NURSES are being “exploited” in social care via practices that pose a “serious risk” to the sector, leading medics have warned.

The Royal College of Nursing (RCN) said some migrant workers coming to England to work are being underpaid, having their visa position used as leverage to demand “huge” repayments and having their pay and conditions altered.

The college said it has seen a surge in people seeking support “due to exploitative practices” including excessive working hours, high exit fees, poor and overcrowded accommodation and illegal work-finding charges.

A report from the college, released today, warns “the inhumane treatment of staff who have come to support Britain’s social care system poses a serious risk to the sector’s stability.

It comes after Prime Minister Andy Burnham pledged to “put everything I’ve got” into fixing adult social care.

The new premier said successive governments have failed to tackle reform of social care in England, seeing it as “too risky, too difficult and too complicated” as he called for cross-party consensus to fix the problem.

The report, which examines the experiences of 383 staff who have sought support from the RCN between 2023 and 2025, details cases of employers using repayment clauses to recover costs from staff wishing to leave employment before the end of their contract, with one reportedly demanding £25,000.

Others reported being paid less than their agreed contractual hourly wage, while some said they were being forced to work additional hours.

The RCN pointed out that adult social care is “deeply reliant” on migrant health and care staff with 30 per cent of all jobs in the sector held by a non-British national.

Chief executive and general secretary Professor Nicola Ranger said: “Just a week after the Prime Minister laid out his plans for social care in England, this report exposes the scale of grotesque exploitation taking place in the sector.

“A National Care Service meeting the needs of an ageing population, with complex conditions, will need to be registered nurse-led. 

“We’re the ones with the skill and expertise to make it work, but that cannot happen while so many of our migrant colleagues are being exploited.”

The Department of Health and Social Care was approached for comment.