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Overseas nurses tied to jobs by threat of penalties if they leave

Nurses trapped in contracts making them liable to pay thousands of pounds if they try move jobs, with some employers frightening them with threats of deportation
Picture shows a young female Asian nurse staring at a wall and looking sad

Nurses trapped in contracts making them liable to pay thousands of pounds if they try move jobs, with some employers frightening them with threats of deportation

Picture shows a young female Asian nurse staring at a wall and looking sad
Picture: iStock

Some NHS and private employers are imposing contractual clauses on overseas nurses that punish them if they try to leave their role – a practice the RCN has warned ‘flourishes in a climate of chronic understaffing’.

There have also been reports of employers trying to frighten nurses into staying in their roles through threats of deportation.

An investigation by the Observer newspaper has uncovered a practice of trapping international nurses in their jobs through contractual clauses that require them to pay thousands of pounds to cover recruitment costs should they wish to leave.

RCN urges employers to work with the union to tackle the reasons nurses want to leave

RCN England director Patricia Marquis said the college is ‘very concerned’ about the practice. ‘We are aware some employers include punitive clauses in the contracts of employment for overseas workers. This can result in healthcare staff being forced to pay thousands if they decide they want to work elsewhere if their visa allows.

‘We have also heard of cases in which employers try to frighten and intimidate staff with threats of deportation should they choose to work elsewhere.’

RCN England director Patricia Marquis
Patricia Marquis

Ms Marquis called on the government and employers to work with the union to instead tackle the reasons many nurses want to leave, including poor pay, unsafe staffing and practices that ‘devalue our hard-working nursing staff’.

The Observer found that in extreme cases some nurses were tied to their jobs for five years and faced fees as high as £14,000 if they wanted to change jobs or return home early.

The fees are designed to recoup recruitment costs, often covering flights to the UK, visas and fees for taking the relevant Nursing and Midwifery Council (NMC) exams.

International recruitment more sustainable than relying on agency staff, says Nuffield Trust report

Overseas recruitment has significantly ramped up during COVID-19, with international recruitment expected to deliver between 51,000 and 57,000 more nurses by 2024, according to Department of Health and Social Care (DHSC) figures.

One contract at a trust in the east of England, seen by the Observer, states that international nurses must repay ‘costs related to [their] recruitment’ if they leave within three years. Those leaving within 18 months are expected to repay 100% of the costs.

It costs around £10,000 to £12,000 to recruit an international nurse, compared with at least £26,000 that the government typically spends on a single nurse training post.

According to a Nuffield Trust report into nursing recruitment, a more sustainable model is offered by international nursing recruitment than reliance on agency staff. The report said: ‘Any initial savings by filling the post instead with an agency nurse would typically be exceeded by the cost of the likely higher hourly rate of agency staff within six months to two and a half years.’


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