What the RCN casework found

The Royal College of Nursing reviewed almost 400 adult social care cases handled between 2023 and 2025. It said most of the people represented were registered nurses and that more than half of the cases involved a demand to repay recruitment or employment costs. Most demands identified by the college were above £3,000, while the largest reached £25,000. The cases also included disputed pay, sponsorship being withdrawn and workers who felt unable to leave poor conditions because changing employer could affect both their immigration status and their finances. These figures describe people who reached RCN caseworkers. They are not a random sample of international recruits, care providers or the wider nursing workforce.1

Casework has a particular value even when it cannot measure prevalence. It contains contracts, correspondence and events serious enough for a worker to seek representation, allowing advisers to see how several pressures interact. A repayment demand may be difficult for any employee, but it can have greater leverage when the employer also controls visa sponsorship and the worker has limited time to find another sponsor. A pay dispute can reduce the money available to challenge a clause or relocate. The RCN characterised the pattern as exploitation and called for stronger enforcement. That description reflects the college’s assessment of cases it handled, not a legal finding that every employer or every clause in the dataset acted unlawfully.1

The reported £25,000 demand should not be treated as a normal price of international recruitment. Government guidance distinguishes costs that may legitimately be recovered under a fair agreement from business expenses that must not be transferred to the worker. A large figure also needs an itemised explanation. Without one, the employee cannot tell whether the sum represents training they received, travel or accommodation that was agreed, or prohibited items such as sponsorship administration and recruitment agency costs. A clause may appear in a signed contract and still conflict with the recruitment code, general employment law or rules on deductions. Signing is relevant evidence, but it does not turn every term into an enforceable debt.1

The college’s analysis also cautions against reducing the issue to a few unusually large bills. Smaller demands can trap workers whose earnings are low, especially when accompanied by underpayment, unexpected accommodation charges or threats to sponsorship. The practical effect depends on the person’s salary, family responsibilities, time in the role and ability to move. Good employers may use proportionate clauses for genuine expenses and release workers fairly. The policy question is how to distinguish that practice from a term designed to prevent departure. Itemisation, tapering over time, independent advice and a realistic route to challenge the amount provide more useful tests than the existence of a repayment clause alone.1

What the recruitment code says

England’s code of practice for international recruitment says overseas health and social care personnel should receive the same legal protections and terms as domestically trained staff. Where a repayment clause is used, it should be transparent, proportionate, time limited and flexible enough to account for individual circumstances. Prospective employees should receive the information before accepting the job, not discover it after arriving or when they resign. The code applies ethical standards to recruiters and employers, but it is not a substitute for legal advice on an individual contract. Its importance lies in setting an official benchmark against which recruitment conduct, contract wording and the response to a worker who needs to leave can be examined.2

Recoverable costs should be genuine expenses incurred for the individual and should be clearly itemised. The code says employers should not pass on the immigration skills charge, sponsor licence fee, certificate of sponsorship fee, interview costs or recruitment agency fees. These are costs of the employer’s recruitment and sponsorship activity. A clause that bundles them into a single unexplained amount prevents meaningful scrutiny. Workers and representatives can ask for the original agreement, a calculation showing each item, evidence that the expense was incurred and an explanation of the remaining balance. An employer may have a legitimate cost in the list, but that does not validate unrelated or inflated items included beside it.2

The guidance expects repayment to reduce over time because the employer receives the benefit of the worker’s service. It gives a tapering example in which 100 per cent may be due in the first year, 50 per cent in the second, 25 per cent in the third and nothing after 36 months. That example is not a mandatory formula for every contract. It illustrates proportionality and the need for a clear end point. The code also says interest should not be charged and that a repayment plan should be available. A five year clause demanding £14,000 in the scenario set out by government is described as inconsistent with the code because of its duration and scale.2

Flexibility matters when departure follows conditions outside the worker’s control. The code says employers should consider waiving repayment in circumstances such as bullying, poor working conditions, health needs or a move for career progression. A fair process must let the worker explain what happened before a demand is finalised. It should not require them to remain in an unsafe setting merely to avoid debt. Records of grievances, rotas, payslips, occupational health advice and attempts to resolve problems may become important. Employers should make the decision at an appropriate level, document the reasons and allow review. Automatic recovery through a final salary deduction can bypass those safeguards and may create a separate dispute about lawful deductions.2

Sponsorship changes the balance of power

A sponsored worker who loses a job may need to secure a new eligible role and update their immigration position within a limited period. That dependency can make ordinary workplace choices much harder. Raising a grievance, refusing extra hours or resigning may be weighed against the risk of losing income and permission to remain. Family members may also depend on the worker’s status. Employers have legitimate compliance duties as sponsors, but sponsorship must not be used as a threat to stop staff exercising workplace rights. Communications about visa consequences should be accurate, measured and separated from decisions about performance, discipline or repayment wherever possible.1, 3

Government guidance for overseas applicants advises people to understand the contract, salary, working hours, location, accommodation and any repayment terms before travelling. In practice, documents can be lengthy and a worker may be dealing with an agency, employer and immigration process at the same time. A verbal assurance should not replace the written offer. Applicants can ask which organisation will employ and sponsor them, whether hours are guaranteed, what deductions will appear, and what happens if the role or promised accommodation is unavailable. They should keep copies of adverts, messages, receipts and each version of the contract. Those records may later show what was represented before money was spent or a move was made.1, 3

A certificate of sponsorship is not a personal favour that allows an employer to disregard employment standards. Sponsored staff remain entitled to the National Minimum Wage where applicable, contractual pay, lawful deductions, rest and protection from discrimination. The correct pay rate also matters for immigration compliance. Problems should be raised early, but workers may understandably fear retaliation. Trade unions, Citizens Advice, Acas and specialist immigration advisers have different roles. Employment advice does not automatically resolve a visa question, and immigration advice must come from an appropriately regulated person. Coordinating both can prevent a step in one process from creating an avoidable problem in the other.1, 3

The RCN said it had encountered more than 100 cases involving sponsorship withdrawal since 2023 in related social care work. That number again reflects referrals rather than the total incidence. It nonetheless points to the need for a safe transfer route when a provider closes, loses its sponsor licence or ends employment. National and local bodies can share vacancies and explain procedures without steering workers towards another unsuitable employer. A transfer process should verify the new role, pay, location and sponsor rather than treating any placement as a solution. Speed is important, but so is preventing a person who has already experienced poor recruitment from entering the same arrangement again.1, 3

How to examine a repayment demand

The first step is to establish exactly what is being claimed. The worker should obtain the signed contract, separate repayment agreement, policies incorporated into it, itemised calculation and evidence of the expenditure. Dates matter because different versions may have been issued before and after arrival. The amount should be compared with the taper promised in the agreement and the time actually worked. Any salary deduction should be checked against the contract, payslip and written consent rules. A demand from a debt collector does not remove the right to dispute the basis or sum. Workers should avoid acknowledging liability they do not understand and should seek advice promptly because legal time limits may apply.2, 3

The second step is to identify costs that the recruitment code says should not be charged. Sponsor licence administration, certificates of sponsorship, the immigration skills charge, agency recruitment and interview expenses require particular scrutiny. Training costs need detail about what was provided, its actual price and whether it was mandatory for the employer’s own compliance. Accommodation and travel require the same evidence and should match what was agreed. A round number described only as recruitment costs is not transparent. Even a genuine expense can be disproportionate if the charge bears little relation to the benefit received, lasts too long or ignores substantial service already given.2, 3

The circumstances of departure form the third part of the assessment. A worker leaving after serious underpayment, bullying, unsafe conditions, illness or a fundamental change to the promised job is not in the same position as someone who freely leaves soon after receiving costly optional training. The code expressly supports flexibility, and other legal arguments may be relevant. Evidence can include complaints, witness accounts, rota records, bank statements, care quality concerns and messages asking the employer to act. The worker should preserve originals and create a dated chronology. That helps an adviser understand the relationship between the employment problem, resignation, sponsorship action and repayment demand.2, 3

The final step is to choose an appropriate route. An internal grievance may produce the calculation or waiver, while a union representative can negotiate and assess employment claims. Acas can explain rights and is involved in early conciliation before many tribunal claims. Regulators and sponsor compliance teams may need information about wider misconduct, but reporting to them will not necessarily recover wages or stop a particular deduction. Urgent immigration advice is essential if sponsorship has ended or correspondence from the Home Office arrives. No single organisation handles every part. A clear record of referrals and deadlines helps prevent the worker being passed between services while time runs out.2, 3

What employers and commissioners should change

Responsible employers can audit every repayment agreement against the current code rather than waiting for a dispute. The audit should remove prohibited costs, require itemisation, set a short and explicit taper, ban interest and describe a fair waiver process. Recruitment partners should be checked against the same standards, because outsourcing does not remove responsibility for what applicants are told. Contracts and explanations should be available in accessible language, with time for independent advice before signature. Managers who handle resignations need authority to pause recovery when there is a grievance or safeguarding concern. Payroll should not make a deduction merely because a template clause exists.1, 2

Pay governance needs equal attention. Employers should compare advertised, sponsored, contracted and paid rates, investigate missing hours or deductions and make corrections with a clear breakdown. Rosters and payslips should allow a worker to see how the payment was calculated. Accommodation supplied by an employer needs written terms and lawful charges. Staff must be able to report concerns without threats concerning their visa, housing or references. Training for managers should cover both sponsorship responsibilities and the limits of their role. They should not give improvised immigration advice or suggest that raising a safety concern puts lawful status at risk.1, 2

Commissioners and public bodies purchase a substantial amount of adult social care and can place ethical recruitment requirements in contracts. Assurance should go beyond asking whether a provider has a policy. It can sample repayment terms, examine staff turnover and grievances, and require remediation where recruitment partners charged improper fees. Commissioners must design this proportionately and avoid creating an inspection exercise that discourages providers from recruiting internationally. The goal is a level field in which services that budget for fair employment are not undercut by organisations transferring recruitment costs and risk to individual workers.1, 2

The RCN evidence does not show that exploitation defines all international recruitment or all social care employment. Overseas nurses are a major part of the workforce, and many employers provide lawful, supportive jobs. The casework shows where safeguards fail and why a worker’s apparent agreement cannot be considered apart from pay, sponsorship and the ability to leave. Better clauses are necessary but insufficient if enforcement is inaccessible. A credible response combines transparent contracts, accurate payroll, independent advice, sponsor accountability and continuity routes for people whose employment ends. That would reduce the leverage of debt without preventing employers from recovering a genuinely agreed and proportionate expense.1, 2