Article

Code of Practice frequently asked questions

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

7 April 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 at workforcesupply@nhsemployers.org if you have further questions.

Purpose and scope of the Code of Practice

What is the Code of Practice for International Recruitment?

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.

Who does the Code of Practice apply to?

The Code of Practice applies to all health and social care employers, contracting bodies and recruitment agencies in the UK, including the private sector. It applies to the appointment of all health and social care personnel recruited internationally, including medical staff, nurses, dentists, carers, healthcare scientists, radiographers, physiotherapists, occupational therapists and all other allied health professionals.

Does the Code of Practice apply to the provision of locum and temporary staff?

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

Why do we have a UK Code of Practice for International Recruitment?

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.

What is ethical overseas recruitment and why is it so important?

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.

Why have you not gone further and banned all recruitment from red countries on the WHO Health Workforce Support and Safeguard List 2020?

We are clear that individuals have the right to migrate for economic or social purposes and we should not be seeking to prevent this. Where individual healthcare professionals from red list countries 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 behalf.

What role does NHS Employers play in the Code of Practice for international Recruitment?

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.

Isn’t the code discriminating against the nationality of those in red listed countries?

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.

We are clear that 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 professionals from countries on the list but ensuring they are able to 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 care professionals have to migrate.

Agencies

Why should I only use an agency who adheres to the guiding principles within the Code of Practice for International Recruitment?

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.

Can I use an agency who is not on the list to recruit internationally?

No. Employers must only use agencies included on the agency list to recruit internationally.

How does an agency apply to join the list of agencies?

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.

How long will an application take?

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

Can an agency pay a referral bonus to an individual who is referring a friend from a red country on the WHO Health Workforce Support and Safeguard List, 2020?

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.

I know of an agency who is actively recruiting from a country on the WHO Health Workforce Support and Safeguard List 2020. What should I do?

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 workforcesupply@nhsemployers.org. NHS Employers strongly encourages employers to share any information on Code of Practice breaches.

I know of an agency that is sub-contracting an agency in a country on the WHO Health Workforce Support and Safeguard List 2020, to recruit staff. What should I do?

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 workforcesupply@nhsemployers.org.

An agency has advised that they can sponsor international personnel from a country on the WHO Health Workforce Support and Safeguard List 2020, and place them in my organisation. Is this okay?

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.

What is the penalty for breaching the Code of Practice as an organisation, agency or sub-contractor?

There are various sanctions that can take place should an agency, sub-contractor or organisation be found in breach of the Code.

(a) A period of monitoring for a length of time between one and 12 months. The Code of Practice team at NHS Employers conducts spot checks on 30 agencies a month. An agency who breaches the Code of Practice would be added to the spot check list every month with their website, social media and news outlets checked for any breaches.
(b) A requirement for the agency or sub-contractor to facilitate appropriate training and provide subsequent evidence of training processes where staff have breached the Code of Practice.
(c) A formal warning that a repeat of the breach (or other breaches) could result in removal from the Code of Practice.
(d) Notification to NHS England and NHS Improvement that a breach has taken place. A condition of the recent NHSEI financial support offer on nursing is ensuring that all NHS Trust and Foundation Trust international recruitment activity adheres to the Code of Practice.
(e) Full removal from the Code of Practice, with frameworks and health and social care organisations to be notified. As a general rule, agencies can re-apply after six months. However, should an agency continue to contravene any aspect of the Code of Practice, However, persistent infringements or repeated breach for contravening the Code of Practice rules could lead to an increased ban on re-applying of up to three years, or potentially a permanent ban.

If a recruitment agency is removed from the list of agencies that comply with the Code of Practice can the agency appeal against this decision?

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.

If a recruitment agency is removed from the list of agencies that comply with the Code of Practice can I still use them to find recruits for my hospital?

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

Can a recruitment agency charge fees to applicants for their services?

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.

 

Employer and international recruits

What happens when health or social care personnel from a country on the WHO Health Workforce Support and Safeguard List 2020, applies to an employer directly, but the employers require the support of an agency to take the applicant through the process?

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.

Can a health or social care worker who is a national of a high-income country, but working in a country on the WHO Health Workforce Support and Safeguard List 2020, be targeted for recruitment?

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

An overseas candidate from a country on the WHO Health Workforce Support and Safeguard List 2020, wishes to apply directly to a health or social care vacancy. Is this ok?

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.

Who pays for the visa when recruitment has been targeted?

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

Who pays for the visa when an overseas candidate applies directly to an employer?

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.

When an individual has been appointed who pays for the cost of flights to the UK?

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.

Can social care employers access NHS Employers advice and support regarding the Code of Practice?

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

How will complaints or information around breaches from social care employers be raised?

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