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Updated: Aug 14, 2023

Drive up retention rates. Drive down contingent labour costs.

When the economy is struggling, domestic recruitment (recruiting staff from within the UK) in the care sector tends to deliver more readily than overseas recruitment from the sub-continent because when employment is harder to secure in the UK more people look to the Care Sector for employment. The bottom line is, when unemployment rises, recruiting people into the care sector, when compared with overseas recruitment it is simpler, quicker and less expensive.

However, the long-standing labour shortage in the sector is testament to the unpredictability of locally sourced workforce and as has been seen time and time again, as the economy recovers, the opposite happens. People leave the sector for less demanding jobs and labour becomes harder to source and the recruitment headaches quickly return along with the continual cost of contingent labour and un-ending recruitment.

So, what exactly are the pros and cons of overseas recruitment?

This is a difficult question to answer because there are very few statistics available to compare.

What we do know is that overseas recruitment doesn’t offer a quick fix and requires a medium to long term view. The recruitment process, in the short term, is costlier and more complex than domestic recruitment. But, strategically it does offer significant long-term advantages over domestic recruitment.

Let’s look at it in more detail.

Thankfully, forming the backbone of the sector’s workforce, there is an army of highly competent, very committed care workers living and working in the UK and they should continue to be applauded for the excellent job they do.

However, statistics prove that domestically sourced labour in the UK care sector is fickle and retention, or lack of it, is a costly and evasive challenge. Too often, the decision to seek employment in care for many is based on the lack of options elsewhere rather than a desire to enter the sector which is why the recruitment burden eases when unemployment rises. A combination of low wages and difficult and at times, high risk working conditions means that domestic recruitment tends to sweep up a large contingent of a nomadic workforce, dipping in and out of various sectors with short term aims. Because of this, the ratio of the competent and highly committed, against the indifferent, here today but gone too soon contingent is simply too low. This is arguably the root cause of the ongoing staffing shortage that costs the sector billions.

Does recruiting overseas workers automatically bring a higher level of commitment, less volatility and therefore better retention?

There is a compelling argument to say that it does. The level of commitment generally from the overseas candidates tends to be much higher than from domestically sourced staff simply because of the magnitude of their decision to move to a foreign country to start a new life and a new job.

If we look at the decision process for a qualified nurse living on the sub-continent, considering a move to the UK as a care assistant. In all likelihood, their decision to come to the UK to work as a care assistant will have been far more considered and the process, as well as the potential cost involved, will have already been a test of their commitment, long before they start work.

In addition, most of the candidates sourced by Harley Medical for example, are either fully qualified nurses or students completing their care training therefore more familiar and fully accepting of the vocational aspect of the role. Add to this their commitment shown by uprooting from their home country to start a fresh in the UK and the overall sense of obligation to the role and their level and commitment is high.

It is also worth noting that in case studies with client sponsors, it is reported that the need and use of contingency or agency staff diminishes considerably post arrival of overseas workers. Apart from the simple fact that retention of staff remains high therefore rota planning can be confidently set in advance, overseas staff tend to be more agreeable to additional hours of work. The mentality the overseas workers arriving in the UK is typically, ‘we’re here to learn and earn’ and if they’re not busy with their language training, extra work is always welcome. Many of the workers will have family back home and once they have covered their own bills here in the UK, it is culturally appropriate that most will send much of what’s left back home to support their families. Given that their visa allows them to work an additional 20 hours per week, most overseas workers readily take up the offer of this overtime.

Consider the ethics

Another aspect of overseas recruitment to consider, that doesn’t apply in the same degree to domestic recruitment is the question of ethics and the responsibility of the employer to ensure that candidates are not exploited during the overseas recruitment process. However, this can be easily affectively dealt with by selecting the right recruitment partner.

It’s important to work with a recruitment partner who can demonstrate the control and transparency across the entire supply chain to provide the peace of mind to candidates and employers that the recruitment process is indeed ethical and free from exploitation.

How do the costs compare?

Aside from the initial cost of securing a sponsorship license, there is a skill charge to pay to the Home Office for each candidate of around £1,000 per year. So, if you recruit an overseas candidate on a 3-year contract, it will cost you around £3,000 in the skills charge alone. But the upside is that that candidate is likely to be in post for the 3-year duration. If you compare this with the cost of re-filling the role with locally sourced candidates as many as 9 times during that same 3 year period, adding in the cost of contingent labour to plug the gaps and then the cost of the disruption and the perpetual induction and re-training, the costs of over-seas recruitment start to compare more favourably.

The skills charge is also refundable if a candidate does not complete the term of their contract. In such circumstances, the skills charge refund is calculated on a pro-rata basis. So if a nurse on a 3 year contract returns after one year, the Home Office will refund the sponsor the remaining 2 years. The only non-refundable cost is the £199 HO admin fee.

The benefits of overseas recruitment to many care providers is so evident that, as well as the skills charge and recruitment fees, they are also prepared to pay a large proportion of the candidate’s migration costs.

Does overseas recruitment still work for smaller care providers?

There is no getting away from the fact that overseas recruitment is, in many respects easier to accommodate for larger providers than it is for smaller operators. However, that does not mean it can’t work for smaller organisations. There are many ways that costs can be mitigated and cash flow preserved by smaller companies that aren’t available to larger organisations.

The first step for any employer considering overseas recruitment is to obtain a sponsorship license from the Home Office which allows a UK Company to source talent from outside the UK. The cost of securing the license is significantly lower for smaller businesses than it is for large companies. Harley Medical can also provide legal assistance with the license application process.

Harley Medical offer a wide range of advice and guidance to smaller companies who wish to explore the benefits of overseas recruitment.


Harley Medical have been supplying medical professionals to the NHS and private care providers since 2014 and have developed a proven channel for the recruitment of qualified nurses from the sub-continent. For more information email

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