Shape recruitment process
transparently and fairly

For many acute and long-term care institutions, international recruitment starts with the consideration of whether they would like to design, coordinate and organise the entire recruitment process themselves or whether they hand over some of the associated tasks and work packages to recruitment agencies. In both cases, it is important to ensure that the processes are also made transparent for the international nursing staff and, above all, are designed fairly.

Whichever path the employer decides to follow, it’s important to bear these things in mind in every case:

• WHO list – supplement to §38 Rules of Employment (BeschV)
  The World Health Organisation (WHO) published a list of 57 countries (so-called WHO list) in 2006, in which there was a critical shortage of health professionals (especially doctors for human medicine, healthcare workers and nursing staff). It recommends that health professionals from these countries should not be actively recruited or employed. To implement the Global Code of Practice on the International Recruitment of Health Personnel, which was passed in the year 2010, Germany has implemented this regulation in applicable law . Active recruitment and work placement of health personnel for private commercial purposes is forbidden in these countries. The list is revised regularly, most recently in 2023. The current list of countries from 55 countries is available for Download here (English) and here Download (German, BeschV, Annex to Section 38).

• Employer pays principle
  The “employer pays” principle is the obligation of employers that during the recruitment process, no costs related to the recruitment must be paid by the employee. This principle is widely acknowledged and is supported by the International Labour Organisation (ILO) in particular. A publication of the ILO from the year 2019 sets out which recruitment fees and costs are included in this obligation.
• Matching
  In the past, many companies have had the experience that although they were able to acquire nurses from other countries, and that these also started work in Germany, several returned to their country of origin after a short period of time or changed company because in the end it “simply didn’t fit” or “didn’t match”. This is a difficult situation for all involved and represents a loss of financial and time resources for all parties. Therefore it is enormously important to find a good match between the employer and the candidate and agree expectations. For example, it can be counterproductive if a rural long-term care facility recruits a nurse who specialises in paediatric nursing and prefers living in a city. Before signing the contract you should therefore ensure that a potential nurse is a good match for the facility and the team. The expectations of the recruited nurse should also be taken into consideration. This ultimately saves both the facility and the nurse frustration and irritation, and increases the probability that they will stay longer with the company and feel at home.

• Information sharing
  The topic of information sharing is closely linked to the topic of matching. Even before arrival, a company should pass on as much information as possible to the nurses, so that they can get a good idea of what is expected of them when they arrive in Germany. Besides facility-specific information, the “Information Brochure on Labour Migration In the Nursing Sector to Germany” can be helpful; it is available in nine languages on the website of the “Anwerbung und Vermittlung von Pflegekräften aus dem Ausland e.V.” quality association and can be handed out to the nurses.

• Transparency The topic of transparency is essential for the entire recruitment process. Facilities should communicate and disclose all steps transparently to the nurses from the very beginning, but should also ensure that all service providers involved also do this too.
  In addition, transparent communication of information is also valuable for employees of your own company in order to get their agreement and prepare them for the challenges associated with recruitment. To this end, it is helpful to involve employees in the processes at an early stage and to inform them about the necessity and advantages of recruitment.

• Coordination processes In the course of the recruitment process and its associated procedures, it is essential to maintain an overview of all the necessary steps and prerequisites of the migration. To this end, it helps to find out well in advance which procedural steps have to be taken as part of the recruitment process and what opportunities exist for the participation of other stakeholders. Facilities should think carefully about which stakeholders need to be involved in which coordination processes and where the responsibilities lie in concrete terms. Especially when working with recruitment agencies, but also other external service providers, it can be that they offer very wide-ranging and different services. You should therefore look carefully beforehand which tasks could/should be handed over to external parties and which ones should remain in-house. The resulting responsibilities should be set down in writing, for example in an operational integration management concept.

The operation of the application procedure for entry and recognition within the framework of the accelerated skilled workers procedure in the responsibility of your own company requires good document management to keep an overview of required documents. To that end, it is helpful to clarify in advance with the authorities who carry out the recognition and other authorities involved, which documents are required and in what form.

Cooperating with recruitment agencies is a way of surrendering some of the package of tasks involved in international recruitment. This can help facilities in managing the processes and their own personnel resources. As the Federal Republic of Germany has not ratified the ILO Private Employment Agencies Convention 181 of 1997, there is no obligatory state mechanism that regulates the work processes of recruitment agencies. This means that it is even more essential for facilities to pay careful attention with which agencies they work.

Often facilities do not know in advance whether a recruitment agency is trustworthy, transparent and provides a good service. To support facilities as well as internationally recruited nurses in selecting a suitable recruitment agency, the state-sponsored “Fair Recruitment Healthcare Germany” seal of quality was awarded to recruitment agencies in February 2022 for the first time. The seal of quality has established standards for the non-state recruitment of nurses. The accredited recruitment agencies undergo a test process in three different fields, and have to fulfil the necessary criteria. The test process places special value on transparency and fairness in the recruitment procedure. You can find further information about this here.

Even in the case of self-organised recruitment, facilities should maintain certain standards. The standards of the quality association Anwerbung und Vermittlung von Pflegekräften aus dem Ausland e.V. can offer good orientation. If you want to have your own recruitment programme accredited with this seal of quality, you can apply here.

Questions that can help in determining whether it is a serious recruitment or placement procedure:

• How and via which medium are the nurses approached?
• Are the nurses required to sign unethical binding and/or repayment clauses?
• Has the nurse received all necessary information to make a well-founded decision regarding work migration?
• Do the nurses known which service providers they are working with?
• Do the nurses have a contact person in case they have any questions?
• Are expectations between the employer and the nurses discussed BEFORE the contract is signed?
• Are the nurses kept regularly up to date about possible changes in the timing of the recruitment procedure?
• Have the nurses received work contracts in their respective native language as well as in German?
• Is there cooperation with a certified language school during the placement process?
• What are the exact services offered by the recruitment agency and who is responsible for which service?
• Are the facility, the recruitment agency and the nurse aware of when and where which documents should be submitted and in which format?