International recruitment is where employers seek to employ people from outside the UK to supplement their traditional workforce resourcing policies.

International recruitment of healthcare workers takes place in three main ways.

  1. Active recruitment: by employers or recruitment agencies. This usually involves advertising UK employment opportunities in the target country, holding interviews there and processing applications for successful candidates.

  2. Passive recruitment: this is where overseas or European workers individually pursue career options, often after moving voluntarily to the UK.

  3. Refugee entrants: initiatives are starting to facilitate the employment of refugee doctors and nurses.

International recruitment is necessary in healthcare because of staff shortages in NHS Trusts and some parts of the wider NHS, eg in general practice. In an economy currently close to full employment, there are recruitment difficulties and skill shortages across the public sector. International recruitment is a relatively speedy solution to skill gaps, since training home-grown workers can take up to three years or longer depending on the job role. It is now an in-built part of Trust resourcing strategies, and the Department of Health has supported international recruitment through a number of specific routes, such as the international fellowship scheme for consultants.

There are particular NHS staff shortages in London, where vacancy rates are higher than the rest of the UK. London also has a higher proportion of internationally qualified nurses — 14% compared with the UK as a whole (source: Royal College of Nursing Annual Members Survey 2003), contributing to a highly mobile workforce. Most nurses come from six countries: the Philippines, South Africa, Australia, New Zealand, Nigeria and Ghana.

In the summer of 2010, the then UK Government announced a limit on the number of non-EU migrants allowed to work in the UK, as part of a wider review of numbers in the longer terms. There are now limits on tiers 1 and 2 applications and NHS Employers have produced a set of Frequently Asked Questions to help employers understand the changes and the longer term implications.

In July 2014, NHS Employers updated its UK Code of Practice (CoP) map for international recruitment, which includes all the commercial recruitment agencies who adhere to the CoP. Employers are encouraged to adhere to the list when choosing to work with international recruitment agencies.

The UK CoP sets out the principles and the benchmarks laid down in the World Health Organisation (WHO) CoP, which encourages voluntary principles and practices in the ethical recruitment of international healthcare professionals within Member States of the European community.

On 30 September 2020, the Home Office launched a new campaign to guide employers in navigating the new points-based immigration system due to be introduced on 1 January 2021.

Resources are available at https://pbisemployers.campaign.gov.uk.

The information includes details on hiring from the European Union (EU) from 1 January as well as details on how to register as a sponsor for employers who have not already done so.

NHS Employers has also created a web section specifically for NHS organisations to be found on the international recruitment pages of the NHS Employers website.

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