Article

Code of Practice frequently asked questions

These FAQs on the Code of Practice for International Recruitment cover purpose and scope, for agencies, for employers and for international recruits.

11 November 2021

These frequently asked questions on the Code of Practice for International Recruitment have been split into three categories.

  • Purpose and scope of the Code of Practice.
  • Agencies.
  • Employers and international recruits.

We hope you find these useful and please get in touch with the team if you have further questions.

Purpose and scope of the Code of Practice

  • The UK, through the Department of Health and Social Care, and the devolved administrations is committed to recruiting ethically from outside the UK. The Code of Practice reflects the World Health Organisation (WHO) Code of Practice, which promotes voluntary principles and practices in the ethical recruitment of international health and social care personnel within member states and advances focus on international cooperation and health system strengthening. For further information about the WHO Code, please visit the WHO website.

  • The Code of Practice applies to all UK health and social care employers (including the NHS, the private sector and local authorities), contracting bodies and recruitment agencies internationally recruiting to the UK. It applies to the appointment of all health and social care personnel recruited internationally to the UK, such as medical staff, nurses, midwives, doctors, dentists, senior care workers, social workers healthcare scientists, radiographers, physiotherapists, occupational therapists, and all other allied health professionals.

     

  • Yes. The Code of Practice applies to all recruitment agencies supplying health and social care personnel. This includes permanent, locum and temporary employment.

  • The Code of Practice exists to help ensure the UK ethically recruits from outside of the UK, both protecting international personnel and the 47 countries on the WHO Health Workforce Support and Safeguard List 2020, where active, targeted recruitment should not take place, unless there is a government-to-government agreement to support managed recruitment activities that are undertaken strictly in compliance with the terms of that agreement.

  • Ethical overseas recruitment ensures a high standard of recruitment practice for overseas recruits and that international recruitment does not weaken the health system of the country of origin or exacerbate existing workforce shortages.

  • Individuals have the right to migrate for economic or social purposes and the UK should not be seeking to prevent this. Where individual healthcare and social care personnel resident in countries on the WHO Health Workforce Support and Safeguards List 2020 want to move to the UK to work, they can apply to a health and social care employer for a job directly and on their own accord.

  • NHS Employers maintains the list of recruitment agencies who adhere to the guiding principles and best practice benchmarks within the Code of Practice. We also work with employers in the NHS and social care to ensure they recruit ethically from overseas. Health and social care employers must recruit through agencies on the agency list.

    The dedicated team who maintain the list of agencies perform biennial agency reviews and regular spot checks to ensure agencies on the list maintain their standards and commitment to the Code. If breaches occur, the team can investigate agencies and if necessary, an independent panel can decide on any appropriate sanctions for the agency. These sanctions can be found in the agencies section of these FAQ’s below.

    The UK Code of Practice implements the principles set out in the World Health Organisation (WHO) global Code of Practice on the international recruitment of health and social care personnel.

    The Code of Practice belongs to the Department of Health and Social Care and has been in existence since 2003. It was updated and re-published on 25 February 2021. Each of the UK’s four nations’ devolved administrations adhere to the Code of Practice but have their own Code to reflect individual structures. NHS Employers’ role is to hold the list of agencies that adhere to the Code, process applications, undertake routine monitoring, and report back to the Department of Health and Social Care.

    It therefore recommended that agencies and employing organisations refer to ‘adhering to the UK Code of Practice’, and do not indicate that the Code belongs to NHS Employers by use of name or logo.

  • The Code does not discriminate against individuals based on their nationality. Ethical recruitment is determined by the country from which the individual is being recruited, rather than the nationality of the individual.

    All individuals have the right to migrate for economic or social purposes and the Code does not prevent this. Individuals from a country on the WHO Health Workforce Support and Safeguards List 2020 can apply to health or social care employers direct using NHS Jobs or the Everyday is Different campaign for social care, and can expect equitable and fair treatment during the process like any other applicant.

    By restricting active recruitment of health and social care personnel resident in countries on the list but ensuring they can apply for jobs directly in the UK health and social care sector, the Code is balancing the mitigation of negative effects from migration on countries facing severe health workforce vulnerabilities with the rights health and social care personnel have to migrate.

  • A direct application is considered to be an application to a health or social care employing organisation that a candidate has made independently, without support from any third-party organisation. The candidate must search, apply, interview, and accept the job offer for a role to an employing organisation to be considered direct.

    It is only once a candidate has accepted a job offer, following a direct and independent application to the employing organisation, that an agency could be approached by that employing organisation to support with further administration relating to their move to the UK.

  • The intention of the Code of Practice is to safeguard health and social care workforce in countries with the most pressing needs. It is not intended to restrict nationals of any country from accessing opportunities. Therefore, the Code refers to the country of residence for any international candidate, rather than the candidate’s nationality.

    For example, active recruitment is currently permitted in India; however, Nigeria is currently listed on the WHO Safeguard and Support List 2020 where no active recruitment is permitted. If an Indian national who is resident in Nigeria approaches a recruitment agency for support, an agency is not permitted to support that candidate into a health or social care role in the UK before a job offer is made by an employing organisation. If, however, a Nigerian candidate resident in India approaches a recruitment agency for support, the agency would be permitted to work with that candidate to secure a health or social care role in the UK.

  • The Department of Health and Social Care (DHSC) announced that from Thursday 11th November Kenya will be added to the “amber” list of countries in the Code of Practice for the International Recruitment of Health and Social Care Personnel in England. This means employers and recruitment agencies, including NHS trusts, must stop all active recruitment of health and social care professionals from Kenya to the UK with immediate effect.

    If employers have already given a conditional offer to health/social care personnel from Kenya on, or prior to, Thursday 11 November 2021, you may continue with the recruitment process. This recognises the investment which has already been made to get the candidate to this stage of the recruitment process and will ensure candidates who are fully expecting to be able to move to the UK to work are treated fairly. While Kenya is not on the WHO Health Workforce Support & Safeguards List, it remains a country with significant health workforce challenges. Adding Kenya to the “amber” list in the Code will protect Kenya from unmanaged international recruitment which could exacerbate existing health and social care workforce shortages.

    The UK and Kenya signed a Bilateral Agreement in July 2021 to provide a framework for future international recruitment. The detailed guidelines for how employers and agencies will be able to ethically recruit health and social care professionals from Kenya to the UK are currently being developed and will be published in due course.

Agencies

  • For the purpose of the Code of Practice ‘active international recruitment’ is defined as the process by which UK health and social care employers, contracting bodies, agencies and sub-contractors target individuals, either physically or virtually, to market UK employment opportunities, leading to UK employment in the health or social care sector. This can include, but is not limited to, advertising to candidates through all types of communication mediums, incentivisation activities such as referral bonus schemes and referring candidates to specific vacancies in the UK in return for a fee from the employing organisation. Recruitment organisations are not allowed to charge fees to the individual employee.

    Other examples of active recruitment include referring candidates who are currently resident in countries on the WHO Safeguard and Support List 2020 to an employing organisation, even if they have approached the agency directly,  Agencies should also be vigilant to online activity, particularly responses to social media and web enquiries. If your website enables CVs to be submitted, an agency should include a supporting statement that applications from individuals resident in countries on the WHO Safeguard and Support List 2020 cannot be accepted and agencies must screen all CVs to filter candidates.

    The only exception to this definition is where a candidate has already been appointed by a UK employer following a direct, independent application and selection without the support of a recruitment agency. In this case, if required, a recruitment agency can support and facilitate the employee’s passage to the UK. In such cases it is the agency’s responsibility, if challenged, to provide evidence that the services they are providing are permitted under this exception.

    Examples of what is and is not considered active recruitment can be found within the Code of Practice and this quick guide.


     

  • Agencies on the list commit to recruiting ethically from overseas. They do not actively target individuals from countries on the WHO Health Workforce Support and Safeguard list, and will effectively support candidates to come to the UK, offering high levels of assistance. For information on what good overseas recruitment is and examples of best practice, visit the NHS Employers International Recruitment toolkit. This also explains the benefits of choosing an agency on an approved framework.

  • All employing organisations are strongly encouraged to only use agencies that appear on the Code of Practice agency list. By working with agencies that adhere to the Code, your organsiation has the reassurance that all recruitment by the agency is conducted ethically. The Code applies to both the public and private sector and to that end, it is important that all employing organisations work together to ensure that any recruitment practices that are unfair or could damage the health and social care systems  of countries on the WHO Health Workforce Support and Safeguard List 2020 are prevented .

  • Details on how to apply to the list of agencies can be found in the agency application section which links to an online application form. The application form confirms:

    (a) the agency's commitment to fully adhere to the Code of Practice
    (b) the business practice of the agency
    (c) a declaration of all associated business activities relating to the commercial recruitment of health and social care personnel.

  • NHS Employers aims to process applications within 10 working days of receipt.

  • No. Referral bonus schemes are deemed to be active recruitment and are not permitted in red countries on the WHO Health Workforce Support and Safeguard List 2020, which can be found in annex A of the Code.

  • If you suspect or have evidence that an agency is actively targeting or has targeted individuals from countries on the WHO Health Workforce Support and Safeguard List 2020, please email the team. NHS Employers strongly encourages employers to share any information on Code of Practice breaches.

  • Agencies should not be targeting individuals or cohorts of potential staff through the use of another agency in a country which features on the WHO Health Workforce Support and Safeguard List 2020. This contravenes the Code of Practice and NHS Employers encourages for this information to be shared by emailing the team.

  • No, this is not okay. Significant trust is placed on sponsors and they have a duty to act in accordance with the immigration rules. The Home Office sponsorship guidance on page 38 states ‘If you are an employment agency, you can apply for a sponsor licence but only to sponsor migrant workers who will be directly employed by you in connection with the running of your business. You cannot sponsor a migrant if you will then supply them as labour, to another organisation, regardless of any genuine contractual arrangement between the parties involved." NHS Employers will notify the Home Office if it is found an organisation is not acting in accordance with the immigration rules.

  • NHS Employers regularly monitors recruitment agencies’ and employing organisations’ recruitment activity. If a breach in the Code is detected, NHS Employers can impose a range of sanctions such as:

    • Monitoring the agency and organisation for a period of time.
    • A formal warning that a repeat or further breach could result in removal from the Code of Practice.
    • Requirement of training and subsequent evidence of training processes where staff have breached the Code of Practice.
    • Notification to NHS England and Improvement that a breach has taken place.
    • Full removal from the Code of Practice, with frameworks and NHS organisations to be notified.

    If an agency is removed from the Code of Practice, this would impact their ability to recruit individuals into health and social care roles in the UK.

    If an agency is on a framework and is subsequently removed from the Code of Practice, this could also affect their framework status.

  • A recruitment agency will only be removed from the list of agencies if, following a thorough investigation, it is identified that they are in breach of the Code of Practice. A recruitment agency may appeal against this removal following the process set out in the Steps of Escalation at Annex B.

  • No. NHS employers must only use agencies included on the agency list to recruit internationally.

  • No. The Code of Practice explicitly states that a recruitment agency will not charge any applicant seeking employment within the UK any fee related to gaining such employment. Any recruitment agency registered within the UK charging fees to applicants will be in contravention of statutory employment agency legislation and will be reported to relevant authorities for further investigation. Employers should also satisfy themselves that UK recruitment agencies with whom they contract are not in any partnership agreement with agencies in other countries who allow fee charges to individuals solely for the purpose of placement within the UK.

  • By working with agencies that adhere to the UK Code of Practice for International Recruitment, an employing organisation has the reassurance that all recruitment by the agency is conducted ethically. The Code applies to both the public and private sector and to that end, it is important that all employing organisations work together to ensure that any recruitment practices, that are unfair or could damage the health and social care  systems of countries on the WHO Health Workforce Support and Safeguard List 2020,. are prevented.

  • No. Agencies must not refer any candidate resident in a country on the WHO Health Workforce Support and Safeguard List 2020 to any health or social care employer in the public or private sector. Instead, agencies can sign post the candidate to the NHS Jobs portal or the Everyday is Different campaign and advise candidates they must find and apply for a vacancy and be offered the position of their own accord.

  • If an agency is operating under a different name to its parent company or is a trading arm of a wider organisation, this will not affect your application but must be declared in the initial application to join the Code of Practice. Furthermore, it is important that company information is kept up-to date: the agency is obliged to inform NHS Employers of any changes to company information, including (but not limited to) the organisation’s name, contact information for the Managing Director, contact information for the agency and any website changes.

Employer and international recruits

  • An agency may only support a candidate following a successful, independent, and direct application to the employing organisation. That is to say that if an individual has independently applied directly for a vacancy in a health and social care organisation, the employer may enlist the support of an agency to help with the remaining part of the recruitment process after an appointment has been made.

  • No. The Code of Practice considers these individuals in the same way as any other health or social care personnel working in a country on the WHO Health Workforce Support and Safeguard List 2020, that is to regard them as a potential loss to the healthcare workforce of that country. Ethical recruitment is determined by the country from which the individual is being recruited, rather than the nationality of the individual.

  • Yes, If a candidate from a country on the WHO Health Workforce Support and Safeguard List 2020, sees a vacancy in the UK without any targeted recruitment activity having taken place, they are within their rights to apply directly to the health or social care setting and if successful, travel to the UK under the appropriate visa.

  • It is at the employer’s discretion whether they meet the cost of visa.

  • It is the responsibility of the appointed individual to ensure that they secure any visa required to exit their home country and/or gain entry to the UK. It is at the employer’s discretion whether they meet the cost of visa and/or professional registration fees.

  • The individual who is successfully recruited to a position in the UK is not usually expected to pay the cost of their flight to the UK. This cost is normally met by the employing organisation. For individuals who apply directly, without targeted recruitment, the cost is usually met by the individual.

  • The NHS Employers website is accessible to all and social care organisations will be able to read about the code, access FAQs etc.

  • Social care employers can contact Skills for Care who can then raise it with the team at NHS Employers.