How NHS return of service clauses work

A return of service (or tie-in, or repayment) clause says that in return for the employer paying certain costs to bring you to the UK, you agree to stay for a minimum period. Leave before it ends and you repay a share of those costs, usually on a scale that falls the longer you have stayed. They are not unique to the NHS, but they matter more for international recruits because the sums are larger. The Code of Practice sets four principles for employers to follow:

• ✓ Transparency. The clause and an itemised breakdown of how each amount was worked out must be set out in the contract or offer letter and explained in full before you accept. Only genuine, evidenced, auditable expenses count.
• ✓ Proportionate costs. Relocation, visa fees and regulatory exam fees can be recovered. Agency fees, the Immigration Skills Charge, sponsor licence fees, Certificates of Sponsorship and interview costs must not be reclaimed. Interest must not be charged.
• ✓ Timing. The amount tapers: 100% in months 0 to 12, 50% in months 13 to 24, 25% in months 25 to 36, nothing after 36 months.
• ✓ Flexibility. Employers should consider waiving repayment case by case, for example for adverse health impacts, bullying, discrimination or poor working conditions, changes outside your control, or a career progression move.

Source: Code of practice for the international recruitment of health and social care personnel in England, gov.uk, updated 27 March 2025, checked 7 October 2026. It is a code of practice, not an Act of Parliament, so it does not by itself make a clause void, but it is the benchmark employers are expected to meet and the one to quote back to HR.

Worked example: £4,000 of costs, a 36-month clause

Say your employer paid £1,500 of flights and relocation, £1,500 of initial accommodation and £1,000 of exam fees: £4,000.00 in total, with a 36-month clause. The table runs the same engine as the calculator at four points in your service.

At 14 months the Code of Practice schedule gives 50% (£2,000.00), and the next step is at month 24, when it falls to 25% (£1,000.00). Waiting until then would save £1,000.00. That cliff-edge pattern is why the date you finish matters more than it would with a smooth reduction. If you add the start date and your planned last day, the calculator shows the exact date of each step.

Costs that should not be in your clause

Section 2 of the calculator lets you type in any amounts your contract tries to recover that the Code of Practice says must not be reclaimed: the Certificate of Sponsorship fee, the Immigration Skills Charge, a sponsor licence fee, an agency or recruitment fee, or interview costs. They are left out of the total you owe, and the result shows what they would add to the claim, so you have a figure to raise with HR.

The Home Office sponsor guidance backs this up. Part 1, section L6.17 says sponsors will normally have their licence revoked if they recoup the Skilled Worker Certificate of Sponsorship fee and associated administrative costs, the sponsor licence fee, or the Immigration Skills Charge where it is payable, with this applying from 31 December 2024. The wording refers to the Skilled Worker route, so ask your employer how it applies to your own Certificate of Sponsorship if your clause lists these costs. Our guide to the Certificate of Sponsorship covers who pays for it.

Can the trust deduct it from your final pay?

Under section 13 of the Employment Rights Act 1996 an employer can generally make a deduction from your wages only if a statute or a relevant term of your contract authorises it (and you were given a copy or told about it in writing beforehand), or you previously agreed to it in writing. HMRC's national minimum wage manual also treats most deductions that benefit the employer as reducing the pay that counts towards the minimum wage. So a deduction from final pay is not automatic, and it is worth asking for the exact clause relied on. The Code of Practice also says employers should offer a monthly repayment plan, so a lump sum taken from your last payslip is not the only route. Our guide to NHS overpayment of wages explains how deductions and recovery generally work, and notice periods covers the resignation side.

Does the Employment Rights Act 2025 change any of this?

We checked the contents of the Employment Rights Act 2025 on legislation.gov.uk on 7 October 2026 and did not find a section on training or relocation repayment ("stay or pay") clauses. This is a check of the contents list rather than a legal opinion, and parts of the Act are being brought in over time, so confirm the current position with Acas, your union or a solicitor if a clause is significant. We will update this page if that changes.

What to do before you resign

• ✓ Ask HR, in writing, for the clause you signed, the itemised cost breakdown and the exact figure that applies if you leave on your planned last day
• ✓ Check which costs are listed and whether any of them (Certificate of Sponsorship, Immigration Skills Charge, sponsor licence, agency or interview costs) should not be
• ✓ Check the schedule against the 100/50/25 benchmark, and look for the next step-down date: a few weeks can change the figure a lot
• ✓ Ask for a monthly repayment plan with no interest, and ask in writing whether the trust will waive or reduce the amount in your circumstances
• ✓ If you are on a sponsored visa, understand that changing employer is a separate immigration step. See renewing your visa and switching employer
• ✓ Take advice from a solicitor, your union or Acas before agreeing to a deduction from pay or signing a repayment agreement

How this calculator works and what it assumes

• • The default schedule is the gov.uk Code of Practice example for England: 100% before month 12, 50% from month 12 to 24, 25% from month 24 to 36, then nothing. If you enter a service period other than 36 months, the same percentages are stretched to thirds of your period, and the tool tells you so.
• • Months served are completed calendar months to your last working day. The anniversary date counts as the start of the next month. Contracts differ on whether they measure to your last day or your resignation date, so check yours.
• • Only the cost types in section 1 are included in the amount owed. Anything you enter in section 2 is excluded from the total and flagged.
• • The linear option is a comparison, not a claim about how any trust does it. The custom option lets you type the steps your contract uses.
• • Nothing you enter is sent anywhere. The share link puts your numbers in the web address, so only share it with people you trust.

Sources: the gov.uk Code of Practice (England); Home Office sponsor guidance Part 1 (section L6); Employment Rights Act 1996 section 13; HMRC national minimum wage manual; Employment Rights Act 2025 contents. Read our editorial policy for how we check facts. Last updated October 2026.