The United Kingdom has recently amended its ‘Code of Practice for the international recruitment of health and social care personnel in England,’ following the release of the World Health Organisation Workforce Support and Safeguard List 2023. This development has generated a considerable amount of attention and uncertainty, particularly among Nigerian health workers. Contrary to certain claims, the UK government has not prohibited Nigerian health and care professionals from working in the UK. Rather, the updated code seeks to improve the recruitment process and guarantee ethical practices in international hiring.

Context of the updated list

The UK government has acknowledged an estimated global deficit of 10 million health workers required to achieve universal health coverage in low and lower-middle-income countries by 2030. Consequently, it has revised its code of practice to ensure quality health care for its citizens and the rest of the world. The health worker shortage in Nigeria has been exacerbated by brain drain, as numerous skilled health workers move to the UK, US, Canada, Australia, and other developed countries in search of better opportunities. Under the updated code, hiring health and care professionals from specific countries on the red list will be subject to certain restrictions. However, being on the red list does not preclude health workers from being recruited from a country; it merely implies adherence to particular guidelines and limitations.

Decoding the code

The updated code primarily concentrates on the concept of ‘active international recruitment.’ Active international recruitment refers to the process by which UK health and social care employers (including local authorities), contracting bodies, recruitment organisations, agencies, partnerships, and subcontractors target individuals to promote UK employment opportunities. The aim is to recruit individuals for positions in the UK health or social care sector. Active international recruitment may involve advertising to candidates through any medium, offering incentives such as referral bonus schemes, and directing candidates to specific UK vacancies in exchange for a fee from the employing organisation.

Exemptions to the definition of active International recruitment

It is crucial to recognise that there is an exemption to the definition of active international recruitment. If a candidate has already been appointed by a UK employer following an independent direct application and selection without the assistance of a recruitment organisation, agency, or partnership, these organisations can facilitate and support the employee’s journey to the UK. In such cases, it is the responsibility of the recruitment organisation, agency, or partnership, if challenged, to provide evidence that the services they offer are allowed under this exemption.

What does this mean for Nigerian health workers?

The updated code does not preclude Nigerian health workers from pursuing employment in the UK. However, they must be aware of the specific guidelines and limitations that apply to their recruitment. For Nigerian health workers, it is crucial to understand that the code’s provisions do not impose a complete ban on their employment opportunities in the UK.

A statement by the NHS Employer, an employers’ organisation for the NHS in England, confirmed that: “The list doesn’t prevent individual health and social care personnel from independently applying to health and social care employers for employment in the UK, of their own accord and without being targeted by a third party, such as a recruitment agency or employer (known as a direct application).”
Nigerian health and care professionals can still be employed in the UK under the updated code, provided they follow the appropriate recruitment channels and meet the necessary requirements. This involves applying for positions directly through UK employers, who can then facilitate their passage to the UK. Alternatively, health workers can seek the support of approved recruitment organisations, agencies, or partnerships that comply with the code’s guidelines and limitations.

Understanding the legal aspects of international recruitment

It is vital for health workers to be aware of the legal aspects of international recruitment when seeking employment in the UK. In accordance with the Employment Agencies Act 1973, it is unlawful for recruitment organisations of any kind to charge individual applicants fees for job-finding services. Nigerian health workers should ensure that they do not fall prey to dishonest recruitment agencies that may try to take advantage of their desire to work in the UK.
Moreover, health workers should familiarise themselves with relevant visa requirements and immigration laws applicable to their situation. This may involve applying for a Skilled Worker visa, which is the most common pathway for skilled workers seeking employment in the UK. It is essential to research and comprehend the eligibility criteria, such as having a valid Certificate of Sponsorship from a UK employer and meeting the appropriate salary threshold.
However, given the seemingly complex nature of foreign job opportunities for non-immigration professionals, many health workers may struggle to distinguish between what constitutes ‘active recruitment’ and what does not.
Addressing that concern, an immigration lawyer and partner at the Immigration Advice Service, United Kingdom, John Cahill, advised that, “if anyone is unsure about their options and would still like to know if they have work opportunities in the UK, they should seek legal advice and assistance with their application.” These professionals can provide expert guidance on the application process, required documentation, and potential pitfalls to avoid.
Additionally, certain practical tips can also help ensure a successful outcome. These include setting aside time to thoroughly research potential employers and vacancies in the UK health and social care sector. When doing this, it is best to use reliable sources, such as the NHS Jobs website or reputable recruitment agencies that adhere to the updated code. Applicants should prepare a compelling CV and cover letter that emphasise their skills, qualifications, and experience relevant to the position they are applying for. It is of utmost importance to tailor their application to each specific job. They should also prepare well for interviews, whether in-person or virtual, by researching the organisation, practising common interview questions, and being ready to demonstrate their knowledge, skills, and passion for the role. It is equally instructive to stay informed about the latest developments in UK immigration law and policy, as well as changes to the updated code that may affect their eligibility for employment.