Guidance

Code of practice for the international recruitment of health and social care personnel

Sets out the principles and best practice benchmarks health and social care employers and recruitment agencies must follow to ensure effective, ethical international recruitment.

• From: Department of Health and Social Care
• Published: 25 February 2021
• Last updated: 27 March 2025
  Show all updates

  1. 27 March 2025

     Updates include the removal of the foreword, amendments to add further clarity and streamline the guidance, and the addition of 2 new scenarios and 2 new case studies.

  2. 2 September 2024

     Added new contact details for the Employment Agency Standards Inspectorate.

  3. 23 August 2023

     Updated email address for reporting code breaches to: internationalrecruitment@nhsconfed.org.

  4. 23 March 2023

     Updated to align the code red list with the recently updated WHO Health Workforce Support and Safeguards list. Other minor updates include: making it a condition of the benchmark on information provision that the guidance on applying for a health or social care job in the UK from abroad is provided to international candidates at the earliest opportunity; clarifying that appointment of healthcare professionals onto foundation and specialty training programmes is outside the scope of the code; making it mandatory for organisations on the ethical recruiters list to respond to the NHS Employers biannual survey on international recruitment activity; and improving and streamlining the process for code contraveners.

  5. 22 August 2022

     Following the publication of a government-to-government agreement between the UK and Nepal, Nepal has been moved from the red to the amber list of countries. The agreement has been signed on the basis that the active recruitment of health and social care workers from Nepal to the UK will begin with an initial pilot phase, during which active recruitment activity is limited to Hampshire Hospitals NHS Foundation Trust and its partners. No other UK employer or recruitment agency should carry out active health and social care worker recruitment activities in Nepal.

  6. 2 August 2022

     Updated to strengthen best practice benchmarks including the setting of principles on the use of repayment clauses in employment contracts; set out the routes of escalation for concerns about exploitative recruitment or employment practices and breaches of the code; clarify how the code applies to different international recruitment models; and expand scenario examples on how the code applies in practice. The 'Agency list' has also been widened to include all organisations recruiting on behalf of another ​and renamed the 'Ethical recruiters list'.

  7. 11 November 2021

     Updated to reflect the decision to add Kenya to the 'amber' list of countries in the code of practice. Wording has been amended to make it clearer that an amber country is any country where managed international recruitment is permitted only on the terms of a government-to-government agreement.

  8. 25 February 2021

     First published.

Documents

Code of practice for the international recruitment of health and social care personnel in England

HTML

Details

The code of practice promotes high standards of ethical practice in the international recruitment and employment of health and social care personnel. It also sets out the UK’s approach to supporting health and social care systems and workforce, alongside safeguards to prevent active recruitment from countries facing the most critical shortages in healthcare professionals needed to achieve universal health coverage.

While the code of practice is UK policy, specific codes exist for Northern Ireland and Scotland to reflect the different organisational structures. Wales follows England’s code. It is aimed at all health or social care organisations or recruitment agencies undertaking international recruitment.

It is based on the principles set out in the World Health Organization (WHO) Global Code of Practice on the International Recruitment of Health Personnel. It refers to the WHO Health Workforce Support and Safeguards List as the red list of countries that must not be actively targeted by health or social care recruiters unless there is a government-to-government agreement in place to allow managed recruitment on the terms of the agreement.

See also the collection page on government-to-government agreements on health and social care workforce recruitment for details of agreements between the UK and partner countries. The collection page will be updated regularly as new government-to-government agreements are signed. It is recommended that employers, contracting bodies and recruitment agencies regularly check the collection page for updates.