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

Guiding Principles

The 5 guiding principles that underpin the Code of Practice are set out in this section.

1. International migration of health and social care personnel can contribute to the development and strengthening of health and social care systems in both the countries of origin and the destination countries if recruitment is managed properly

See the WHO Global Code of Practice on the International Recruitment of Health Personnel.

International recruitment (migrant workers, moving temporarily or permanently for employment) has made a substantial contribution to the delivery of health and social care services across the world and will continue to play a vital role in the future.

International recruitment is one part of the UK’s strategy to ensure the NHS has the workforce it needs. Work is underway to support greater numbers of domestically recruited health and social care staff through training, improving retention and encouraging staff who have left to return, to achieve a sustainable health and social care workforce which reflects the population it serves and can remain responsive to the UK population’s needs.

With its focus on workforce planning to ensure the NHS and Social Services Sector has a sustainable health and care workforce, alongside increasing the supply of “homegrown” health and care staff through training more, retaining more and encouraging staff who have left to return. The NHS and Social Services have a long history of developing the knowledge and skills of health and care staff coming to Scotland at some time in their careers.

Well managed migration ensures that the health and social care systems of both the origin and destination country derive benefits. Good practice, ethical standards, respect for rights and value for money should underpin all international recruitment activities.

Compliance with this Code of practice ensures that the international recruitment of health and social care personnel minimises harm to the health and care systems of countries of origin, while safeguarding the rights of health and social care personnel to migrate and ensures fair and just recruitment and employment practices.

Opportunities exist for individuals, organisations and the health and the care systems to train, educate and enhance their clinical practice

International recruits gain from opportunities to develop their skills, and in turn, advance their own careers and economic opportunities. International health and social care personnel bring new and valuable perspectives and learning that enables the transfer of experience and the sharing of ideas.

Collaborative partnerships for training and continuous learning can bring benefits for individuals, organisations and health and care systems of the UK and the source country.

There must be no active international recruitment from countries on the red list, unless there is an explicit government-to-government agreement to support managed recruitment activities that are undertaken strictly in compliance with the terms of that agreement.

Skilled and experienced health and social care personnel are a valuable resource to any country. For some low and lower middle-income countries, increasing the scale of health and care worker migration threatens the achievement of national health and social care goals.

Countries on the red list must not be targeted for international recruitment, unless there is a government-to-government agreement negotiated and signed by the Department of Health and Social Care (DHSC) on behalf of the UK Government and recruitment is consistent with the provision of the agreement. Where recruitment is restricted solely to the terms of the government-to-government agreement, the country will appear on the amber list. Such agreements can be designed to help regulate or mitigate against any negative impacts of health or care migrant flows to the UK. All agreements will take WHO guidance on bilateral agreements on health worker migration and mobility into account.

Government-to-government agreements must take steps to ensure that migration to the UK does not exacerbate existing health and social care workforce shortages in the country of origin, and the country of origin derives proportional benefits.

Consideration of evidence will form part of decision-making on agreements, and will include:

• A health labour market analysis for red-listed countries.
• Engagement with health sector stakeholders in countries of origin.
• Consultation with the WHO.

Recruitment of international health and social care personnel is monitored through published immigration, regulator and employer data

DHSC will continue to monitor data on health and social care international workforce alongside other government departments, devolved governments (inc. the Scottish Government), and employer stakeholders. Information will be analysed to understand the country of origin of recruits.

DHSC and the Foreign, Commonwealth and Development Office (FCDO) will continue to share information with the UK’s FCDO diplomacy network. DHSC also shares reports with the WHO as part of the UK’s global commitment to uphold the principles of WHO Global Code of Practice. This information directly strengthens understanding of and cooperation on global mobility patterns.

Where trends indicate increases in recruitment from low and lower middle-income countries or fragile and conflict-affected states, further work may take place in partnership with FCDO to understand the causes and impact of this activity.

2. 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 have the same access to further education and training and continuing professional development.

• All staff, regardless of country of origin or training, have the same legal protections within the workplace.
• Relevant employment legislation applies as long as the employee holds a valid permit or appropriate visa.
• All health and social care employees will be employed on the same terms and conditions of employment as domestically trained employees.
• Employment legislation protects and guides the conditions of service for all employees, regardless of their country of origin or training.
• Health and social care employees must meet and maintain requirements for continued professional regulation if the role is regulated by UK law.
• The opportunity to enhance skills and experience are important underpin international health and social care mobility.
• International workers employed within the NHS, social care sector and other health and care organisations that comply with the Code of Practice, will receive high standards of induction and support in their new career equal to other employees.