Employers should consider waiving controversial repayment clauses for internationally recruited nurses in certain situations, new government guidance has said.
An updated Code of practice for the international recruitment of health and social care personnel in England now states that where the health and wellbeing of a recruit is being affected, or where a member of staff leaves their job because of bullying or discrimination, the employer should consider not triggering repayment clauses.
“This will be welcomed by all overseas-trained nurses and may motivate more people to come”
In addition, the updated guidance sets out for the first time a set of principles on the use of repayment clauses in employment contracts for health and social care staff recruited from abroad.
It states that any such clause must be made clear by employers in a job offer letter and explained to the candidate before the job is accepted.
Changes to the guidance, published on 2 August, follow concerns expressed over such repayment clauses, which have seen nurses locked into “exploitative” contracts and forced to pay thousands of pounds to their employer if they want to leave their job.
An investigation published by the Observer in March this year found contract clauses being used by both NHS employers and care homes that forced nurses who had moved from overseas to pay large sums to cover their joining costs if they left before a certain length of service.
The newspaper reported that the most extreme contracts tied nurses to their roles for up to five years and included fees as high as £14,000 for those who wanted to leave early.
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In its new guidance, the government explained: “Repayment clauses may be used in health and social care employment contracts to recover some of the upfront costs that the employer has invested in recruiting health or social care personnel if they leave employment within a given period.”
Through its latest update, it said it had strengthened best practice benchmarks, including by setting principles on the use repayment clauses in employment contracts.
Now, any repayment clause included in an employment contract must abide by the four principles of: transparency, proportionate costs, timing and flexibility.
For example, it states that a repayment clause “must be set out in the contract or job offer and explained in full to the candidate before the job is accepted” and that “only genuine, evidenced, auditable expenses incurred can be reclaimed”.
In addition, the guidance notes that employers must make clear how the costs will be recouped and states that cash payments are not acceptable.
Costs must only include expenses met by the employer such as relocation expenses and visa fees and rechargeable costs must taper down with the amount of time a member of staff spends in their job, it added.
The guidance also states that employers must be flexible on when they levy any repayment clause, including considering waiving the charge if a recruit’s personal circumstances change in a way that is beyond their control, or if the member of staff wants to leave to further their career. This should also be considered where the nurse is leaving due to bullying, discrimination or poor working conditions, or where their health and wellbeing is being adversely impacted.
Responding to the update, British Indian Nurses Association general secretary, Suresh Packiam, told Nursing Times: “This will be welcomed by all overseas-trained nurses and may motivate more people to come, but how far it goes is the big question.
“How are employers are going to be held accountable? We need some form of monitoring because we have seen so many disparities between organisations in how they use these clauses.
“It’s clear that the government has listened to us, but we will have to see how this works on a case-by case-basis once it is implemented.”
Meanwhile, Royal College of Nursing general secretary and chief executive Pat Cullen, said: “The horrendous practice of international nurses being charged excessive fees to change jobs in the UK must end.
“Measures like requiring employers to produce evidence to support any charges are a step in the right direction.
“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.”