Immigration analysis: The Health and Care Worker (HCW) visa was introduced in August 2020, to support the recruitment of international health and care professionals into the NHS and adult social care sector. By February 2022 the route was expanded to include care worker and senior care worker roles, ostensibly with a view to fill 165,000 vacancies in a sector that had been ravaged by the joint pressures of Brexit and the coronavirus (COVID-19) pandemic. This analysis looks at what has happened since then, including the various restrictions imposed on the route and its final closure for new applicants, the increase of enforcement actions against sponsors, the more limited worker-facing response, and the uncertain future introduced by the ‘Earned Settlement’ proposals. Written by Dr Dora-Olivia Vicol, CEO at the Work Rights Centre.