Plan

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Before you begin internationally recruiting staff, you should undertake a period of planning, that can be done in conjunction with wider workforce planning.  

The planning aspect of international recruitment will help you identify draw together a working group, understand your vacancy position and identify your stakeholders.  It is a critical element of successful international recruitment and can take up to three months.  You might want to use this planning time to apply for your sponsorship licence if you do not already hold one.

Understanding International Recruitment

All international recruitment must be ethical, and with an understanding that projections indicate that by 2030 there will be a global shortage of around 10 million health and care workers. 

Therefore, active recruitment is prohibited from countries that the World Health Organization (WHO) recognise as having the most pressing health and care workforce-related challenges.

These countries are listed on the WHO health workforce support and safeguards list 2023 and are graded as red (these lists can be found here: https://www.gov.scot/publications/scottish-code-practice-international-recruitment-health-social-care-personnel-march-2023-revised/pages/10/)

Ethical international recruitment means not actively recruiting from red list countries. There is a global code of ethical practice developed by the WHO that can be found here: https://www.who.int/publications/i/item/wha68.32

To support health and social care employers in ethical recruitment, a list of recruitment organisations, agencies, and collaborations which operate in accordance with the Code of Practice is owned and updated by NHS Employers. 

Health and social care local employers and contracting bodies should only use recruitment organisations, agencies or collaborations who are on the Code of Practice Ethical Recruiters List. 

The list is maintained by NHS Employers and can be found here https://www.nhsemployers.org/articles/ethical-recruiters-list

Scottish Code of Practice

Scottish Code of Practice

In line with the WHO code of practice, any social care provider in Scotland undertaking international recruitment must adhere to the Scottish Code of Practice.

The Scottish Code of Practice has two aims:

  1. To promote high standards of practice in the ethical international recruitment and employment of health and social care personnel, and ensure all international recruitment is conducted in accordance with internationally agreed principles of transparency and fairness.
  2. To protect and promote the sustainability of health and care systems through international cooperation, by ensuring there are safeguards and support for countries with the most pressing health and social care workforce challenges.

The Scottish Code of Practice draws together a range of pertinent information to support providers in readying their internal environments for international recruitment and for understanding how to undertake ethical recruitment.  This includes important definitions for understanding the key elements of international recruitment such as:

  • Active International Recruitment – health and social care employers target individuals to market Scottish employment opportunities, with the intention of recruiting to a role in the Scottish health or social care sector.  
  • Direct Applicants - an individual makes an application directly and on their own behalf to an employing organisation. Direct applications do not use a third party, such as a recruitment organisation, agency, or collaboration.
  • Resident - the country an individual is living in when they apply for a health or social care job.
  • Employment Agency - a business that recruits candidates for vacant positions (permanent or temporary), for health and social care employers in need of personnel.
  • Recruitment Organisation - an organisation that recruits candidates to vacant positions (permanent or temporary) on behalf of a health or social care employer whether or not it is on a commercial basis.
  • Recruitment Collaboration -  a group of organisations that have partnered together to pool resources into a central system to recruit candidates for vacant positions within that collaboration, whether or not it is on a commercial basis
  • Employer - the person or organisation by whom an employee or worker is (or was), employed.
  • Contracting Body - health or social care providers who contract with health and social care personnel to provide a service, rather than employing them directly.

The Scottish Code of Practice details the scope, guiding principles and best practice benchmarks for international recruitment into health and social care in Scotland, as well as information on international health workforce vulnerabilities, including the WHO’s red list for international recruitment. 

The five guiding principles that underpin the Scottish Code of Practice, which any employer undertaking international recruitment must adhere to are:

  • International migration of health and social care personnel can contribute to the development and strengthening of health and social care systems if recruitment is managed properly.
  • Opportunities exist for individuals, organisations and health and care systems in relation to training and education and the enhancement of clinical practice.
  • There must be no active international recruitment from countries on the red list, unless there is an explicit government-to-government agreement with the UK to support managed recruitment activities that are undertaken strictly in compliance with the terms of that agreement.
  • Recruitment of international health and social care personnel is monitored and reported on to the Cross Whitehall International Recruitment Steering Group.
  • International health and social care personnel will have the same legal rights and responsibilities as domestically trained staff in all terms of employment and conditions of work. They will also have the same access to further education and training and continuing professional development.

It also includes the ethical recruiters list.  All information can be found here 

https://www.gov.scot/publications/scottish-code-practice-international-recruitment-health-social-care-personnel-march-2023-revised/pages/8/

International Recruitment: where to start?
planning

As well as adhering to both the WHO ethical framework for international recruitment and the Scottish code of Practice, there is a host of information that can help you with international recruitment workforce planning.  You can find some of these below.

Guidance on workforce planning to aid you in beginning your international recruitment journey can be found here:  Scottish Social Services Council (SSSC) – Workforce Planning and Development

Pre-employment and induction guides for employers

Understanding what will be needed before an employee joins your organisation and what expectations there will be for their induction when they do join will be important for succeeding in international recruitment.  One guide which offers helpful information is the NES, SSSC and Scottish Refugee Council joint publication ‘Pre-employment and Induction Guide for Employers of Overseas Workers, Refugees and Asylum Seekers’; the SSSC has also produced helpful resources on employing people from Ukraine.  Both offer advice on employing overseas workers, including refugees and asylum seekers  They can be found here

The Cost of International Recruitment

Many care providers have been struggling to find new employees in the social care sector. In fact, by the end of 2022, 47% of care providers reported vacancies, which is much higher than the 11% reported in other sectors. This is largely due to difficulties in recruiting from the domestic workforce pool. As a result, some employers are turning to international recruitment to fill the gaps in their workforce and grow the overall social care sector workforce in Scotland. However, there are additional costs associated with recruiting internationally, although these can be offset by reducing the cost of employing agency staff. A helpful guide has been created to provide information on the costs of international recruitment and who is responsible for paying them.

This guide is designed to help employers decide if international recruitment is the right option for their organisation.

The cost of recruiting into Scottish social care

Recruiting Directly or with a Recruitment Agency

When undertaking international recruitment, you may decide to go it alone using internal recruitment resources, or you may decide to use an agency to help your organisation with managing the whole of the recruitment process, or perhaps just specific elements of it.  To help you understand the pros and cons of each approach, take a look at this video https://vimeo.com/893331538

Any agency used as part of international recruitment must come from the Ethical Recruiters List | NHS Employers. This is a list of recruitment agencies that comply with the revised Code of Practice.  Always verify that the recruitment agency you are working with is on this list. To understand how you can utilise agencies within the process of international recruitment, CWSS has produced a guide to international recruitment agencies.   

Using a recruitment agency

Points-Based Immigration System

The Home Office (Future Borders Immigration System (FBIS) External Engagement) has produced an informative Q&A document concerning points-based immigration, ‘Social Care: Q&A – Points-Based Immigration System’.  The document covers most of the questions that you may have regarding points-based immigration BUT, it was released in February 2022 so there are some important changes and developments that you must be aware of when referring to it:

  • The minimum salary requirement for a Health and Care Visa has now increased from £20,480 to £20,960 per annum.
  • The minimum hourly rate for a Health and Care Visa has now increased from £10.10 per hour to £10.75 per hour.
  • The number of hours used to calculate the minimum salary has changed from 39 hours per week to 37.5 hours per week.
  • SOC 6145 (Care Workers and Home Carers) roles were automatically included onto the latest revision of the Shortage Occupation List (SOL), so references to temporary inclusion no longer apply.
  • Individuals on a Student Visa can no longer switch onto a Health and Care Visa unless they have completed their course of study.

To help you understand the UK’s points-based immigration system, becoming a sponsor and much more, CWSS have produced this guide that covers many of the key points around the process of recruiting overseas workers.

Certificates of Sponsorship

A Certificate of Sponsorship (CoS) must be assigned to every non-UK worker that an organisation employs, except those on a non-sponsored route, such as those with a Graduate Visa.  This guide provides a general overview of Certificates of Sponsorship and some tips for preparing the strongest possible application, but it should not be considered as legal advice.  For more details on any particular aspect of the CoS process, refer to the UK.GOV sites, ‘SMS Guides’, ‘UK Visa Sponsorship for Employers’ and other linked resources within the text.

Planning and Attraction
checklist

Attraction Checklist

Retention should be built into international recruitment strategies.  Organisations undertaking international recruitment need to think about what they can offer candidates in terms of career development and progression and pastoral support, as well as how they recognise and value all parts of their workforce, so that people can flourish within their organisations.  This is as important as pay, terms and conditions offered. A checklist of what this might involve can be found here:

Attraction Checklist

Asset Mapping

Key to attracting candidates is understanding what you as an organisation can offer them.  A vital element of this is understanding what your internal assets are as an organisation.  Asset mapping can be done to help you solidify your understanding of what the organisation offers.  It is usually done by organisations to understand the assets of their local community, but it can work well for organisations in developing and articulating their employee value proposition statements.

Asset mapping entails building knowledge and culture that is positive and focuses on what everyone can bring, rather than a deficit approach.   It recognises and builds on a combination of human, social and physical capital that exists within individuals, organisations, and communities, underpinned by attitudes and values related to personal and collective empowerment.

Traditionally asset mapping is used to identify and mobilise assets within individuals and communities; and is done in the context of positive change for health improvement.  Asset mapping will also be helpful for organisations actively undertaking international recruitment, because knowing what is in your local community will enable you to link your employees into local communities through their interest. 

Internal asset mapping – applying asset mapping methodologies and approaches to organisations to help identify and articulate organisational assets which can help foster cultural change and can be used in attraction strategies.

External asset mapping – mapping assets within local communities to foster positive change in health improvements.

Further information and tools to help you undertake asset mapping can be found here:

Accommodation for overseas workers

Social care is experiencing unique recruitment difficulties.  International recruitment is a potential pipeline to help grow the social care sector workforce in Scotland. 

If you decide to recruit internationally for social care roles, such as care workers and senior care workers, in Scotland, one of the greatest challenges that you are likely to encounter, is sourcing suitable temporary accommodation for your new recruits.  The Centre for Workforce Supply Social Care (CWSS) team considers employers providing up to 3-months accommodation for overseas workers as best practice.  This 3-month period provides employees with space to settle into their new life in Scotland, and to make their own, more permanent, arrangements.

The provision of 3-months of temporary accommodation is one of the critical factors in the quality of an internationally recruited employee’s experience, which in turn is a critical factor for longer-term retention.

There are several options available to an employer seeking to organise accommodation as part of their international recruitment strategy. CWSS have produced a guide Accomodation for overseas workers that contains many accommodation options that a care provider may wish to consider.  You can also view a video summary of the options.

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