Finally, the Migration Advisory Committee (MAC) published “The Fiscal Impact of Immigration”^{[footnote 4]} which uses a dynamic model to estimate the fiscal impact of migration on government finances. In this report, they published estimates for the 2022 to 2023 cohort of inflows that showed: 

• for care workers, the net lifetime contribution is estimated to be -£36,000 
• for adult dependants on the Health and Care route, the net lifetime contribution is estimated to be -£67,000

2. Methodology 

2.1 Considerations 

In this methodology note, the estimates produced for the fiscal lifetime cost of care workers and adult dependants for the 2022 to 2023 cohort are applied to the Home Office settlement forecasts between 2026 and 2030 to produce an estimate of the lifetime fiscal cost of the cohort expected to settle.  

2.2 Volume calculations 

In order to produce this estimate, a refined breakdown of the published Home Office settlement forecasts is required. Specifically, of the 462,000 people who originally came on the Health and Care route that are expected to settle between 2026 and 2030, an estimate of how many main applicants came to work as a care worker, and how many of the dependants are adults. 

The 154,342 visas issued for people working in “Caring Personal Services” represented approximately 62% of all visas issued to main applicants on the Health and Care route.  

As no data is available to match dependants to individual occupations, it is assumed that the same 62% of dependants accompanied those working in “Caring Personal Services”. While this is uncertain, it is possible this is an underestimate. Using published Home Office visa data^{[footnote 5]}, the ratio of main applicants to dependants in 2021 before care workers and home carers were eligible for the Health and Care visa was 1:1. By 2023 this ratio had increased to 1:1.4 suggesting care workers could be bringing more dependants than other occupations on the route.   

In the background section above, 47% of visas issued to dependants were to adults aged 18 and over.  

Applying these proportions to the Home Office settlement forecasts produces: 

Care worker main applicants expected to settle between 2026 and 2030: 

189,000 * 62% = 117,000

Adult dependants of care workers expected to settle between 2026 and 2030: 

274,000 * 62% * 47% = 79,000 

2.3 Fiscal impact calculations 

These volume estimates are then multiplied by the relevant lifetime fiscal estimates from the MAC report set out in the background section above.  

While these estimates are for 2022 to 2023 cohort they represent the Home Office’s best estimate of the lifetime fiscal impact of the relevant cohorts and it is assumed that these estimates apply to the entire cohort over the period. 

Care worker main applicants expected to settle between 2026 and 2030: 

117,000 * -£36,000 = £4.2 billion net cost 

Adult dependants of care workers expected to settle between 2026 and 2030: 

79,000 * -£67,000 = £5.3 billion net cost 

2.4 Combined impact 

£4.2 billion net cost + £ 5.3 billion net cost = £9.5 billion net cost 

3. Conclusions  

Based on the calculations above, the net lifetime cost of care workers and their adult dependants expected to settle between 2026 and 2030 is estimated at £9.5 billion, or £10 billion to the nearest billion.

1. Entry clearance visa applications and outcomes detailed datasets. ↩

2. Sponsored work entry clearance visas by occupation and industry (SOC 2020). ↩

3. A Fairer Pathway to Settlement: statement and accompanying consultation on earned settlement (accessible). ↩

4. The Fiscal Impact of Immigration: Static and Dynamic Estimates for the UK. ↩

5. Entry clearance visa applications and outcomes detailed datasets. ↩