International recruitment of health and social care personnel: code of practice - March 2023 (revised)

2. Scope

2.1 There are 3 elements to the Code of Practice:

(a) The Code of Practice;

(b) The country list, and

(c) The ethical recruiters list

Remit of the Code of Practice

2.2 Each Devolved Administration adheres to the common aims, objectives and guiding principles and best practice benchmarks of the UK code of practice, but holds their own code of practice to reflect the different organisational structures in each nation.

2.3 This Code of Practice applies to the appointment of all international health and social care personnel in Scotland, including all permanent, temporary, agency and locum staff in clinical and non-clinical settings. This includes but is not limited to, medical staff, nursing staff, midwives, doctors, dentists, healthcare scientists, allied health professionals, care workers, social workers, residential and domiciliary care workers, and support staff.

2.4 The following organisations must adhere to the Code of Practice when undertaking international recruitment activity to appoint health and social care personnel:

(a) All health and social care employing organisations, including local authorities (both public and independent);

(i) NHS boards and local authorities should ensure that there is compliance when they are setting up local contracts with independent providers.

(ii) Where national contracts are signed with the independent sector to increase capacity in the health or social care sector, compliance with the Code of Practice is a contractual obligation.

(b) Any recruitment organisation agency or collaboration that wishes to supply health and social care personnel to the NHS, local authorities, social care organisations or any other Scottish health and care provider. These organisations should appear on the ethical recruiters list.

(c) Any organisation which is employing and/or supplying health or social care personnel, on a temporary basis or permanent basis, to be deployed for the provision of a service in health and/or social care.

2.5 Training Programmes – Appointment of healthcare professionals onto postgraduate training programme listed at Annex C fall outside the scope of the Code of Practice

Roles and responsibilities in relation to the Code of Practice

Scottish Government

2.6 Works with the UK Department of Health and Social Care (DHSC), and the other Devolved Administrations to set the policy for the Code of Practice.

Department of Health and Social Care (For England)

2.7 Works with the Devolved Administrations to set the policy for the code of practice. Leads on bilateral discussions on health and care workforce and the negotiation and implementation of government to government agreements and maintains stakeholder relations with the WHO on international recruitment matters including exchange of information and reporting. Responds to complaints or other information about the code of practice and any breaches, in conjunction with NHS Employers.

NHS Employers

2.8 Although NHS Employers is the employers' organisation for the NHS in England, its work in relation to the Code of Practice is carried out on behalf of the whole UK, including the Devolved Administrations.

2.9 NHS Employers manages and hosts the ethical recruiters list of recruiting organisations that adhere to the code of practice to help health and social care employers with their selection process.

2.10 Hosts and updates information about each of the UK Codes of Practice, and the red and amber list of countries on its website, and undertakes communications activity to promote the Code of Practice.

2.11 Provides a dedicated advice and support service to health and care organisations throughout the UK to help them to follow the guiding principles of the Code of Practice in all their recruitment activities.

2.12 Provide a mechanism for stakeholders across the system to promote the Code of Practice, assess activity and, if necessary, address poor practice with employers.

2.13 Undertakes routine checks on compliance of a recruitment organisation, agency or collaboration with the Code of Practice and responds to complaints or other information with regards to breaches of the Code. NHS Employers also takes necessary action as set out in the process for Code of Practice contraveners at Annex B.

Local health and social care employers (NHS, local authority, and independent/private sector employing organisations)

2.14 Ensure that all recruitment of international health and social care personnel to fill vacancies or to take part in exchanges or education initiatives, is carried out in line with the Code of Practice.

2.15 Form a comprehensive plan for induction, pastoral and professional support. This should include preparing their own workforces and workplaces and ensure international migrants are signposted to appropriate organisations for further support, advice and guidance on their arrival and induction.

2.16 Should use recruitment organisations agencies or collaborations on the ethical recruiters list, that operate in accordance with the code of practice. Although the ethical recruiters list is maintained by NHS Employers, the list must be used by all organisations engaged in international recruitment.

Recruitment organisations, agencies and collaborations

2.17 Provide international recruitment services to health and social care employers wishing to employ health and social care personnel from countries outside the UK.

2.18 Must appear on the ethical recruiters list and operate in accordance with the code of practice. The list is maintained by NHS Employers

2.19 Must follow the relevant best practice benchmarks in all recruitment practices and maintain their duties with respect to the code of practice. The relevant recruitment lead within each organisation must:

• ensure their contact details are kept up to date on the ethical recruiters list, and
• submit timely data on recruitment activity when requested by NHS Employers or UK state regulators.
• ensure all staff involved in the recruitment of health and social care personnel are aware of and adhere to the code of practice.

Health Education England

2.20 On behalf of DHSC and the Devolved Administrations, establishes institutional partnerships and education exchange schemes as agreed by the Cross Whitehall International Recruitment Steering Group, to ensure recruitment is managed and mutual benefits are derived.

Cross Whitehall International Recruitment Steering Group

2.21 Chaired by the Department of Health and Social Care (DHSC), with membership from the Foreign, Commonwealth and Development Office (FCDO), Department for International Trade, Home Office (HO), Department for Business, Energy and Industrial Strategy, Department for Levelling up, Housing and Communities, Health Education England (HEE), NHS England/Improvement (NHSE/I), NHS Employers Department of Health for Northern Ireland, Welsh Government's Department of Health and Social Services and the Scottish Government.

2.22 Provides national policy oversight on implementation of the Code of Practice and collaboration on international recruitment supply activity, ensuring ethical practices across health and care.

2.23 Monitors migrant flows and impact.

2.24 Provides oversight of diplomatic and development relationships related to international recruitment and training with partner countries.

2.25 Approves any updates and changes to the Code of Practice, in consultation with the WHO. The Code of Practice will be reviewed annually until otherwise stated.

World Health Organization

2.26 Provides guidance through the WHO Global Code of Practice on the International Recruitment of Health Personnel and, in collaboration with its Member States, periodically reviews the WHO global code of practice's relevance and effectiveness. WHO also monitor implementation of the global code of practice by member states and reports on this to the World Health Assembly every three years. WHO, as recommended by its Member States, has a list of the countries with the most pressing universal health coverage related health workforce challenges, which is subject to periodic review.