Health and social care personnel - international recruitment: updated code of practice

Ethical Recruiters List

NHS Employers updates and maintains a list of recruitment organisations, agencies and collaborations that operate in accordance with the Code of Practice, known as the ethical recruiters list.

Health and social care local employers and contracting bodies should only use recruitment organisations, agencies or collaborations who are on the Code of Practice ethical recruiters list.

Although the ethical recruiters list is maintained by NHS Employers, the list should be used by all health and social care organisations engaged in international recruitment, both in the public and independent sectors.

Application procedure

Recruitment organisations, agencies or collaborations wishing to apply for inclusion on the Code of Practice ethical recruiters list are required to complete an online application form and a knowledge test of this code of practice. Information on the application process for the ethical recruiters list is available on the NHS Employers website.

The organisation responsible for processing applications and monitoring the ethical recruiters list reserves the right to introduce a fee for recruitment organisations, agencies or collaborations to be on the ethical recruiters list for the Code of Practice at a future point in time.

How the ethical recruiters list is monitored

The process for monitoring organisations and their adherence to the Code of Practice is set out on the NHS Employers website.

Health or social care organisations are encouraged to check the ethical recruiters list before working with any employer, organisation or collaboration. This is to ensure the organisation in question remains on the ethical recruiters list at the time of any recruitment exercise.

Removal from the Ethical Recruiter List

A recruitment organisation, agency or collaboration will be removed from the ethical recruiters list if, following an investigation, it is found to be breaching the principles of the code of practice.

Each case will be investigated on an individual basis and an abridged version of the escalation process for informal and formal investigations can be found below. This process includes an appeals procedure.

Information on any breach will be shared with EAS. Information on removals will be shared with framework providers following the resolution of the appeals procedure or after the time limit for submitting an appeal has passed. Organisation information, such as names and postcodes, will be shared with DHSC, EAS and relevant framework providers only to enable accurate record matching and removal from the framework. Users of the ethical recruiters list may be notified that the list has been updated, but no organisations will be named.

Failure to respond to the data collection from NHS Employers will result in removal from the ethical recruiters list, without the need for an independent panel.

Process for Code of Practice contraveners

This section describes an abridged version of the informal and formal escalation stages of investigation when NHS Employers becomes aware of recruitment and/or associated activity that contravenes the Code of Practice.

The detailed process is housed securely by NHS Employers and applies to all recruitment organisations, agencies and collaborations listed on the ethical recruiters list. Employing organisations who are reported as being in breach of the code will also be investigated. This will include the informal stage as outlined below, as well as discussions with DHSC, and possible additional investigations if activities were supported by a recruitment organisation, agency or collaboration as outlined below.

If there are any concerns about potential breaches to the Code, please contact internationalrecruitment@nhsemployers.org

Informal stage

NHS Employers receives information about an organisation, either through random checks or another manner, that indicates a potential breach of the Code of Practice.

NHS Employers carries out desktop research and other checks including but not limited to conducting a spot check on Companies House, the organisation website and social media presence to determine whether there is any evidence to pursue further investigation. NHS Employers also considers if any other breaches or investigations have been previously recorded as well as their knowledge test as part of their initial application to the Code of Practice (for those who joined after August 2022).

If appropriate, the organisation is contacted via email to clarify their business activities, how it may have breached the Code of Practice and is given ten working days to respond. The reply from the organisation and any supporting evidence will be reviewed and considered against the guiding principles and best practice benchmarks of the Code of Practice .

The organisation’s response is considered and depending on the response, NHS Employers may decide:

• To close the informal investigation.
• To give the organisation may be given an opportunity to correct their behaviour by giving an informal warning and making additional spot checks
• To begin the formal procedure

Formal stage

Where a formal investigation is required, any relevant information (including data submissions, media articles, social media activity, promotional/website material) from the organisation under investigation in relation to alleged wrongdoing or contact from an employer, framework provider, trade union representative or other stakeholder will be collated and saved securely and in accordance with any relevant data protection laws to aid future investigations.

This information will be shared with the organisation in a formal letter. The formal letter will be addressed to the most senior person listed on the organisation details as provided to NHS Employers and sent to the organisation.

The formal step in the process is to outline the initial findings from the informal stage, provide them with the evidence that has been gathered and give the organisation concerned a right to reply.

The organisation will have ten working days to provide a formal written response. NHS Employers may consider a short extension to the ten-day response time frame, in exceptional circumstances, at their discretion.

The panel receives relevant documentation 5 working days before the panel meeting

The independent panel will consider all the evidence presented and where appropriate will recommend sanctions to DHSC, which may include temporary or permanent removal from the ethical recruiters list. Other sanctions may include:

• The organisation will remain on the ethical recruiters list but subject to monthly spot checks for up to one year, and/or additional training imposed.
• A formal warning that a repeat of the same activity (or other code breaches) will result in removal from the code of practice.
• Requirement for additional training and a re-sit of the knowledge test.

DHSC approves the independent panel’s recommended sanction and next steps.

NHS Employers formally writes to the organisation outlining the outcome and decision on any sanctions.

Generally, a one-year waiting period comes into effect before the recruitment organisation, agency or collaboration can apply to be placed back on the list. However, the sanction may be to permanently remove the organisation from the Code of Practice.

It is at the discretion of NHS Employers as to whether this waiting period should be extended, or any applications should be immediately refused in future. They will consider:

• Repeated breaches
• The measures put in place to prevent future breaches
• The organisation’s co-operation in any investigations

To re-apply an organisation will need to provide evidence that it has changed its business practice as well as completing the full application process.

The organisation will either be accepted or declined. If declined, the organisation will need to wait an additional 12 months before re-applying. If there have been persistent infringements or a particularly severe/repeated breach contravening the code off practice this could lead to an increased ban on re-applying of up to 3 years, or a permanent ban.

Appeal Stage

On receiving the formal notification letter from the Independent panel from the formal stage, the organisation can appeal to NHS Employers by providing the reason why they believe the sanction to be inappropriate, unproportionate and/or unfair within 10 working days.

The purpose of the appeal procedure is to review the process and reason for sanctions imposed, including the decision to remove an organisation from the list when the organisation believes the process was improperly administered or the decision was unjustified. The purpose of the hearing is not for the appeal panel to rehear the evidence presented to the independent panel hearing.

The appeal panel will be independent of any previous decision making in the process.

The panel will include:

• NHS Employers staff member at director level
• NHS Confederation staff member at assistant director level
• NHS Employers or other Stakeholder staff member at programme lead or manager level

The appeals process should normally be completed within 6 weeks of receiving the written appeal unless there are circumstances that warrant an extension. In these circumstances, the appeals panel should inform the organisation in writing of the reasons and, where possible, the timescale of the delay.

The panel members will consider the appeal submission and any evidence together with the original papers supplied by the NHS Employers’ investigation team.

Panel members can ask for additional information or clarification from either the organisation or the NHS Employers’ investigation team.

Consideration should be given to the following:

• Whether the primary investigators clearly demonstrated on the balance of probability a breach or breaches of the code of practice has taken and the sanction imposed, such as the decision to remove the organisation from the ethical recruiters list is proportionate
• There is any possibility that the information on which the original decision was based is incorrect
• The organisation has been given an opportunity to respond and provide an explanation of their actions
• The organisation disproved the evidence or raised serious doubt about its validity
• The process has been handled appropriately by the investigation team and the independent panel

The panel will make a majority decision whether to uphold or reject the appeal. It may also make other specific recommendations. When the review is completed, the organisation will be notified of the outcome in writing by NHS Employers.

If the appeal is upheld, the sanction will be removed or adjusted in line with the appeals panel decision and relevant stakeholders will be notified of any sanction applied.

Action by appeals panel

Panel members do not have to consider the appeal together in a formal face-to-face meeting but should meet if requested by one of the panel members.