Our regulatory policy position on modern slavery and unethical international recruitment

Page last updated: 8 November 2023

We recognise that workers recruited from overseas are a hugely valuable and important part of the UK’s health and social care workforce. International recruitment itself is not a risk that leads to modern slavery.

However, a nationwide shortage of staff across health and social care, along with recent changes to immigration visas, has introduced concerns and increased the risk of mistreatment of both the existing workforce and internationally recruited staff. This includes an increased risk of modern slavery and unethical international recruitment practices.

Modern slavery and unethical international recruitment practices can be present in any health and social care setting. Victims could be either staff working in a service or people who are using a service.

These practices are incompatible with our values. We fully support the government’s objective to eradicate modern slavery and human trafficking.

CQC does not have authority to investigate concerns relating to modern slavery and unethical international recruitment practices directly and has no authority to take enforcement action under the Human Rights Act 1998. However, we should use what we know about modern slavery concerns to help partners ensure compliance with the Human Rights Act 1998. These include the right for people to be free from slavery and forced labour under Article 4 of the European Convention on Human Rights, as incorporated into the Human Rights Act 1998

Our purpose is to ensure health and care services provide people with safe, high-quality care and to encourage those services to improve. Aligning with the Human Rights Act, this means that care should:

  • respect people’s human rights
  • not expose people to the risk of abuse, improper treatment, and neglect
  • protect people from risk of harm.

Studies inform us that providers who treat their staff poorly are more likely to deliver poor quality care to the people who use their services, through no fault of the victim.

We will use our powers under the Health and Social Care Act 2008 and its associated regulations to take regulatory and enforcement action against registered providers where we identify a risk of harm and breaches of these regulations.

Our new assessment framework will allow us to routinely assess how a provider is managing the risks of modern slavery and ensuring the wellbeing of internationally recruited staff.

We expect providers to have safeguarding policies and procedures that offer clear support and guidance for staff if they suspect someone is at risk or is a victim of modern slavery. We also expect providers to have safe, thorough, and effective recruitment processes that prevent modern slavery. Where providers are using a recruitment agency, they need to check that the agency is carrying out the recruitment checks that they would normally do.

Recognising and responding effectively to these issues can be challenging as workers may fear reprisals if they raise concerns. We need to be alert to potential cases of modern slavery and to listen sensitively and with compassion when people raise issues of poor employment practices with us. We will respond in the following ways:

  • If we receive or discover information that may indicate modern slavery, we will identify and log this risk. We will do this even if the person contacting us does not refer to it as modern slavery.
  • We will refer identified and potential victims through our established safeguarding referral routes and to first responder agencies under the National Referral Mechanism for victims of human trafficking or modern slavery.
  • We will monitor registration applications to check for the warning signs of potential exploitation of skilled workers recruited from overseas. We will notify and collaborate with Home Office UK Visas and Immigration where we find evidence of this.
  • We will monitor registration applications to check for the warning signs that sponsor licences are being exploited. Where a registered provider holds a UK sponsor licence to recruit skilled care workers, we will:
    • monitor notifications of a provider becoming dormant (when it does not deliver care from the registered location) to check for warning signs that could indicate modern slavery
    • notify and collaborate with UK Visas and Immigration if a provider is dormant and holds a sponsor licence
    • if necessary, review the provider’s dormant status and take appropriate action.
  • We will use all our regulatory powers and consider taking appropriate regulatory and enforcement action where modern slavery and unethical international recruitment practices pose a potential risk of harm. This is independent of criminal prosecutions by the police for modern slavery.
  • We work with other organisations at a national level to address the root causes and reduce the likelihood of modern slavery and unethical international recruitment practices in health and social care settings. These include:
  • We also share national information about risks to equality and human rights, including those associated with modern slavery, through our existing memorandum of understanding with the Equality and Human Rights Commission.