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Crackdown on punitive fees for overseas nurses trying to move jobs

Welcome for move to end ‘horrendous’ practice by rogue employers who try to impose unfair fees on overseas nurses to prevent them from leaving
Image of a wall with a hole torn in it exposing the words 'No hidden fees'

Welcome for move to end ‘horrendous’ practice by rogue employers who try to impose unfair fees on overseas nurses to prevent them from leaving

Image of a wall with a hole torn in it exposing the words 'No hidden fees'
Image: iStock

NHS and private employers will now have to provide evidence for contractual fees that punish overseas nurses who try to leave their jobs.

Under new guidance from the Department of Health and Social Care (DHSC), employers will have to ensure greater transparency of costs linked to recruitment, relocation expenses and visa fees.

Any repayment fee expected to be met by overseas nurses must be explained in full before a job is accepted, an itemised list of costs to be reclaimed should be supplied and evidence must be provided that nurses did not begin repaying the costs before arriving in the UK.

Only genuine, evidenced, auditable expenses incurred can be reclaimed, the guidance states.

Nurses can no longer be forced to pay back agency and sponsor fees that some employers demanded

Employers can also only claim back ‘proportionate costs’ such as relocation expenses, visa fees and regulatory exam fees. All other costs including the agency fee, sponsor fees and costs related to the interview process must be paid by the employer.

The changes come after it was revealed that some NHS and private employers were trapping overseas nurses in their jobs through contractual clauses that required them to pay thousands of pounds to cover recruitment costs should they wish to leave.

The UK currently relies heavily on international recruitment, which was ramped up significantly during COVID-19. International recruitment is expected to deliver between 51,000 and 57,000 more nurses by 2024, according to DHSC figures.

Latest NMC registration data shows that almost half (48%) of last year’s 48,436 first-time joiners trained overseas, with the majority recruited from the Philippines, India, Nigeria, Zimbabwe and South Africa.

RCN welcomes move to end ‘horrendous practice’ in which rogue employers harass nurses

RCN general secretary Pat Cullen said the updated guidance was ‘a step in the right direction’.

‘The horrendous practice of international nurses being charged excessive fees to change jobs in the UK must end,’ she said. ‘Employers must respect and apply these new rules and the UK government must clarify how it will ensure they are enforced, especially in the independent sector, where nurses and support workers frequently face harassment from rogue employers.’

Other measures put in place to ensure fairness for overseas nurses include flexibility around when costs can be recouped, with employers told to assess on a case-by-case basis.

Repayment clauses should be waived in cases where the health and well-being of a nurse is being adversely impacted or they leave due to bullying, discrimination or poor working conditions, their circumstances have changed beyond their control either in the UK or their home country, or if they are moving on for career progression.

A DHSC spokesperson said: ‘The updated code of practice sets out stringent ethical standards that employers should follow when recruiting health and social care staff from overseas.’

They said any cases of disproportionate or punitive costs should be reported to the Gangmasters and Labour Abuse Authority, a government agency that protects vulnerable and exploited workers.


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