International Recruitment Global Scheme

Recruitment Process

April 2003

International Recruitment Global Scheme

Recruitment Process

April 2003

Contents

Flowchart of the international recruitment process TMP Send CVs in relevant specialty Register vacancy with TMP Worldwide via the website Trust notify TMP they are interested Extra support package available Trust to contact the candidate to discuss opportunities Invite doctor to visit the trust Advertise post Sift, invite suitable candidates and send occupational health form to candidate Processing application forms Shortlisting of candidates AAC/visit to trust if not done earlier The Advisory Appointments Committee Selecting the AAC Membership of AACs Assess level of English language support the doctor will need Doctors outside the EEA Doctors from the EEA Linguistic Centres Conditional offer subject to GMC registration, police checks, occupational health How to register as a permanent consultant within the UK EEA Candidates Non-EEA Candidates GMC/STA confirm registration Police Check Criminal Records Bureau Overseas Information Service Apply for work permit (non-EEA nationals only) Occupational health check

1 2 2 2 2 4 4 4 5 5 5 6 6 6 7 7 7 7 8 8 8 8 9 10 10 12 13 13

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International Recruitment Global Scheme Unconditional offer Terms and conditions of employment NHS Pensions NHS Housing Initiative Contracts Arrange induction and language support General Induction Induction into Clinical Practice Not Directly Clinical but relevant induction Arrange National Insurance interview Induction and ongoing language support Mentorship and Appraisal Pastoral Support Social and Professional Networks Continuing Professional Development Contacts 14 14 14 14 14 15 15 16 16 17 17 17 18 18 18 19

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Identify post for international recruitment

1. Register vacancy with TMP via the website (www.doh.gov.uk/international-recruitment)

2. TMP send CVs in relevant specialty

3. Trust notify TMP they are interested

4. Extra support package available

5. Trust to contact the candidate to discuss opportunities

Interested

Not interested

6. Invite doctor to visit the trust (optional). TMP can assist with this

Flowchart of the International Recruitment Process

7. Advertise post

8. Sift, invite suitable candidates and send occupational health form to candidate

9. AAC/visit to trust if not done earlier. TMP can assist with this Suitable

10. Assess level of English language support the doctor will need
Not suitable

11. Conditional offer subject to GMC registration/specialist register, police checks, occupational health

12. GMC/STA confirm specialist registration. TMP can assist with this

13. Police check. TMP can assist with this

15. Occupational health check TMP can assist with this.

14. Apply for work permit (non EEA nationals only). TMP can assist with this

16. Unconditional offer Inform TMP offer has been made 19. Arrange National Insurance interview for week doctor arrives

17. Terms and conditions of employment

18. Arrange induction and language support

Doctor arrives

20. Induction and ongoing language support

21. Continuing Professional Development

International Recruitment Global Scheme

1. Register vacancy with TMP via the website (www.doh.gov.uk/internationalrecruitment)

The Department launched a global recruitment campaign in September 2001, to identify doctors interested in working in England either as consultants or GPs. The campaign targets shortage specialities and specialities where significant expansion is needed. The project is handled by a response management agency, TMP Worldwide1, who were appointed by the Department of Health to produce a database of potential recruits. The database will hold information of sufficient detail to allow trusts to be confident that the applicant should be considered for a vacancy. Interested employers with funded vacancies can register their vacancies with the Department of Healths electronic mailbox (international.recruitment@doh.gsi.gov.uk). A template for completion by employers who wish to register vacancies is available on the International Recruitment website (www.doh.gov.uk/internationalrecruitment).

2. TMP send CVs in relevant speciality.

Once your vacancy is registered you will receive an acknowledgement from TMP Worldwide who are working with the Department of Health on this initiative. TMP Worldwide will send you details of candidates who are suitable for your vacancy once they have been accepted onto the specialist register, or who are already engaged in the process (in the case of EEA doctors), along with further information about how to proceed.

3. Trust notify TMP they are interested

It is important that you keep TMP Worldwide informed of progress with the recruitment exercise or inform them if vacancies are filled from other sources to enable them to keep accurate records. It is also important that TMP receive feedback on the suitability of candidates so they can take account of this when matching other posts.

4. Extra Support Package available

The Department of Health has been working with TMP Worldwide to assist doctors through the first part of the process - obtaining specialist registration and identifying suitable vacancies that they may wish to apply for. To assist trusts and doctors through the remainder of the recruitment process, the Department is working with TMP Worldwide and Phoenix ARC, the relocation company who currently support the International Fellowship Scheme, to provide an enhanced service. This service will be funded by the Department and aims to reduce the administrative burden on trusts who are recruiting consultants. EXTRA SUPPORT FOR TRUSTS WHO WISH TO RECRUIT CONSULTANTS THROUGH THE INTERNATIONAL RECRUITMENT CAMPAIGN Recruiting consultants from abroad is a complicated and lengthy process. The Department of Health has been working with TMP Worldwide to assist doctors through the first part of the process obtaining specialist

TMP Worldwide, Chancery House, 53-56 Chancery Lane, London, WC2A 1QS nhsinternationaldatabase@tmp.com 0207 406 3618/5866

International Recruitment Global Scheme registration and identifying suitable vacancies that they may wish to apply for. To assist trusts and doctors through the remainder of the recruitment process, the Department is working with TMP Worldwide and Phoenix ARC, the relocation company who currently support the International Fellowship Scheme, to provide an enhanced service. This service will be funded by the Department and aims to reduce the administrative burden on trusts who are recruiting consultants The package that is being developed will offer the following support to trusts;

We will arrange informal visits with the trusts and interested doctors, assisting with their travel arrangements and booking accommodation. Help will be provided in arranging the Advisory Appointment Committees to ensure the availability of the panel members and the college representative. We will take up and chase references on behalf of the trust. There will be assistance in arranging occupational health assessments to ensure that doctors are assessed by the trusts representative and any tests undertaken whilst the doctor is in the UK for interview Assistance in applying for work permits on behalf of trusts will be available We will undertake police checks in the doctors home country on behalf of the trusts.

And the following support to doctors;

The organisation of a pre-arrival consultation to discuss the move with the doctor and his/her family, allay any concerns they may have, and discuss their requirements, prior to their arrival in the UK. There will be assistance with arranging the transportation of personal effects to the UK, from the doctors home country. We will provide an accompanied home search for the doctor and family to identify a suitable property to rent or buy, matching their requirements and the location of their new post. A school search, which provides details of relevant schooling in the new location, matching the needs of any school age children within the family will be available. A partner/spouse support programme is provided which will assist the doctors partner in finding a job in the UK. Arrival assistance will be offered for consultants and their families, which includes a check-in to their rented property (if applicable), a detailed Area Guide covering the facilities in their new area, and assistance with opening Bank Accounts, and connecting the relevant utilities at their new home. There will be on-going assistance for the doctor and their family for 12 months after their move, to assist in answering any questions they may have or help to resolve any problems that may occur with their new home.

If you are interested in utilising this service to help you to recruit any of the doctors you meet at the Job Fair, please contact Jahna Sullivan at TMP Worldwide on 0207 406 5866 or jahna.sullivan@tmp.com or Andrew Hopgood at Phoenix Arc on 01256 817888 or andrew.hopgood@phoenixarc.com

International Recruitment Global Scheme What else are we doing to help you?

We are developing new software which will allow trusts and AACs to download doctors CVs via the website to reduce both time and the amount of paperwork/copying.

5. Trust to contact the candidate to discuss opportunities

Discussing the opportunities available with the candidate is useful, together with the job specification; in order to:

Assess the language and communication skills of the doctor. Talk to the doctor about the NHS, your trust and its location. Discuss the aims of the doctor and if s/he has any special interests. Find out whether the candidate is likely to apply when you advertise.

6. Invite doctor to visit the trust

If you are interested in the candidate, you can invite him/her to visit your trust to discuss the position further and any other issues you or the doctor may have. This also gives the doctor the opportunity to visit the hospital and environment that s/he will be working in. It is recommended that employing authorities pay all reasonable travel and accommodation costs for potential international recruits who are called for visits and interviews. Canvassing for support of any application for a consultant post is prohibited. Applicants or prospective applicants should feel able to visit the relevant unit and meet some of their prospective colleagues before the AAC selects its shortlist and holds interviews. The opportunity to make such visits should be drawn to the attention of candidates for the post and a list of relevant contacts such as the Medical Director, Chief Executive and other officers provided. However, the status of the visits should be made clear to applicants or prospective applicants and no offer or promise of success in the application should be made. Such visits form no part in the selection process.

7. Advertise post
The complete Appointment of Consultants Good Practice is available at http://www.doh.gov.uk/hrinthenhs/consultantregulations.htm All posts must be advertised, unless the prior consent of the Secretary of State not to advertise has been obtained. Examples of such exemptions can include grade assimilation where it is part of a specific national agreement. In addition, Secretary of State for Health can issue a waiver for advertising where applicants for a post are exclusively coming from the international recruitment campaign. Each application for a waiver will be treated on its individual merits. It is not possible to generalise. However, waivers may be given where Secretary of State considers it appropriate for any individual post. Advertisements must normally appear in at least two professional and nationally distributed journals which are commonly used for similar advertisements. The advertisements are normally quite small and appear in the

International Recruitment Global Scheme classified section. Display advertising is rarely needed. Where possible the date of interview should be included in the advertisement. This is particularly important for international recruits who need to make travel arrangements. The closing date for applicants, which is normally three or four weeks after the publication of the advertisement, should also be included. Advertising should be carried out in such a way to encourage applicants from suitable candidates of both sexes and from all sections of the community. Employing bodies may find it helpful to refer to Sections 37 and 38 of the Race Relations Act 1976 where they identify special needs. Advertisements should not prescribe requirements such as length of residence or experience in the UK. Where a particular qualification is required it should be made clear that a fully comparable qualification obtained overseas is as acceptable as a UK qualification. Guidance on "Health Clearance for Serious Communicable Diseases: New Health care Workers", currently out for consultation, recommends that employers publicise the new health clearance requirements in job advertisements, descriptions and application packs. Publicity material should make it clear that health clearance will be required in accordance with this guidance see paragraph 43 of draft health clearance guidance, available at http://www.doh.gov.uk/healthclear/healthclear.pdf

8. Sift, invite suitable candidates and send occupational health form to candidate
The complete Appointment of Consultants Good Practice is available at http://www.doh.gov.uk/hrinthenhs/consultantregulations.htm Processing Application Forms Applicants should be asked to complete the standard application form so that basic information is available to the committee members in a standard format. A CV should also be requested. Applicants should be asked to provide references from their two most recent employers. All staff dealing with applicants and applications must receive training in fair recruitment and selection procedures. The nominated manager in each employing body shall receive and acknowledge all applications. S/he shall be responsible for ensuring that an initial check is made to ensure that basic information about the candidates is given and current GMC or GDC registration and inclusion, or eligibility for inclusion, on the specialist register is confirmed. Employing bodies should ensure ethnic and gender monitoring of applicants, shortlisted candidates and successful candidates at interviews. This is in line with Goal 2 of 'Ethnic Minority Staff in the NHS: A Programme of Action'. It may be appropriate to collect such information by means of a tear off slip on the application form. Employing bodies should collect and analyse ethnic monitoring data on the appointments process in order to identify possible areas of concern and take appropriate action to redress them. Shortly after the closing date, copies of all applications received together with the job description and selection criteria should be sent to each member of the AAC for consideration. Shortlisting of Candidates Each member of the Committee, including the lay members must have the opportunity to contribute to the selection of candidates to be interviewed, and for this purpose must receive a copy of each application. Shortlisting must be carried out by assessing candidates against the selection criteria which all AAC members will need to have available for this purpose.

International Recruitment Global Scheme A short list can be undertaken by correspondence, taking into account the views of all the members of the Committee. Individual shortlists should be returned to the nominated manager. It is important to note that valid reasons for not shortlisting particular candidates should be given. In all cases the Chair should ensure that the members are content with the shortlist. It may be necessary to discuss the short list. Records of these decisions should be retained by the employing body for a period of at least six months. It is the stage that the advice of the college assessor is most important. It is the college assessor who can advise on whether doctors who are still in a Specialist Registrar post are likely to complete a specialist training programme successfully and be awarded a CCST within the following three month period. They are also particularly fitted to judge whether the applicant has appropriate experience commensurate with the requirements of the particular post applied for. Candidates unsuccessful at this stage should be notified in writing. Before the interview, the Committee should draw up objective criteria against which all the candidates are to be considered. Decisions on the suitability of candidates should relate to the agreed selection criteria. Reliance on facts rather than impressions is less likely to lead to sex or race bias. Shortlisted candidates are invited for interview and asked to return a health questionnaire. The health questionnaire is confidential and must be kept unopened until a candidate is recommended for appointment, at which time it will be forwarded to the Occupational Health Physician. The Physician will notify the employing body of the assessment of the candidates fitness, or otherwise, for employment. Paragraph 30 of the Health Clearance Guidance (http://www.doh.gov.uk/healthclear/healthclear.pdf ) requires overseas recruits to have any health checks relevant to the post conducted in their own country before applying to the NHS and for the results to be included in their health declaration/health questionnaire. Information relating to an applicants criminal record, health or professional status must not be routinely sought from every applicant who applies for a position. NHS bodies need to consider the best way to discharge their duty of care to patients and others. It may be that this can be met by obtaining such information from only the successful applicant prior to making an unconditional offer of appointment. References should be obtained at a last stage of the recruitment process, unless this can be justified by considerations relevant to the appointment decision.

9. AAC/visit to trust if not done earlier

The Advisory Appointments Committee The complete Appointment of Consultants Good Practice is available at http://www.doh.gov.uk/hrinthenhs/consultantregulations.htm Selecting the AAC Where possible the date of the AAC should be arranged at the time of placing the advertisement and should be approximately six weeks after the closing date for applications. The composition of the AAC should be made in accordance with the requirements of the Statutory Instrument and Direction for Trusts (see also paragraph 2.4 of the guidance). In selecting the AAC consultation should take place with the named contact at the appropriate Royal College of Faculty who will provide an assessor for the AAC. Requests for nominations should include a copy of the job description and selection criteria and the date and time of the AAC when this has been arranged before the names of the outside assessors are known.

International Recruitment Global Scheme Membership of Advisory Appointments Committees The Regulations and Direction set out the provisions governing the membership of AACs for different types of appointments. In meeting the requirements of these, employing bodies should seek to secure a balanced Committee. The core membership of Advisory Appointments Committees, as specified in Regulations, is set out below:

a lay member (normally the chair of the employing body or another non-executive director) an external assessor from the relevant college or Faculty the Chief Executive (or his or her nominated senior manager) the medical director of the employing body (or relevant director of public health for public health appointments) or his/her medically qualified nominated deputy consultant from the employing body normally from the relevant specialty in the case of appointments to units which have either substantial teaching or research commitments or both the committee must also include a professional member nominated after consultation with the relevant university (see also paragraph 2.3 Selecting the AAC).

10. Assess level of English language support the doctor will need
Language Doctors outside the EEA Doctors from outside the EEA have to demonstrate a necessary knowledge of English to satisfy the General Medical Council that they are suitable to be included on the limited or full medical register. At present, this is done by achieving a certain standard in the International English Language Testing System (IELTS) in addition to the Professional and Linguistic Assessment Board test (PLAB). This test is available in 105 countries throughout the world and is administered by the British Council. A list of these countries is available on the IELTS website at http://www.ielts.org/centres.cfm Any test conducted as part of a formal appointments procedure must be applied equally to all candidates for the job. Doctors from the EEA It is unlawful to impose a test of linguistic competence upon EEA nationals of an EEA member state other than the UK, or upon others with enforceable EC rights, for the purposes of determining their suitability for entry to the medical register. However, employers have a responsibility and a duty for ensuring that a doctors proficiency in written and spoken English is sufficient for the purposes of their employment and that their linguistic ability meets the requirements laid out in the job specification. International recruits should be offered the opportunity to have their linguistic and communication skills assessed and if necessary are offered a suitable language training course to improve English and communications skills.

International Recruitment Global Scheme Linguistic Centres Association of Language Excellence Centres (ALEC) The Garden Studios 11-15 Betterton Street London WC2H 9PB Tel: 0704 401 2532 www.lxcentres.com Language National Training Organisation 20 Bedfordbury London WC2N 4LB Tel: 020 7379 5134 Language Learning Centre 128 Mount Pleasant University of Liverpool Liverpool L69 3GW Tel: 0150 794 1487 www.languagelearningcentre.org Institute of Applied Language Studies University of Edinburgh 21 Hill Place Edinburgh EH8 9DP Ials.enquiries@ed.ac.uk

11. Conditional offer subject to GMC registration/specialist register, police checks, occupational health
How to register as a Substantive Consultant within the UK TMP assist doctors with registration and will be able to advise on the status of the doctor. In order to practice as a Permanent Consultant within the UK, the doctor must hold Full & Specialist Registration with the GMC www.gmc-uk.org . In order to obtain Full Registration, the Medical School a Doctor undertook his Primary Medical Qualification in, must be recognised by the World Health Organization. For a list of these schools, you can visit http://www.who.int/health-services-delivery/med_schools/. In order to achieve Specialist Registration, there are 2 different paths dependent on whether the Doctor is an EEA or Non EEA Candidate. EEA (European Economic Area) Candidates TMP assist doctors with registration and will be able to advise on the status of the doctor.

International Recruitment Global Scheme EEA candidates are eligible for immediate Full Registration with the GMC2. They also are eligible for Specialist Registration provided that their Specialist Qualification is listed on the European Medical Directive. To qualify as an EEA Candidate, the doctor needs to meet the following criteria: 1. 2. 3. Hold EEA Nationality Have completed Primary Medical Qualification within the EEA Have completed Specialist Medical Qualification within the EEA and this Qualification be listed on the European Medical Directive

When a candidate meets the above criteria a Full and Specialist Registration application is forwarded to them to complete. The Doctor will need to provide documentary evidence to support their application. Only original documents can be accepted and they are:

Primary Medical Qualification Specialist Medical Qualification Licence to Practice Medicine Certificate of Good Standing from Regulatory body of the country they are practising Proof of Nationality either Passport or National Identity Card CV Registration fee of 290

Once all documentary evidence is provided and Full and Specialist Registration is granted they are now eligible to practice within the UK as a substantive Consultant. You can check whether a Doctor is registered via the GMC website at www.gmc-uk.org and then click on Check a Doctors Registration. All Doctors on this list hold Full Registration. If a Doctor holds Specialist Registration a SR (Specialist Registration) indicator will appear in their record. Non EEA (Non European Economic Area) Candidates TMP assist doctors with registration and will be able to advise on the status of the doctor. Those candidates who do not fulfil the criteria of EEA or EEA candidates whose Speciality is not listed on the European Medical Directive, must have their Specialist training assessed by the STA (Specialist Training Authority)3. The STA assess whether the Specialist training undertook by the Doctor is equivalent to what is undertaken for the award of UK CCST.

General Medical Council, 178 Great Portland Street, London, W1W 5JE Tel: 020 7915 3630, Fax: 020 7915 3532 www.gmc-uk.org The Specialist Training Authority of the Medical Royal Colleges, 70 Wimpole Street, London, W1G 8AX Tel: 020 7935 8586 www.sta-mrc.org.uk

International Recruitment Global Scheme To do this the candidate needs to make an application to the Royal College/Joint Committee for their Speciality area. The Royal College/Joint Committee assess applications on behalf of the STA. The candidate completes an application form and needs to provide documentary evidence as requested by the Royal College/Joint Committee. This evidence and fees will vary, dependent on the Royal College/Joint Committee criteria. Please contact TMP4 for relevant details. Once all required documents are received by the Royal College/Joint Committee they assess it for equivalence to the UK CCST and then make a recommendation to the STA. The STA have final decision to whether it is seen as equivalent and will write to the candidate regarding the results. If a candidate is successful with this assessment they are eligible for Specialist Registration with the GMC.

12. GMC/STA confirm specialist registration

Once all documentary evidence is provided and Full and Specialist Registration is granted they are now eligible to practice within the UK as a permanent Consultant. You can check whether a Doctor is registered via the GMC website at www.gmc-uk.org and then click on Check a Doctors Registration. All Doctors on this list hold Full Registration. If a Doctor holds Specialist Registration a SR (Specialist Registration) indicator will appear in their record.

13. Police checks

Criminal convictions As with all other appointments, references from current and previous employers and/or education providers are taken up in the normal way in line with HSC 2002/008. HSC 2002/008 'Pre and post appointment checks for all persons working in the NHS' which can be found at http://www.doh.gov.uk/hrinthenhs/preandpostemploymentchecks.htm details mandatory employment checks which must be carried out when recruiting staff to the NHS. HSC 2002/008 applies equally to staff recruited from abroad. NHS employers who recruit staff from abroad should undertake the necessary police checks in keeping with that country's justice system and the requirements in the UK. Under the Protection of Children Act, there is a legal requirement in the NHS to carry out a check against the Protection of Children Act List before an appointment is made to a child-care position. This is carried out through the Criminal Records Bureau (CRB), which also checks the individual against the Police National Computer and local police force records where necessary. Full guidance about the obtaining of criminal record checks can be found at www.doh.gov.uk/crb. Employers should bear in mind that the existence of a criminal conviction does not in itself prevent anyone from working in the NHS. Some types of offence (eg, involving violence or sexual abuse) may indicate that an applicant is unsuitable to have access to patients and should not be employed. In general, however, the information in the disclosure should be considered in the light of all relevant circumstances, including the

TMP Worldwide, Chancery House, 53-56 Chancery Lane, London, WC2A 1QS nhsinternationaldatabase@tmp.com Tel: 0207 406 3618/5866

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International Recruitment Global Scheme nature of the offence, the age of the applicant at the time the offence was committed, the applicants subsequent record and the relevance of the offence to the post applied for. The Criminal Records Bureau (CRB) also offers an advisory service for employers seeking criminal record information other countries. The service is based around a faxback facility. The number of countries covered by this service will increase over time, currently the service provides information for 15 countries. Details of the countries covered by the faxback service can be found on the CRB website www.crb.gov.uk or by calling the Overseas Information Enquiry Line on 0870 0 100 450. Please see attached sheet.

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International Recruitment Global Scheme

CRB Overseas Information Service The service provides information regarding the availability of criminal record information from overseas. The fax must first be set to polling mode - how this is done depends on the fax machine. Then it is a case of dialling the number appropriate to the country that you are interested in. The information should be faxed back more or less straight away. To begin with, the countries and their corresponding numbers are: 0906 55 55000 0906 55 55001 0906 55 55002 0906 55 55003 0906 55 55005 0906 55 55006 0906 55 55007 0906 55 55008 0906 55 55009 0906 55 55010 0906 55 55011 0906 55 55012 0906 55 55013 0906 55 55014 0906 55 55015 Denmark France Germany Irish Republic Netherlands Spain Sweden Poland Canada Jamaica South Africa Malaysia Philippines Australia New Zealand

The information given out is no more than 4 pages long (and often no more than 2) and is self-explanatory. iTouch (the faxback service provider) provide a national rate help-line for technical problems 0870 906 3434. 0870 0 100 450 Overseas Enquiry Line This national rate enquiry line is intended for those seeking general advice about the countries covered by the faxback service, and associated procedures (e.g. some countries require fingerprints we are liasing with the police service in an effort to provide fingerprinting services at certain locations nationwide). A voicemail facility will be provided in due course if customers require a call-back. The CRB will not have any involvement in applications made by individuals to overseas authorities. Nor are we responsible for the length of time taken by overseas authorities in dealing with an application, or the information that may be returned by them. E-mail An email enquiry facility will shortly be available for customers who may prefer to send us their queries electronically. The address will be overseas@crb.gsi.gov.uk

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International Recruitment Global Scheme

14. Apply for Work Permit (non-EEA nationals only)

Candidates who have been offered a post in the UK must have a valid work permit before taking up employment or, where appropriate for some medical staff, have obtained "permit free" training status.

NHS employers may only apply for a work permit following a professional registration assessment by the relevant statutory body. Work Permits (UK) will require either Full or Limited Registration to have been granted or, to see that a specified period of supervised practice has been recommended before issuing a work permit. All staff having taken up post in the UK, are employed on the same terms and conditions as locally recruited employees. All relevant UK employment legislation will apply as long as the employee holds a valid work permit.

NHS Employers should:

Ensure that individual work permits have been issued and that systems are in place to apply for renewal.

Further information concerning work permit applications can be obtained by telephoning the Work Permits general enquiry line on 0114 259 4074 or visiting the Work Permit (UK) website at www.workpermits.gov.uk NB: From 1st April 2003, there will be a charge for each application.

15. Occupational health check

All job offers, whether local or international, can only be made subject to occupational health clearance. Occupational health assessment is confidential and medical information cannot be divulged to either the employer or the commercial recruitment agency. The Department of Health is currently consulting on guidance to strengthen health clearance for serious communicable diseases (see www.doh.gov.uk/healthclear). Employers need to keep abreast of this guidance to ensure that the health assessment appropriate to the post is carried out. For posts that require the performance of exposure-prone procedures (EPPs), candidates currently require health clearance for hepatitis B. Those beginning training involving EPPs also require clearance for hepatitis C. [The DH guidance being consulted on proposes extending the clearance requirement to all new recruits/trainees who will do EPPs and to cover HIV as well as hepatitis B and C.] The doctor is free to decline tests for health clearance but this will prevent him/her from undertaking work that involves exposure prone procedures. Occupational Health Screening Forms must be completed by the candidate at the time of interview, which is normally in the country of original application. The completed Occupational Health Screening Form is sealed, in confidence, and addressed directly to the relevant Occupational Health Department used by the employing organisation. NHS Employers should:

Ensure that agencies are aware of all the information that is required in order for candidates to be properly assessed and in accordance with Occupational Health Guidance.

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International Recruitment Global Scheme

Ensure that all successful candidates undergo the appropriate occupational health assessment and are deemed fit for work or, if appropriate, the necessary adjustments to the workplace are arranged in keeping with the Disabilities Discrimination Act 1995. Ensure that candidates are aware of the relevant General Medical Council (GMC) guidance with regard to serious communicable diseases. This guidance can be found at http://www.gmcuk.org/standards/default.htm

Further information regarding occupational health and a sample occupational health form is available in the Departments Management of Health, Safety and Welfare Issues for NHS Staff guidance. This is available on the Departments website at http://www.info.doh.gov.uk/doh/point.nsf/publications

16. Unconditional offer Inform TMP offer has been made.

It is important that you keep TMP Worldwide5 informed of progress with the recruitment exercise or inform them if vacancies are filled from other sources to enable them to keep accurate records. This will ensure that TMP will not attempt to match the candidate to further posts.

17. Terms and Conditions of Employment

NHS Pensions For further information regarding NHS pensions, please visit the NHS Pensions agency website at http://www.nhspa.gov.uk/ NHS Housing Initiative The NHS employs a vast range of staff of various professions, who have differing accommodation needs. Requirements range from rented single rooms to home-ownership. The objective of NHS Estates is to provide staff with a choice of type, cost and location of accommodation. NHS Estates are working towards fulfilling that objective and, as part of that process, details of rental accommodation available to NHS staff and on home ownership (including the Starter Home Initiative) are provided on the NHS accommodation web site at www.nhs.uk/accommodation. Where individuals' requirements are not met, details of other provider organisations are available. Assistance on accommodation matters is available on the NHS accommodation helpline telephone number 0845 6040240 or E-mail: NHSAccommodationhelpline@doh.gsi.gov.uk Contracts Guidance on the model consultant contract is set out in circular PM(79)11. Some parts of the model consultant contract have become out of date, but it nevertheless remains the model on which all consultant contracts under national agreements are based.

TMP Worldwide, Chancery House, 53-56 Chancery Lane, London, WC2A 1QS nhsinternationaldatabase@tmp.com 0207 406 3618/5866

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International Recruitment Global Scheme National terms and conditions of service for hospital, public health and community health service doctors can be found at www.doh.gov.uk/hrinthenhs/doctorstermsandconditions

18. Arrange induction and language support

For further information, please see the Guidance on International Recruitment of Consultants and General Practitioners for the NHS in England, which is available on the international recruitment website at http://www.doh.gov.uk/international-recruitment/guidance.pdf It is important for health care organisations to understand that an effective induction programme to support doctors is essential. Postgraduate Deans run short induction courses, usually of 2 or 3 days duration, for doctors who are entering training in England from abroad. It may be helpful to seek the Deans advice when designing an induction programme for international recruits. One needs to remember that the induction requirements of fully trained doctors and their families may well be different from younger doctors who come to England to commence postgraduate training. Regardless of their skills and experience doctors need a thorough period of adjustment to the NHS. Therefore trusts should consider developing a more extensive programme during the first months of the doctors period of employment. A three-month programme would appear to be sensible however each doctor will have different requirements. The exact time and nature of induction should be agreed with the trusts Medical Director. If during the programme the doctor only practices under close supervision, ideally with his/her mentor, such a policy would allow an appreciation of the approach in England to clinical practice and would enable the mentor to determine the continuing professional development needs of the doctor. There should be three aspects to the induction process: 1. General induction to life in England and the cultural differences that the doctor will need to know and understand. Induction into practice that should focus on the clinical aspects of the job. Not directly clinical but nevertheless relevant medically important issues such as death certification, coroners referral, prescribing and the law as it relates to medical practice in England.

2. 3.

General Induction The responsibility for the provision of this aspect of the induction lies with the Workforce Development Confederations although employers have the responsibility to ensure that doctors attend the induction. The general induction programme should be thorough and comprehensive and should include all the family members. It should cover:

An introduction for the doctor and his family to life in England and to his/her new local area. All aspects of employment law, tax and pensions, e.g. how to obtain a National Insurance number, open a bank account, obtain a tax code etc. The use of public facilities such as transport and the utilities (telephone, gas, water, electric and council tax).

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Advice on finding suitable accommodation, including how to purchase a house, obtain a mortgage and rent furniture. Advice on suitable childcare facilities both within the NHS and privately, e.g. nannies and au pairs. An introduction to the English education system and help with finding school places. An introduction to the English culture and customs. An introduction to the local dialect. Registration with an appropriate GP. Other more general issues such as advice on shopping for household goods etc.

Each trust (primary and secondary) should produce an information pack which covers all of the above but could be extended to include notable local sights and places of local interest, e.g. Lake District, Cotswolds, museums, theatres, art galleries, concert halls and sporting facilities. Induction into clinical practice The responsibility for this aspect of a doctors induction lies with the individual employer. Induction into the clinical specialty is the responsibility, in the hospital sector, of the Medical Director in conjunction with the Clinical Director and of all medical colleagues in the directorate. In primary care all principals in the practice should be involved in the induction programme but with one partner asked to take the lead responsibility to organise and co-ordinate the programme. The advice of the Postgraduate Dean and the Director of Postgraduate General Practice Education can always be sought if it is decided that a placement external to the employing organisation is needed for a period of supervised practice. Not directly clinical but relevant medical induction The responsibility for the provision of this aspect of the induction lies with the Workforce Development Confederations, although employers have the responsibility to ensure that doctors attend the induction. Finally, Workforce Development Confederations should work with trusts to organise an induction which is related to medical matters but is not directly of a clinical nature. Such a programme would address:

How the employing organisation works, who are the key people and what are their roles and responsibilities. Meeting on a one to one basis the key people in the employing organisation. Relationship of the employing organisation to other health care organisations in the local health economy. An understanding of the structure and workings of the NHS. The role of the GMC in holding the medical register and its philosophy of protecting patients by guiding doctors.

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The roles of the Commission for Health Improvement, the National Clinical Assessment Authority and the National Patient Safety Agency as they relate to clinical practice. How to break bad news, the importance of clinical governance, clinical audit, adverse incident reporting and the law as it relates to medicine (especially mental health) and employment. How to write reports, fill in a death certificate, write a prescription and when to report a death to the coroner. The importance of continuing professional development, the role of the Medical Royal Colleges, the British Medical Association and the help that can be provided by the Overseas Doctors Association (ODA) and the Arab Medical Association (UK and Ireland).

For further information regarding language support please see the language section (paragraph 9).

19. Arrange National Insurance Interview for week doctor arrives

The NHS employer should contact their local social security/Jobcentre Plus office to arrange an appointment for the National Insurance interview. In some cases depending on volumes of doctors recruited, the staff from the local office might come to the Trust to complete the paperwork. In order for the application to progressed as quickly as possible, doctors/nurses should bring as much documentary evidence as possible, i.e. passport, visa, work permit, letter of registration with the GMC/NMC, offer of employment from the Trust etc. [The Department of Work and Pensions are looking to introduce a simplified system to avoid appointments at local offices. This will also ensure that National Insurance numbers are generated much more quickly.]

20. Induction and ongoing language support

Mentorship and appraisal Due to the uniqueness of the NHS, doctors need support during their period of adjustment. It could take up to 6 months before a doctor feels fully integrated into the NHS. Ideally the mentor should be from within the same specialty/general practice but this is not an absolute requirement. If the mentor is not from the same specialty/general practice there must be close co-operation with doctors from within the specialty/general practice to ensure that there is a smooth and safe transition to clinical practice in England. If it is decided at the time of appointment that a period of supervised practice is required then this should ideally be carried out in the clinical department or general practice in which the doctor is working. On occasions when the doctor has been recruited to a shortage specialty or to a non-training practice these arrangements might not be feasible. In such circumstances it would be appropriate to enlist the support of a neighbouring trust or training practice that has a better staffing situation in the specialty and invite them to arrange the period of supervised practice on behalf of the employing authority.

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International Recruitment Global Scheme The appraisal process should review performance against the various elements of the job. It should reflect on what has gone well and why and what could have been better. It then should look forward towards equipping the individual to face tasks better in the future. The mentor should carry out appraisals at two, six and twelve months and thereafter annually, as is the case for all UK doctors. Any continuing professional development programmes should be agreed at the end of each appraisal and incorporated in the doctors personal development plan. Pastoral Support Primary and secondary care trusts should find a member of staff who would take responsibility for ensuring that appropriate and responsible pastoral support systems are in place. Expertise for this type of a role usually resides in the Human Resource Department (if this is not present in primary care, it is suggested that the Primary Care Trust seek help from the local Secondary Care Trust). It would be the role of this individual to ensure that the induction and mentorship programmes are in place and to audit their effectiveness. They would also act as a continuing source of expert advice and support until the doctor felt that s/he had successfully completed the transition to the NHS and the English way of life. Social and professional networks Successful integration into the British way of life will be one of the cornerstones that will make international recruitment a success. Employers with the help of the international recruitment co-ordinators should seek to access the social and professional networks which are currently being developed by the international recruitment team for the Department of Health (and will be the subject of future guidance). It is envisaged that these networks will encourage doctors and their families to meet and develop friendships and professional relationships with others who have been recruited from abroad. For further information regarding language support please see the language section (paragraph 9).

21. Continuing professional development

Continuing Professional Development is very important to all doctors, therefore the doctor should discuss with his/her Trust mentor an individual programme of study in the relevant specialty. NHS consultants are entitled to up to 30 working days in any three year period for training and professional development (including pay and expenses). This can include study leave, research, teaching, visiting clinics and attending conferences. For further information about the Departments international recruitment initiatives and forthcoming events, please visit the international recruitment website at www.doh.gov.uk/international-recruitment

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Contacts
TMP Worldwide Chancery House 53-56 Chancery Lane London WC2A 1QS nhsinternationaldatabase@tmp.com Tel: 0207 406 3618/5866 Department of Health International Recruitment Team 2N35D Quarry House Quarry Hill Leeds LS2 7UE International.recruitment@doh.gsi.gov.uk www.doh.gov.uk/international-recruitment Workforce Development Confederations The current contact list of International Recruitment Leads at the Workforce Development Confederations is available on the international recruitment website at http://www.doh.gov.uk/international-recruitment/wdccontacts.htm The Specialist Training Authority of the Medical Royal Colleges 70 Wimpole Street London W1G 8AX Tel: 020 7935 8586 www.sta-mrc.org.uk General Medical Council 178 Great Portland Street London W1W 5JE Tel: 020 7915 3630 Fax: 020 7915 3532 www.gmc-uk.org

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 Crown copyright 2003 Produced by the Department of Health 31816 1p 2k Apr 03 (RIC) The text of this document may be reproduced without formal permission or charge for personal or in-house use. First published March 2003 Department of Health Publications PO Box 777 London SE1 6XH Tel: 08701 555 455 Fax: 01623 724 524 E-mail: doh@prolog.uk.com 08700 102 870 Textphone (for minicom users) for the hard of hearing 8am to 6pm Monday to Friday. 31816/International Recruitment Global Scheme can also be made available on request in Braille, audio-cassette, disk, large print and in other languages.