Resolution: Ethical overseas recruitment

This resolution passed.

Members can view a recording of the debate here.

International recruitment should be conducted ethically, in line with the principles set out in the UK (Department of Health and Social Care, 2021; Scottish Government, 2021) and Global Codes of Practice (World Health Organization, 2021). It must be transparent, dignified and ensure that employment of nursing staff in the UK is free from exploitation. International nursing staff face a range of issues throughout the recruitment process that both employers and governments must work to address.

At present, there are 131,640 international nurses on the NMC register, and international recruitment continues to be pivotal to the UK Government’s plans to fill workforce gaps (Department of Health and Social Care, 2022). NHS England’s delivery plan for tackling the COVID-19 backlog included a target to recruit more than 10,000 international nurses in the last financial year alone (NHS England, 2022).

An International Council of Nurses (ICN) report raised concerns that international recruitment by some high-income countries during the pandemic could undermine the ability of some source countries to respond effectively to the pandemic (ICN, 2022). The RCN is concerned by the number of nurses joining the NMC register from countries identified as having severe health workforce shortages where active recruitment is not permitted’ (World Health Organization, 2020). The UK should work to introduce bilateral agreements, with the involvement of national nursing associations, to ensure recruitment is mutually beneficial for these countries.

The RCN has heard from a number of internationally recruited members who are tied into contracts through early-exit fees, and in some cases intimidated by their employers into repaying them through threats of deportation. These fees (reported to be as high as £14,000), may pressure workers to remain within contracts.

RCN members also report difficulties in bringing family members to the UK through sole responsibility and adult dependent relative routes, due to the amount of evidence that is required by the Home Office. The RCN is concerned that workers are misled by recruiting agencies that the immigration system is easier to navigate than it is, which reduces the ability to make informed choices.

Internationally trained nursing staff must have the same access to continuing professional development as their domestically trained colleagues. They should be supported to work to the full extent of their capabilities and enhance their knowledge and skills during their employment in the UK. This ultimately leads to retention, a sense of belonging, and professional fulfilling of one’s true potential.

Reading lists for each agenda item can be found here.

References

Department of Health and Social Care (2021) Code of practice for the international recruitment of health and social care personnel in England. Available at: https://www.gov.uk/government/publications/code-of-practice-for-the-international-recruitment-of-health-and-social-care-personnel/code-of-practice-for-the-international-recruitment-of-health-and-social-care-personnel-in-england (Accessed 21 April 2022).

Department of Health and Social Care (2022) 50,000 nurses programme: delivery update. Available at: https://www.gov.uk/government/publications/50000-nurses-programme-delivery-update/50000-nurses-programme-delivery-update#retention  (Accessed 21 April 2022).

International Council of Nurses (2022) Sustain and retain in 2022 and beyond: The global nursing workforce and the COVID-19 pandemic. Available at: https://www.icn.ch/system/files/2022-01/Sustain%20and%20Retain%20in%202022%20and%20Beyond-%20The%20global%20nursing%20workforce%20and%20the%20COVID-19%20pandemic.pdf (Accessed 21 April 2022).

NHS England (2022) Delivery plan for tackling the COVID-19 backlog of elective care. Available at: https://www.england.nhs.uk/coronavirus/publication/delivery-plan-for-tackling-the-covid-19-backlog-of-elective-care/ (Accessed 21 April 2022).

Scottish Government (2021) Scottish code of practice for the international recruitment of health and social care personnel. Available at: https://www.gov.scot/binaries/content/documents/govscot/publications/advice-and-guidance/2021/02/code-practice-international-recruitment-health-social-care-personnel/documents/scottish-code-practice-international-recruitment-health-social-care-personnel/scottish-code-practice-international-recruitment-health-social-care-personnel/govscot%3Adocument/scottish-code-practice-international-recruitment-health-social-care-personnel.pdf  (Accessed 21 April 2022).

World Health Organisation (2020) Health workforce support and safeguards list, 2020. Available at: https://cdn.who.int/media/docs/default-source/health-workforce/hwf-support-and-safeguards-list8jan.pdf?sfvrsn=1a16bc6f_5 (Accessed 21 April 2022).

World Health Organisation (2021) WHO global code of practice on the international recruitment of health personnel: national reporting instrument 2021. Available at: https://www.who.int/publications/m/item/nri-2021 (Accessed 21 April 2022).