Working with agencies - top tips

This page holds top tips for employers on working with recruitment organisations, agencies, or collaborations for their international recruitment.

19 March 2024

Some employers choose to contract with a recruitment organisation, agency, or collaboration to help with international recruitment campaigns. The number of people you are looking to recruit will determine the procurement or tendering exercise you will need to go through, and you will need to draw up a clear specification and have up-to-date job descriptions. 

You can also find information about best practice and alternative ways to conduct overseas recruitment via our International Recruitment Toolkit.

If you do decide to use a recruitment agency, organisation, or collaboration, below are some tips to consider.

1. Use agencies, organisations, or collaborations on the Code of Practice Ethical Recruiters List, and agencies on an approved framework

Choose an agency on an approved framework, such as those managed by the NHS Workforce Alliance (a joint collaboration of NHS Procurement in Partnership and Crown Commercial Service) or Health Trust Europe. This will give you reassurance that their recruiting processes adhere to all legal requirements and that you are getting the best value from their service.

You should also check that the recruitment organisation, agency or collaboration you contract with is on the Ethical Recruiters List (ERL) for the Code of Practice for International Recruitment, which is a self-declaration that they are working ethically supported by a knowledge test. You should check the ERL every time you work with an external supplier, regardless of how many times you have worked with them in the past. NHS Employers regularly monitors and updates the ERL and this includes removing organisations for various reasons, such as no longer trading or breaches to the Code of Practice. While an organisation could have appeared on the ERL previously, there is no guarantee that they will remain on the list in perpetuity. 

NHS Employers monitor and spot-check organisations on this list, however, you should be aware of your obligations as an organisation not to recruit from Code of Practice red list countries, and that recruitment organisations, agencies, and collaborations should not be facilitating the recruitment of staff from red list countries in line with the Code.

See the information below (section 12) regarding contacting NHS Employers if you believe a recruitment organisation, agency, or collaboration is acting inappropriately.

2. Set clear expectations

Set clear expectations of cohort sizes, expected numbers, what recruitment organisations agencies, or collaborations are expected to pay for and at what stage (potentially including caps on prices on flights etc. if you as an employer are likely to be charged – take a look at guidance for reclaiming expenses from people recruited from overseas on the NHS Employers website) early in the contracting process. More detail on contracting with tips from a number of NHS trusts is available in our International Recruitment Toolkit (page 35).

3. Have a dedicated contact at your trust

Even if you use a recruitment organisation, agency, or collaboration, you will need to ensure you have a dedicated contact in your organisation who can liaise them and your recruiting managers.

4. Confirm point of payment

It is important to include a contractual statement in the service agreement about the point of payment. For example, you might want to stipulate that the recruitment organisation, agency, or collaboration will not receive payment for their services until they provide staff who have been adequately screened and have appropriate professional registration.

5. Agree costs

Agree a fixed rate per person and/or a payment plan. The costs can vary depending on volume of candidates and the services the recruitment organisation, agency, or collaboration are to undertake.

6. Include a contractual statement preventing the recruitment organisation, agency, or collaboration advertising to staff

You might also want to consider including a contractual statement to prevent (for a defined period of time) the recruitment organisation, agency, or collaboration from encouraging individuals to join a different arm of their company and being placed in another trust or even another country.

7. Agree a pre-employment screening process

Have clear arrangements in place about what the recruitment organisation’s, agency’s, or collaboration’s responsibilities are for pre-employment screening. Your contract agreement should outline:

  • the types and levels of checks required for different posts, and who is responsible for the different types of checks involved
  • that the organisation will be liable for financial penalties if it is discovered that any staff have not been adequately screened
  • that you retain the right to audit the recruitment organisation’s/agency’s/collaboration’s screening process at any time
  • that the organisation agrees to adhere to guiding principles and the best practice benchmarks as set out in the Code of Practice while recruiting on behalf of your organisation, this includes providing clarification around applications or approaches from applicants in red list countries.

8. Confirm the process for assessing candidates

Decide if you might want the recruitment organisation, agency or collaboration to undertake the initial sift of candidate applications. You may also want the recruitment organisation agency, or collaboration to ask potential candidates to undertake a range of tests or activities to assess values and competence.

9. Don’t get caught out by judgement calls

If you want the recruitment organisation, agency, or collaboration to make judgements about the candidate’s suitability during screening checks, you should ensure that such judgements follow agreed decision-making guidelines.

10. Agree who will liaise with new recruits

As part of your agreement with the recruitment organisation, agency, or collaboration, be clear about who will be liaising with the new recruits between the offer of employment and their relocation. This is in keeping with the best practice benchmark of the code of practice that appropriate information about the post being applied for will be made available to a candidate at an early stage so international health and social care personnel can make an informed decision on whether to accept a job offer. Guidance is available for candidates applying for health and social jobs in the UK from abroad.

11. Ask for references

Don’t forget that you can also ask the recruitment organisation, agency or collaboration to provide you with references from other employers the organisation has worked with. Follow these up directly to find out what their experience has been.

12. Flag concerns about the practices of a recruitment organisation, agency, or collaboration

If you have any concerns about the recruitment practices of an agency, we advise you to get in touch with the relevant framework provider to report your concerns. If a recruitment organisation, agency, or collaboration is facilitating recruitment from a developing country featured in the link above or charging candidates fees, please get in touch with us at You can find out more about the relevant framework providers on the NHS England website and on our international recruitment frameworks webpage.

Annex E of the Code of Practice details ways of reporting concerns about the welfare and employment rights of health and social care personnel.