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Mandeep Khroud, head of immigration at the law firm Irwin Mitchell, explains that understanding Right to Work checks and how compliance is documented will be essential.
On 1 October, the Government introduced one of the biggest changes to illegal working compliance since Right to Work checks were first introduced, representing a fundamental shift in how compliance is assessed.
The reforms drastically expand immigration compliance beyond traditional employees, apprentices, and specific worker contracts. For the healthcare industry, which relies heavily on subcontractors, labour supply chains and flexible workforce arrangements, the changes are set to have a significant impact.
Right to Work compliance was traditionally treated as an HR and recruitment issue within employer-employee relationships. Responsibility for preventing illegal working now extends more widely across an organisation, potentially affecting procurement, contractor management, labour supply arrangements and broader workforce supply chains.
As a result, it is vital that those operating in the healthcare sector understand precisely how labour enters their organisation, where legal responsibility sits and whether existing compliance processes remain fit for purpose.
Which working arrangements are now covered?
The Right to Work scheme now applies to individuals engaged under worker contracts, individual subcontractors, certain outsourced labour arrangements, arrangements containing substitution rights, where one individual may perform work on behalf of another, and online matching and platform-based services.
The Home Office guidance makes clear that the definition of “employer” now extends beyond traditional employment relationships, and can include businesses engaging individual subcontractors, worker-contract arrangements and other labour supply models.
Importantly, labels such as “self-employed” or “contractor” will not be determinative. The Home Office has made clear that the assessment will focus on the reality of the arrangement and how work is supplied and performed in practice, where this may not necessarily align with tests under employment law.
For example, a contractor engaging a labour-only subcontractor may need to consider whether additional Right to Work compliance obligations arise within that arrangement, depending on how the relationship operates in practice.
Which arrangements remain outside scope?
Despite the broader application, not every commercial arrangement will fall within scope, and the guidance confirms that the extended liability provisions generally do not apply where an organisation is simply purchasing services for its own internal operations. Likewise, genuine business-to-business arrangements involving independent contractors operating through their own companies will generally remain outside the framework.
This distinction will be critical, and many healthcare settings may require specialist advice to determine whether particular working arrangements fall within scope.
What are the consequences of non-compliance?
The risks remain significant. Any organisation that fails to establish a statutory excuse may face civil penalties of up to £60,000 per illegal worker, criminal liability in serious cases, a suspension or revocation of the organisation’s sponsorship licence, and public naming as a non-compliant employer.
The Home Office has also made clear that intelligence sharing with HMRC and other enforcement bodies will continue to underpin enforcement activity to identify those businesses who are non-compliant.
What steps must healthcare organisations now ensure have been taken?
For organisations that fall within the extended liability, provisions will need to establish a statutory excuse against that liability. To benefit from that protection, organisations must demonstrate compliance before work begins.
The requirements are Contractual Controls, whereby organisations must have written contractual provisions requiring Right to Work compliance throughout the relevant contractual chain. Substitution Controls, where contractual arrangements permit one individual to substitute another to perform the work, businesses must ensure there are appropriate processes in place to verify the identity and Right to Work status of any substitute before work commences. Organisations should not assume that a check carried out on the original worker will cover subsequent substitutes. And Identity Verification whereby organisations must have systems ensuring that the individual carrying out the work is the same individual whose Right to Work has been verified.
Healthcare compliance checklist
Healthcare organisations must consider whether they understand every route through which labour is supplied to their projects and have reviewed all subcontractor and labour-only arrangements.
They should identify which relationships fall within and outside the extended Right to Work regime, ensure their contracts contain appropriate Right to Work obligations, and establish processes to verify the identity of workers and substitutes before they begin work. It is also essential that managers and supervisors understand the new requirements, that processes are documented sufficiently to establish a statutory excuse if challenged, and that procurement, commercial and site management teams receive appropriate training on the changes.
The recent reforms mark a significant shift in the UK’s approach to illegal working enforcement. For healthcare organisations operating complex labour supply chains, understanding who is carrying out Right to Work checks, when those checks must take place and how compliance is documented will be essential.
