Guidance

Part 1: applying for health and social care jobs in the UK from abroad

Updated 18 March 2024

This guidance is for people from overseas who may want to work in health and social care in the UK. We want to make sure you understand the process of recruitment, are well informed about working rights and standards and have the information you need to make decisions.

The guidance is in 2 parts. This is part 1, which sets out what you need to think about before you apply, during your application and once you have secured employment. ‘Part 2: living and working in the UK - what you need to know as a health and care worker’ sets out what you need to know in advance of living and working in the UK.

Unfortunately, some people and organisations may try to exploit you during the recruitment process. The ‘recruitment processes and agencies’ section includes information on avoiding scams.

The code of practice for the international recruitment of health and social care personnel sets out the UK government’s written guidelines for ensuring that international recruitment of health and social care staff is done ethically. There is a separate code of practice for international recruitment of health and social care personnel in Scotland.

Introduction to the health and social care system

Healthcare in the UK is mainly provided by the National Health Service (NHS), a group of public bodies that provide or arrange medical care for all permanent residents in the UK (England, Scotland, Wales, and Northern Ireland). Most services provided by the NHS are free at the point of delivery, including:

• hospital care
• emergency care
• mental health care
• community healthcare

The NHS is the largest provider of healthcare provision in the UK. Private healthcare and a wide variety of alternative and complementary treatments are also available but are not publicly funded.

The social care system is made up of organisations that provide personal care or support to children and adults in need or at risk. This includes care funded privately by individuals or funded by local authorities. Most social care services are delivered by for-profit independent sector home and residential care providers.

There are many varied jobs in the health and social care sector. Some jobs need specific training and skills, and to practice, professionals must join professional registers. Find out more about professional registration in the section ‘Registration with a professional regulator’ below.

Recruitment processes and agencies

Summary

When choosing a recruitment agency, do your research. Check if an agency has a strong track record and positive reviews from both candidates and employers.

Do not pay money to UK-based agencies to find work in the UK. This is illegal.

Some trade unions and professional associations can offer support before you start your employment.

The 2 different methods of international recruitment

There are 2 main ways you can be recruited to the UK. You can:

• apply for jobs yourself directly via a jobs board, such as:
  • NHS jobs
  • Find a job in social care
• apply for jobs via a recruitment agency or recruitment organisation

Recruitment and red list countries

If you live in a red list country, recruitment agencies should not be helping you get a job in the UK. This is called active recruitment.

Check the code of practice to see if you live in a red list country.

If you live in a red list country and a recruitment agency contacts you with a job offer, you should reject it. The agency is not following the code of practice.

However, you can still apply for a health or care job if you apply directly. This means that you apply for a job without help from a recruitment agency or any other type of recruitment organisation. This is known as a ‘direct application’. For example, you can apply for a job via a relevant jobs board online such as NHS Jobs or similar.

Choosing a recruitment agency

Before you choose a recruitment agency, do your research. Speak to several agencies to compare working practices, values, services provided, and whether they charge fees. If the agency is based in the UK, they cannot charge you fees for finding work.

Check if the agency has a strong track record and positive reviews from both candidates and employers. You can check this by searching online. You could also ask the agency to put you in touch with existing clients for direct references, or ask the agency for case study examples or client testimonials.

NHS Employers holds an ethical recruiters list of recruiting organisations in the UK and overseas that agree to act in accordance with the code of practice. If you are using a UK-based agency, check they appear on this list.

Agency fees

Agency fees for both UK-based agencies and those based overseas are usually paid by the UK employer. It’s illegal for UK-based agencies to charge anyone recruitment fees, except the employer, for finding work.

You can report any agency based in Great Britain (England, Scotland or Wales) that is charging recruitment fees using the online form or by email to eas@businessandtrade.gov.uk.

If they are based in Northern Ireland, contact the Employment Agency Inspectorate.

Overseas agencies may charge you a fee if the law in the country they’re recruiting from allows it. You should check that it is reasonable and affordable for you.

Some agencies charge for optional additional services. They cannot make these a condition of finding you a job.

Agencies can charge for:

• helping to write your curriculum vitae (CV, also known as a resumé)
• interview coaching
• career counselling
• helping you move to the UK. For example:
  • booking flights or accommodation
  • support with your visa application

Agencies cannot charge:

• recruitment fees (also known as a ‘job finding fee’, ‘job services fee’ or ‘application processing fee’)
• sponsor licence fee
• certificate of sponsorship (CoS) fee
• immigration skills charge

The agency must make it clear to you how much the charge is and what it is for. This must include information about your right to cancel or withdraw and how much notice you must give.

Professional organisations that can support you

Trade unions and professional associations can provide support including:

• employment and immigration advice
• access to legal services
• other professional services 

You should consider joining one as soon as you start your job (see ‘Part 2: living and working in the UK - what you need to know as a health and care worker’ for a list of organisations). Some unions, like the British Medical Association (BMA) offer membership while you are looking for work.

Other unions, like Unison provide online information and welcome sessions before you arrive here.

Scams to look out for and how to check if a job is real

Summary

Be aware of scams and job offers that sound too good to be true. Examples of potential scams, the warning signs and what to check are provided below.

If you commit fraud, you risk:

• losing your job
• losing your professional regulation
• being refused a visa
• being banned from taking the test in the future

You are told to pay recruitment fees

A recruitment agency should never ask you to pay a fee for finding you work in the UK. If you are asked to pay a recruitment fee, it is a scam or an illegal act. You may lose your money or end up in a job different to what you were promised.

Do not accept the offer.

You are offered an easy way to pass exams

People or organisations might offer an easy way to achieve the required English language test score or pass a competence or pre-employment check required for a job.

These are all examples of fraud:

• purchasing test certificates or test report forms without taking the test or exam
• accepting offers to access the test database to change your test score or make fake results appear in the online result verification system
• accepting offers to supply test content before the test
• proxy testing - when someone offers to take the test for you on your behalf
• fake test centres operating without any official documentation. Make sure the test centre appears on an approved list on the relevant professional regulator’s website
• making or adapting test certificates to make a false representation in respect of a test score
• accepting offers to provide you with false documents such as a false passport or forged qualification or education certificates to pass pre-employment checks
• accepting offers to access alternative routes to professional registration, outside those provided by the relevant professional regulators

Employers will:

• use secure online verification services to confirm test results
• check your documents are real
• validate your personal details against reliable sources

It is your responsibility to make sure that the test you are taking is recognised and the result you submit is genuine.

You are offered a job which is not real or based on false promises

If you see a job offer which seems too good to be true, it probably is. Look out for the warning signs, including:

• you are contacted unexpectedly
• you get the job without applying or talking to a recruitment agency
• you are required to pay a fee to get the job
• you are offered a position with no experience needed
• the salary is very high for the job
• the job description is vague, incomplete or poorly written
• the agent’s full contact information (website, email address and physical address) is missing or vague
• you are told if you work for 12 months as a senior care worker, you will be able to register as a nurse without taking the usual English language exam

If you spot any of these signs, it is likely that the job is not real or it is based on false promises. See ‘How to check if a job is real’ below.

You are charged fees that should be paid by your employer

There are fees that an employer must pay, not you. 

These include the:

• sponsor licence fee
• CoS fee
• immigration skills charge

Do not pay.

You risk losing your money or receiving a fake CoS meaning your visa application will be refused, or ending up in a job which is different from what was promised.

You are pressured into signing an employment contract you do not understand or a new contract with different terms and conditions from what you originally signed

You may be pressured to sign an employment contract without being able to read and fully understand it, or the contract could be vague and unclear. 

You may also be asked to sign a new employment contract with different terms and conditions to the contract you originally signed.

You should be wary of signing a new contract. Some employers will use this as a way to reduce your rights. Carefully read and understand your employment contract before signing. Do not be pressured into signing something you are unhappy with or do not understand. Read the contract checklist in Annex B to help you review a contract.

Check for repayment clauses. If it is excessive or unreasonable, it could trap you in a job you want to leave until you can afford to pay the fee. Read Annex A for more detail on repayment clauses and what is acceptable.

You are contacted by an agent asking for payment to fix a visa problem

You might be contacted by someone claiming they are from an official UK organisation telling you there is a problem with your visa and asking for urgent payment to resolve. They might already have personal information about you or ask you to confirm or provide personal information or bank details.

No official organisation will ask you to make a financial transaction on the spot or for your bank details. End the call or delete the email - do not pay.

More information on visa scams.

How to check if a job is real

Search for the company name and website online and on social media. If they are linked to any scams, the job offer may not be real.

If you are applying for a role directly with an employer (rather than through an agency), ask for a job description or role profile. Call or email the employer directly to confirm you’ve received them. Check they’re correct and up to date.

If you’re applying for a job with an independent provider (not publicly funded like the NHS), check that the company is real by looking it up on the Companies House website. If the company is a charity it should be registered on the Charity Commission. If it’s not registered do not take the job. Being registered on Companies House or the Charity Commission does not guarantee that the company is legitimate, but it is a good first check.

Check what typical salaries are for the job you’re going to be doing. Make sure the job offer includes a reasonable salary for the skills and experience you’re providing.

To get a working visa you need to be sponsored by an employing organisation with a licence to hire overseas employees. Check if your employing organisation has the right licence through the register of licensed sponsors.

Check and scrutinise the employer’s website. Some scammers will create their own websites. You could check:

• whether the company is registered with the Care Quality Commission (CQC), the independent regulator which monitors and rates health and social care employers on the quality of care they provide
• whether the company has a physical location by looking for the address on the website. Find a physical postal address listed and check the location using an online map tool
• if the website of the employer or agency is focussed on visa opportunities to come to the UK rather than the care it provides, it is more likely to not be a genuine employer

These details may be found on the website homepage, the ‘contact us’ section or the ‘terms and conditions’ page. If a company does not have these, it does not mean the company is a scam, but can be a sign that you should do some more checks.

Understanding your financial position

Summary

Check:

• the job meets the minimum salary requirements for the Health and Care Worker visa
• how the salary compares to typical salaries and if the salary is fair for the job you are going to be doing
• typical living expenses (in section ‘How salaries compare with the cost of living’) and ask your potential employer for information about the typical costs for the area you’ll be working in. Compare this with your monthly or annual earnings

Be clear what costs you’ll need to pay during the recruitment process and whether your employer will pay any of these for you. Typical expenses are listed in Annex A. Check what you should and should not be charged for to understand if what you’re being asked to pay is fair.

For most visas, including Health and Care Worker visas, you are not entitled to financial help from the UK government (this is also called ‘no access to public funds’).

Being able to drive may be essential for certain community-based roles. Make sure you understand and are able to obtain a driving licence and afford the associated transport costs.

Visa salary requirements

On the Health and Care Worker visa you will need to be paid the minimum salary or the ‘going rate’ for the type of work you’ll be doing - whichever is higher. Check the minimum salary requirements for each job.

Your expected salary

If you work for the NHS you’ll be paid in line with agreed pay bands. The pay bands are different depending which part of the UK you will be working in:

• NHS pay bands for England
• NHS pay bands for Scotland
• NHS pay bands for Northern Ireland
• NHS pay bands for Wales

If you do not have previous NHS employment you can usually expect to receive the minimum threshold of pay band for your role.  

National pay scales for medical and dental NHS staff are different. For more information, see doctors’ pay scales on the BMA website.

Skills for Care Workforce Intelligence publishes information on average wages in the social care sector in their report The state of the adult social care sector and workforce in England

Non-NHS jobs, for example in the private health sector or social care sectors, do not have to use these pay scales. However, all employers must comply with minimum wage law.

Your employer should be transparent and upfront about any deductions that they will take from your salary. These must not leave your income below the minimum wage level.

Some money will be taken off your salary for:

• income tax
• National Insurance
• pension contributions (see more information on workplace pensions in ‘Part 2: living and working in the UK - what you need to know as a health and care worker’

You should ask your employer what your approximate ‘take home’ earnings will be each month.

How salaries compare with the cost of living

The cost of living in the UK varies depending on the location. Your salary may seem high, but the cost of living is also high.

It’s important to consider the cost of living for different locations, the size of your family and other factors to ensure your salary is sufficient for you to live the lifestyle you want. Consider these factors when working out how far your salary will go. There are tools available online to give you an idea of the estimated cost of living in different cities.

Your employer can help by providing typical costs for the local area. Compare this with your monthly or annual earnings. Create a personal budget, so you know your income and expenses. Consider typical expenses including:

• rent or mortgage costs, which will vary depending on where you live and the availability of local accommodation
• council tax, which depends on the size of your property and its location
• utility bills. Water, gas and electricity are usually additional to rent
• mobile phone and internet
• television licence fee
• cost of food and other essential shopping
• travel expenses - you may need to use public transport to get to work or activities
• NHS prescription charges if you require prescribed medicine
• childcare costs - children are entitled to a free place at a state school in the September (August in Scotland) after they have turned 4 - you’ll need to consider childcare costs if your children are too young for school, or your school age children need care before or after school

Most people on a Health and Care Worker visa cannot claim ‘public funds’ (government financial assistance) such as benefits, housing assistance or tax credits. See ‘Part 2: living and working in the UK - what you need to know as a health and care worker’ for more information.

The cost of the recruitment process

There are costs involved at different stages of the recruitment process. Some costs must be paid by your employer. These include costs related to the sponsorship of your visa (such as the CoS fee and the immigration skills charge).

Other costs may be paid by the employer on your behalf. You should check with your employer if they intend to pay for costs for you and if you’ll need to pay these costs back to your employer later or if you leave your job.

Read the guidance on repayment clauses in Annex A. It outlines which fees may be met on your behalf by your employer.

Requirement to drive and costs

Driving is a requirement for some health and social care community-based roles. Most employers will require you to have a driving licence before you apply for this type of role. You should ask your employer to explain if they can support you to get a car, the steps you need to take to get your UK driving licence and the associated costs.

See if you can drive in Great Britain (GB) with your non-GB driving licence.

Information on driving in Northern Ireland. More information on driving in the UK.

Information on learning to drive.

Learning to drive and driving in the UK can be expensive. You need to consider the cost of:

• lessons
• getting licences:
  • sitting the written theory test
  • practical driving test
• purchasing or leasing a car
• car tax
• Ministry of Transport (MOT) test which you must legally have to ensure your car is road worthy
• maintenance
• insurance
• fuel costs

Employment offers, contracts and maternity rights

Summary

Make sure you get a job offer letter from your employer which details the salary, hours, location and any repayment clauses before accepting a job and travelling to the UK.

Use the employment contract checklist in Annex B, to check your employment contract has all the information you need.

Check the cost of any repayment clause in your contract. This is the amount of money you’ll have to pay back to your employer if you leave the job within a certain time. Annex A outlines what to check for when considering a repayment clause.

Do not allow anyone to pressure you into signing a contract until you’re comfortable with what is included. Do not sign a different contract on arrival in the UK. Some employers have used this as a way of reducing your rights.

If you become pregnant during the process of moving to the UK to work in the health or care sector, you’re unlikely to qualify for maternity pay.

Things you should check in your contract

Employment contracts will vary by employer. All employers should:

• give you an employment offer letter before you accept the role. This sets out details of your employment but is not the formal employment contract
• give you a ‘written statement of employment particulars’ on your first day of employment
• give you an employment contract within 2 months of starting your employment

You should always read the job offer letter fully and make sure you understand it before accepting the role. You should do this before you travel to the UK. Check it carefully to make sure that you understand what you need to do and what your employer needs to do.

If you’re unsure of anything or have concerns, you should write them down in a letter or email and ask for written clarification. You can refer back to this if there are any problems or confusion later.

You should not sign a contract that has blank spaces where there should be writing. This could be filled in later with things you did not agree to.

You should pay attention to any repayment clauses included in your contract. This is the amount of money you’ll have to pay back to your employer if you leave the job within a certain time. Do not agree to a repayment clause that asks you to pay back fees that should be paid by your employer. Read Annex A for more detail on repayment clauses.

Check that your job offer includes:

• job title (there is no requirement at this stage to provide details of the role, but you can ask the employer for a copy of the job description)
• salary
• hours of work
• place of work
• start date and length of contract
• any repayments clauses (see Annex A)

Your employment contract is usually provided on the first day of your employment, but not always. Your employer must give you an employment contract within 2 months of your start date. A contract checklist is in Annex B.

On a Health and Care Worker visa you cannot be employed on a zero-hours work contract. This is when an employer does not guarantee you any hours of work. You need guaranteed hours and to meet the salary threshold for the Health and Care Worker visa requirements.

Changes to your employment contract

Employers cannot change your offer without checking with you.

You should not be asked to sign a contract with different terms to your job offer letter. This is called contract substitution and it is not legal.

You should never be pressured into signing different terms from those provided in your job offer letter. If you’re asked to do so, you can refuse. It’s a good idea to keep copies of employment documents safe.

In this situation, contact Acas for advice and support.

Maternity rights

If you become pregnant during the process of moving to the UK or soon after you arrive, you’re unlikely to qualify for maternity pay. To qualify for maternity pay and other benefits as an employee, you must meet certain conditions such as a length of continuous service with your employer. You should consider and plan how you will support your child and yourself before travelling to the UK.

You do not have to tell your employer you’re pregnant until 15 weeks before your due date, but you may want to consider letting your employer know earlier. This is so they can provide you with support and advice and consider any necessary adjustments. They can also provide you with information on what support may be available. Find out about your rights as a pregnant employee.

What you need to know if you’re pregnant or planning a pregnancy: Advice for internationally educated nurses and midwives coming to work in the NHS in England (PDF, 332KB) provides information for international candidates who will be working within the NHS. If you’re working for a different employer, you should ask to see their maternity policy.

See further information on maternity leave and pay.

Organisations that can help you

You can get advice on employment offers and contracts from:

• a trade union if you’ve joined one
• Acas - look under the ‘advice’ section of the website
• Employment Agency Standards Inspectorate (if you are an agency worker) look under ‘Contact EAS’ section of the webpage or the Employment Agency Inspectorate in Northern Ireland
• your local Citizens Advice can give advice

Visas, family dependants, professional regulation and employer support

Summary

Read the Health and Care Worker visa requirements guidance if you’re applying for that visa.

If you are a care worker or senior care worker, your dependants will not be able to join you in the UK unless you are on a Health and Care Worker visa that you applied for before 11 March 2024.

In other roles, dependants may only be able to join you if certain requirements are met. Review the requirements so you can be confident that your family is eligible and will be able to apply successfully.

To work in many health roles, and some social care roles you must join the relevant UK professional register before you can start working here. You can find the regulatory eligibility requirements, including the level of English language requirements on the relevant professional regulatory organisation website.

The Health and Care Worker visa

Most health and social care professionals come to work in the UK on a Health and Care Worker visa. You should check with your employer whether they intend to pay for a visa on your behalf, or whether you’ll need to meet the cost yourself.

The visa fees you pay will be affected by the exchange rate. The rates are calculated in line with the Home Office exchange rate policy and are updated weekly.

Visa application centres may offer additional services for an additional charge (for example scanning and uploading your documents). You do not have to purchase these additional services. Purchasing additional services at a visa application centre does not influence UK Visas and Immigration’s decision on your visa.

You can check what documents you will need and upload these documents yourself for free before attending the visa application centre.

Bringing family dependants

If you are a care worker or senior care worker on a Health and Care Worker visa your dependants cannot join you, unless you are on a Health and Care Worker visa that you applied for before 11 March 2024.

If you work in a health or social care role other than a care worker or senior care worker, your partner and children can apply to join you or to stay in the UK as your dependants if they’re eligible. Make sure you read and understand the requirements so you can be confident that your family is eligible and will be able to apply successfully.

If your employer is organising your accommodation, you should tell them who from your family is joining you and when, so that suitable accommodation can be provided. Some employers will not provide accommodation for your family. More information on arranging accommodation is in ‘Part 2: living and working in the UK - what you need to know as a health and care worker’.

Bringing children from a previous relationship

If you’re separated from your partner and you want to bring your children to join you in the UK, you need to be able to prove you have sole responsibility for your children or that there are ‘serious and compelling reasons’ to grant permission. This is not always easy or straightforward to prove.

Each application is considered on a case-by-case basis and the burden of proof is on you to provide satisfactory evidence.

You should discuss this with your employer and seek guidance on the process and evidence you’ll need to provide.

Bringing an adult dependant relative

You cannot bring adult dependant relatives to the UK on a Health and Care Worker visa.

An adult dependant relative includes your:

• parent
• grandparent
• brother, sister, son or daughter aged 18 years or over

Registration with a professional regulator

Whether you need to register with a professional regulator before you work in the UK depends on the health or social care job you are applying for.

You need to register with a professional regulator to work as a:

• dentist
• doctor
• healthcare scientist
• midwife
• nurse
• nursing associate (England only)
• pharmacist
• allied health professional

For social workers, there are different professional registers in:

• England
• Northern Ireland
• Scotland
• Wales

In England, some social care roles do not require a registration with a professional regulatory body, including senior care workers, care workers, support officers and residential managers. However, there is a requirement to register if you work in:

• Northern Ireland
• Scotland
• Wales

A list of professional regulatory bodies, including how to register, are in Annex C.

English language tests

The professional regulators need to be satisfied that you have the necessary knowledge of English to practice safely here. For professional regulated roles, the minimum English language requirement is higher than the requirement for a Health and Care Worker visa. Details of the evidence you will need are on the professional regulatory websites.

Some employers will need you to achieve the required scores in your English tests before your interview. Other employers may offer language support to prepare you for the test. This support can also be provided by the English test provider such as the International English Language Testing System (IELTS) or the Occupational English Test (OET).

If you will be working as a doctor, dentist, nurse or midwife, you can use the test for your registration to meet the language requirement for your visa, but you must have achieved the required scores in your English language test before you apply for your visa.

Read guidance on proving your knowledge of English for your visa.

Pre-employment checks                                                         

Your employer will carry out pre-employment checks. The checks that they carry out will be dependent on the type of job you are going to do.

This will include checking your identity, qualifications and criminal records.

Qualifications from the European Economic Area (EEA)

If you got your healthcare qualifications in the EEA, you can work in the NHS without needing to sit additional exams or assessments due to the ‘standstill provisions’. The standstill provision will be reviewed in 2028.

Professional indemnity

You must have a professional, clinical indemnity arrangement in place as a condition of your professional registration. Professional indemnity is clinical negligence cover for any claims for patient compensation if they are harmed during treatment. When registering with your professional regulator you will be asked to confirm that you have (or will have) appropriate indemnity cover.

The state indemnity schemes for general practitioners, (Clinical Negligence Scheme for General Practice and NHS Trusts (Clinical Negligence Scheme for Trusts, cover the majority of healthcare professionals delivering NHS care. This means that you will be covered if a claim is made against you in an NHS role (there are some exceptions such as dentists).

If you will be working in private healthcare or in social care, you will need to check if your employer has appropriate indemnity arrangement to cover you.

If you are working through an agency, you may have to arrange your own indemnity cover though an insurer or medical defence organisation.

In all roles, it is your responsibility to check that your indemnity cover is appropriate and adequate for the risks and requirements of your professional practice.

Further information about indemnity can be found on professional regulators’ websites.

Employer support packages

The support provided will differ by employer. It’s important that you know what your employer is providing and what you’ll be expected to organise yourself.

This should include whether they’re paying for your visa or any of your relocation costs such as flights and accommodation. 

Before you arrive

Before you arrive in the UK you may receive:

• regular communication from the moment of the job offer, such as virtual meetings and introductions with your manager and colleagues
• support with relocation costs such as flights, accommodation, visa, and professional regulatory costs.  Ask your employer if you’ll be expected to pay back these costs and check your offer letter for the terms of repayment
• information about what you’ll need to bring or buy in the UK. For example, information about the climate, clothing and plug adaptors
• a chat group that connects you with other new recruits and the local team (such as on WhatsApp)
• information on trade unions and relevant diaspora associations (communities or networks of international health or care workers of the same nationality or culture)
• preparation activities organised by your employer with existing staff, so you’re welcomed and supported while you settle in

After you arrive

After you arrive in the UK you may:

• be met by your agency or employer at the airport and transport provided to accommodation
• receive a welcome pack with things to help you settle in
• receive a local guide to the area
• be supported to register with a general practitioner (GP) in your local area - this is the first person you go to for treatment if you have a health issue
• collect your biometric residence permit
• get support with applying for a National Insurance number if it’s not printed on the back of your biometric residence permit
• get support with opening a bank account
• get a salary advance of cash to ensure you have access to money (you will need to pay this back through deductions from your pay in the future)
• go on a local tour to familiarise yourself with the area: such as local shops, green spaces, places of worship, transport links
• be given a pre-paid travel card or help to purchase a travel card with your salary advance
• be given secure short-term accommodation
• get support to find longer term accommodation
• take part in a buddy scheme between local staff and new overseas recruits
• get information about local community networks

First few weeks at work

During your first few weeks at work, you can expect:

• to complete your employer’s corporate induction process including any mandatory training
• support in learning about the NHS or social care sector and the cultural and working differences
• guidance on regularly used terms and local dialect
• professional specific training and education, for example the Objective Structured Clinical Education programme, known as OSCE
• buddy and peer support arrangements
• to join a staff support group or a staff network group.
• to be given information about trade unions you can join for support

Read Part 2: living and working in the UK - what you need to know as a health and care worker for information on:

• worker exploitation and what to do about it
• arranging accommodation
• worker legal rights
• employment changes and your visa
• equality and inclusion in the workplace
• workplace pensions
• healthcare services
• organisations to support you during your employment

Annex A: repayment clauses and other costs to consider

You employer could include a repayment clause in your employment contract. This is an amount of money you will need to repay to your employer if you leave your job within a certain length of time. Check the amount you need to repay is not excessive and that it reduces over time.

The code of practice for the international recruitment of health and social care personnel in England, or the Scottish code of practice for the international recruitment of health and social care personnel sets out 4 principles you can check to ensure the repayment clause is fair.

If you’ve already signed a contract with a repayment clause, it is legally binding. It would be for a court or tribunal to state if any of the clauses are unenforceable or unreasonable and should be struck from the contract, leaving the rest of the contract to continue.

You can try to negotiate the repayment and agree a repayment schedule that works for both of you. However, the employer can refuse. If you’re in this situation and facing serious financial difficulty, or if you believe you were pressured into signing an unreasonable contract, you can seek advice from a trade union, relevant charity or a diaspora association. Information on organisations to support you is provided in ‘Part 2: living and working in the UK - what you need to know as a health and care worker’.

Recruitment process costs that may be met by an employer on your behalf

Some costs during the recruitment process might be paid by your employer on your behalf.

If your employer expects you to repay the costs met on your behalf, they should give you the option to repay the costs or expenses through a monthly repayment plan.

Costs they might pay include:

• Health and Care Worker visa fees
• tuberculosis test (if applicable)
• professional regulator application, registration and exam fees
• language test fees
• flights
• airport transfers
• accommodation

Annex B: contract checklist

Your employer has up to 8 weeks from your first day of your job to provide you with an employment contract. However, typically, you’ll be provided with it on the first day.

The BMA provides a contract-checking service free of charge for its members on the BMA website.

The Royal College of Nursing (RCN) includes clear and detailed advice on what to check in your contract on the RCN website .

Job title

Check the job title. Your job title is normally included in your employment offer letter. Check your job title is the same as in your employment offer.

Probation period

Employers often require new employees to complete a probationary period. Your continuity of employment should start on your first day of work, not when the probationary period has ended.

Check:

• whether you have a probationary period, how long it is and what support you’ll get during this time
• if there is any pay increase at the end
• if it can be extended
• whether the termination of contract arrangements differ during this period
• whether the employer has the right to terminate employment without reason during this period. Check the probation policy for details

Salary

Make sure the contract has the same salary that was in your offer letter. Employers do make mistakes and once signed it can be time consuming to resolve this. Your initial salary may be lower if you’re starting in a lower grade job until you get your professional registration.

Check:

• if the salary you’ve been offered is on a scale or if it’s a fixed salary
• if the salary is performance related - and if so, what the targets are and who sets them
• what your net salary will be (take home pay after tax and National Insurance are deducted)
• whether bonuses are guaranteed or discretionary
• what provisions there are for an annual pay rise
• about any other benefits that have been agreed, such as
  • an enhanced pension
  • car
  • private health cover
  • equity or share options
  • bonuses
  • commission payments

Annual leave and time off

You are legally entitled to a certain amount of leave. Read the holiday entitlement guidance to find out about the legal minimums.

If you’re employed on an NHS contract, you can read more about your NHS holiday entitlement in the NHS terms and conditions. 

Check:

• how much leave you’ll get and whether public holidays are included in this
• how to book annual leave
• whether you’re limited on when you can take leave - if you have holidays booked, tell your employer this before you accept the role
• when the holiday year runs from - in the NHS it’s normally 1 April to 31 March
• whether you can carry over any untaken holiday into the following year
• whether you’re entitled to carers’ or compassionate leave and whether this is paid or unpaid - this is sometimes referred to as ‘special leave’

Hours of work

Check the hours of work. Make sure your working pattern is reasonable and manageable. If you need different or flexible working hours, speak to your employer before signing a contract. You will need to work the number of hours required for your visa.

You cannot work more than 48 hours a week on average. This law is sometimes called the ‘working time directive’ or ‘working time regulations’. Find out more about maximum weekly working hours.

Your employer can ask you to work more than 48 hours a week on average, and if you agree, this is called ‘opting out’. You cannot be sacked or treated differently for refusing to do so, and you can change your mind even if it’s in your employment contract.

Check:

• your shift patterns and times. Check whether you need to look at adjustments through a flexible working application before you sign
• how long in advance you’ll receive your shift pattern (not all roles have fixed working patterns and can vary)
• if you’re required to do overtime, and if you’ll be paid for this. If you’re employed in the NHS, see section 3 of the NHS terms and conditions for overtime entitlements
• if there’s an opportunity to join a local agency bank (a pool of temporary staff to cover planned or unplanned shortages in the workforce) and what the terms and conditions are
• whether your employer will guarantee the hours needed for a Health and Care Worker Visa

Place of work and travel

Check:

• your place of work or your base and how far this is from your accommodation
• if you work in the community, what your contract says about:
  • travelling time to and from your base and whether you will be paid for this travel time
  • whether you’ll be provided with a lease car or you need to get your own car
  • whether you are reimbursed for business fuel costs or miles driven
• whether you are entitled to travel or petrol allowances when travelling to a temporary workplace
• if you can or will be expected to work remotely
• if the contract allows your employer to relocate you without your agreement - most  NHS contracts state they can move staff within the trust or board. This is known as a ‘mobility clause’

Start date and length of contract

Your start date should be clearly stated in an offer letter and on the contract. The contract should also include whether any previous employment counts towards your continuity of employment.

There will also be a termination date if it’s a fixed-term contract. If it’s a fixed-term contract, check if there are options for it to be extended and if your employer will notify you of this before end of the contract.

Sick leave and pay

You should check what the contract says about sickness absence and sick pay. Ask to see your employers’ sickness policy. Section 14 of the NHS terms and conditions covers sickness entitlement in the NHS.

Some employers will rely on statutory minimum requirements for sick pay, while others may pay more if you are unwell. The statutory minimum requirements can be supplemented with critical illness cover insurance to provide more support if you are unable to work due to illness.

Termination and notice periods

If you want to leave your job, you’ll normally need to give your employer warning. This is called your notice period. Check your contract to see the notice you have to give. More information on handing in your notice.  

Always notify your employer of resignation in writing.

Your notice period usually runs from the start of the day after you handed it in.

Repayment clauses

Some contracts contain repayment clauses which come into force if you decide to leave the employer. These can be time-specific but substantial. If you’re not happy with the clause, try to renegotiate, or turn down the job.

Find out more about repayment clauses in Annex A: repayment clauses.

Your employer’s other policies

Check if the organisation has the following workplace policies:

• uniform
• lease car
• flexible working
• disciplinary and grievance

Annex C: professional regulatory bodies

Nursing and Midwifery Council (NMC)

How to register with the NMC  

NMC: information for employers

General Medical Council (GMC)

How to register with GMC  

Information to help employers understand their obligations around employing and contracting with doctors

Health and Care Professions Council (HCPC)

How to register with HCPC

General Dental Council (GDC)

How to register with GDC

General Optical Council (GOC)

How to register with GOC

General Chiropractic Council (GCC)

How to register with GCC

General Osteopathic Council (GOsC)

How to register with GoSC

General Pharmaceutical Council (GPhC)

How to register with GPhC

Pharmaceutical Society of Northern Ireland (PSNI)

How to register with PSNI

Social Work England (SWE)

How to register with SWE

Scottish Social Services Council (SSSC)

Information about registering with SSSC

Information about careers and education

You can find information on the assessment of international qualifications (there are different processes for social workers and other social services workers):

Social workers with non-UK qualifications 

Non-UK social service qualifications

Social Care Wales

Contact Social Care Wales

Northern Ireland Social Care Council

Contact Northern Ireland Social Care Council 

Northern Ireland Social Care Council registration guides