General guidance

This page contains general guidance about the recruitment of consultants from overseas, including information on making an unconditional job offer, the workers registration scheme, pensions, contracts and induction.

Making an unconditional job offer

NHS employers who recruit staff from abroad should carry out the necessary pre and post-appointment checks in accordance with NHS Employment Check Standards and the prevention of illegal working legislation. If they are satisfied with the outcome of these checks, the candidate should receive a written unconditional offer of a consultant position by the trust. The candidate's decision whether to accept the formal offer should be made in writing.

The following checks are undertaken:

• verification of identity checks
• right to work checks
• registration and qualification checks (must be on the specialist register and have full GMC registration)
• employment history and reference checks
• criminal record checks
• occupational health checks.

Workers registration scheme

Doctors from new member states (Poland, Czech Republic, Estonia, Slovakia, Hungary, Latvia, Lithuania and Slovenia) will need to register with the workers registration scheme (WRS). Applications for WRS need to be made within 28 days of commencement of employment or working will be deemed as illegal.

Contracts of employment

Trusts are responsible for providing written contracts of employment with any international doctor that they employ. Terms and conditions of employment should be in accordance with the National Terms and Conditions of Service.

Trusts who wish to employ doctors for less than two years need to be mindful of the pension arrangements when agreeing the length of the contract. In order for a doctor to be entitled to the NHS Pension Scheme refund, their total period of employment with the NHS must not exceed 729 days.

The employing trust can offer a candidate either an indefinite or a fixed-term contract. A fixed-term contract would be appropriate where the post is available for a limited period of time only or where the doctor is undertaking a sabbatical from another employer. Guidance is available on regulations governing fixed-term contracts on the Department for Business, Enterprise and Regulatory Reform (formerly the DTI) website.

Relocation costs

Trusts may wish to consider providing relocation support packages to international doctors.

Pensions

The NHS Pension Scheme is open to all NHS employees.

NHS Pension Scheme entitlement is available after completion of a two-year qualifying period. Pension entitlement will not be an issue for doctors who return to their home countries at the end of the contract if it is less than two years. Therefore, at the end of the contract, an amount broadly equivalent to the financial value of the NHS pension will be refunded. Provided that the doctor has been employed by the NHS for less than two years in total (including any period of employment before the start of the contract), they will receive a refund from the NHS Pension Scheme broadly equivalent to the 6% employees' contribution (after adjustment for tax and national insurance).

If the doctor has been in the NHS Pension Scheme longer than 729 days, they will be eligible to receive an NHS pension.

Trusts should check an individual's pension rights directly with the NHS Pensions Agency.

Induction and continuing support

The employing trust is responsible for arranging a full induction programme for the doctor which covers:

• welcome and introduction to life in England
• discussion of cultural factors which the doctor needs to know and understand
• induction into the clinical aspects of the job
• other relevant medical issues including legal aspects of medical practice in England.

In particular, trusts must arrange for psychiatrists who will have responsibilities under the Mental Health Act (MHA) to undergo MHA training in order to obtain approval under Section 12.

The trust should, in consultation with the doctor, appoint a doctor colleague to act as a professional mentor. If the post involves research, a research mentor should also be appointed. The trust should also identify a member of staff to ensure that the doctor receives pastoral support and advice during the transition to working in the NHS and settling into life in England. This will include an introduction to social and professional networks for doctors and their families.

Advance planning and consultation with the doctor and their colleagues is essential in arranging an effective induction plan. A good induction is essential to successful integration and ongoing effective professional relationships. Without a good induction, the doctor will find it difficult to perform effectively, there may be problems in relationships with colleagues and the trust may also find it difficult to retain the doctor. If a doctor leaves early because of a lack of good induction, all the effort that went into the recruitment will be wasted. Further guidance on induction, mentoring and pastoral support can be found on the NHS Employer's website.

Continuing professional development

International doctors will have the same entitlement to continuing professional development (CPD) as other NHS consultants on a pro-rata basis, ie a proportion of the 30 working days in any three-year period depending on the length of the contract. Professional or study leave has to be approved by the employer, and includes study, research, teaching, visiting clinics and attending conferences. The trust mentor should speak to the doctor during their induction period to work out a programme of CPD with this objective in view. The Royal Colleges can help to facilitate the arrangement of study visits if necessary.

If practical, other consultants in the same department as the doctor should be able to take part in the visits as part of their CPD, if they wish to. The expenses of doctors and other consultants attending these visits should be paid for by the employing trust as part of the CPD entitlement.