Quick guide: Code of Practice for International Recruitment

A quick guide to support your understanding of the UK Code of Practice

11 November 2021

This resource is designed to quickly outline the UK Code of Practice for International Recruitment, highlight the definition of active recruitment, list the countries the UK cannot currently actively target, and explain the guiding principles which health and social care employers and agencies should follow when sourcing candidates from overseas. 

  • The NHS commits to recruiting ethically through adhering to the UK Code of Practice (CoP) for International Recruitment which implements the World Health Organisation's (WHO) global code of practice. The CoP promotes high standards of ethical practice in the international recruitment and employment of health and social care personnel. It also aims to protect and promote health and social care system sustainability through international cooperation, ensuring safeguards and support for countries with the most pressing health workforce challenges. 

    The CoP aligns to World Health Organisation list of 47 developing countries, which the UK cannot target for active international recruitment. 

  • 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 each have their own Code to reflect individual structures. 

    • Hosts information on the CoP on our website.

    • Provides a dedicated advice and support service to health and social care providers to help them adhere to the CoP.

    • Manages the list of commercial recruitment agencies recruiting internationally that adhere to the CoP. 

    • Processes applications.

    • Monitors the countries agencies recruit from.

    • Works closely with IR Framework providers to ensure agencies on frameworks are on the agency list.

    • Works closely with the unions to help detect any issues following the recruitment of overseas recruits.

    • Carries out spot checks and biennial reviews on agencies.

    • Of necessary, investigates agencies suspected of contravening the guiding principles. If an agency is found to have contravened the CoP NHS Employers can recommended its removal from the agency list. 

    There are currently 487 agencies on the list as of 01/05/2022 

    • The CoP itself.

    • The list of countries the UK cannot target for recruitment.

    • The list of agencies who adhere to the CoP.

    • A set of guiding principles and best practice benchmarks for agencies and employers

  • The Code of Practice applies to all agencies and employers recruiting international candidates for health and social care roles. That is to say, the Code applies to both the public and private health and social care sector.  

Active international recruitment – the definition 

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. 

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. 

Example of active recruitment

A recruitment agency is approached by an individual working in a country on the list who has been referred to the agency by their friend who is working as a social care nurse in the UK. The agency supports the individual with their application and makes a bonus payment to their friend for the referral. This is in breach of the code of practice, an agency should not facilitate the recruitment process unless the candidate has already been appointed by the employer through a direct application. In addition, referral fee schemes are deemed to be active recruitment and are not permitted in countries on the list. 

Example of acceptable recruitment 

A nurse from Sudan applies to work in the NHS unassisted. He is interviewed by the trust and deemed successful for the post, subsequently travelling to the UK on receipt of his visa. This activity did not include any active recruitment therefore does not contravene the code of practice. 

Red List Countries

The map below displays the countries that appear on the do not recruit list and should not be considered for active recruitment to health and social care roles in the UK.


Amber List Countries

As of 11/11/2021, the Department of Health and Social Care (DHSC) announced that Kenya has been 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 personnel from Kenya to the UK with immediate effect. Please read this news article for more information.

Guiding principles of the CoP 

  1. International migration of health and social care personnel can make a contribution to the development and strengthening of health and social care systems to both countries of origin and destination countries if recruitment is managed properly. 
  2. Opportunities exist for individuals, organisations and health and care systems to train and educate and enhance their clinical practice. 
  3. There must be no active international recruitment from countries on the list, unless there is an explicit government-to-government agreement with the UK to support managed recruitment activities that are undertaken strictly in compliance with the terms of that agreement. 
  4. Recruitment of international health and social care personnel is closely monitored and reported on to the Cross Whitehall International Recruitment Steering Group. 
  5. International health and social care personnel will have the same legal rights and responsibilities as domestically trained staff in all terms of employment and conditions of work. They will also have the same access to further education and training and continuous professional development