Code of Practice for international recruitment

World mosaic

The UK, through the Department of Health and Social Care, is committed to ensuring ethical recruitment practices operate within the NHS through adherence to the UK Code of Practice (CoP) for international recruitment.

The updated Code was published on 25 February and you can read the press release on the website. It includes refreshed guiding principles and benchmarks, new case study examples and a suite of frequently asked questions. The other significant change is the list of developing countries, which is now in line with the 47 as set by the World Health Organisation (WHO).

NHS Employers continues to manage the list of commercial recruitment agencies recruiting internationally that adhere to the UK CoP. Agencies can find information about the application process and apply online via our website.

The UK CoP reflects the WHO CoP, which promotes voluntary principles and practices in the ethical recruitment of international healthcare professionals within member states. For further information about the WHO Code, please visit the  WHO website

Who does the UK code apply to?

All healthcare organisations and agencies recruiting internationally are strongly advised to adhere to the code. The code applies to the appointment of all healthcare professionals supplied internationally, including medical staff, nurses, dentists, healthcare scientists, radiographers, physiotherapists, occupational therapists and all other allied health professionals.

Joining the code does not mean that the agency concerned is a preferred supplier, nor that employers do not need to consider their obligations to recruit ethically when contracting the agency. Signing up means that an agency has agreed to adhere to the guiding principles, and NHS Employers will conduct checks (biennially and randomly) to ensure compliance. We also encourage employers to share any concerns about an agency with us if they believe the key principles of the code are being contravened.

Guiding principles

There are five guiding principles that underpin 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

Best practice benchmarks

It is expected that all organisations which comply with the code will apply these best practice benchmarks and will enter into contracts solely with recruitment agencies that have also agreed to abide by these.

  • There is no active recruitment of health and social care personnel from countries on the list.
  • All international recruitment by health and social care employers and contracting bodies will follow good recruitment practice and demonstrate a sound ethical approach.
  • International health and social care personnel will not be charged fees for recruitment services in relation to gaining employment in the UK.
  • All international health and social care personnel will have the appropriate level of English language to enable them to undertake their role effectively and to meet registration requirements of the appropriate regulatory body.
  • All appointed international health and social care personnel must be registered with the appropriate UK regulatory bod
  • All international health and social care personnel required to undertake supervised practice, by a regulatory body, should be fully supported in this process
  • All international health and social care personnel will undergo the normal health assessment prior to commencing employment.
  • All international health and social care personnel will have appropriate pre-employment checks including those for any criminal convictions or cautions as required by UK legislation.
  • All international health and social care personnel offered a post will have a valid visa before entry to the UK.
  • Appropriate information about the role applied for will be available to all international health and social care personnel.
  • All newly appointed international health and social care personnel will be offered appropriate support and induction. As part of this employers and contracting bodies should undertake pre-employment/placement preparation activity to ensure a respectful working environment for all. 
  • Health and social care employers should respond appropriately to applications from international health and social care personnel who are making an individual application.
  • Health and social care employers and contracting bodies should record international recruitment activities. This will support the UK to monitor and measure the impact of international recruitment flows on the health and social care sector in both the country of origin and the UK.

Devolved administrations

Each of UK's four nations' devolved administrations adhere to the aims, objectives and guiding principles of the code of practice, but holds its own code of practice to reflect the different organisational structures in each nation.

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