How to be a UK Nurse: The Ultimate Guide for Overseas Nurses in 2022

The UK is in need of nurses and healthcare professionals more than ever before. NHS and other health facilities in the UK rely on overseas nurses to fill gaps in the nursing workforce shortage. Now that the deployment ban has been lifted by President Duterte, Filipino nurses are now allowed to work abroad. NMC may have made slight changes on some areas of application in line with the Covid-19, but rest assured it is still simpler, easier and cheaper.

The process has been simplified by allowing the applicant to complete the competency tests and registration application simultaneously after deemed eligible to apply. Requirements have been streamlined on the new application process as well.

The application process can now be done entirely online. The NMC has revamped their website to provide an easy to follow steps from start to finish. You can also download a pre-application checklist tool based on your own circumstances. Once you have set up your online account, you can upload your documents and complete the application form. You and your employer/sponsor can check the progress of your application. NMC also promised to provide improved guidance and support to applicants and employers.

STEP 1: Complete the NMC Eligibility Assessment

Before starting your application, contact your referees and verifiers to ensure their details are correct as well as gain their consent on sharing their contact details with the NMC. It is imperative to provide the name, address and email address of your education institution so that the NMC can contact them and verify your details.

If you are a registered nurse, the NMC will contact your regulator (PRC) to verify the registration details you have provided. If you haven't passed the board exam yet, the NMC will contact BOTH your University and regulator (PRC) to confirm that your training can lead to registration in the UK as a nurse.

Make sure that you inform your regulator (PRC) and college/university (whichever is applicable), that you are applying for a NMC registration so that they will respond to our request for confirmation. You may need to submit or complete documents with your regulator to ensure that they respond to our request.

Here are the other required documents:

1. Proof of identity

• Valid Passport (details to be entered on your online account and upload a copy of the picture page)

• Proof of name change if your current name is different from your passport

• Must clearly show your previous name and issued by an official body ie. marriage, civil partnership or divorce certificate, or a deed pool notification

• Upload scanned copy but the original version must be shown on face to face verification

2. Qualification Certificate

• Must have graduated with equivalent foundation degree level in the UK

• Showing your name, qualification title, date achieved, and name of education institution

3. Professional Registration

• PRC registration certificate is only required if you are a board passer.

4. Pay the Evaluation Fee (non-refundable) - £140

• NMC will send you a confirmation email after payment. Take note of your CRM number which you will need for the next step.

5. Obtain a Stateboard Verification (SBV) from PRC and submit to NMC for verification.

• You will need to present your PRC Board Certificate, copy of your valid PRC license, CRM number from the NMC confirmation email and pay 200 pesos.

• Whilst you are already at PRC for your SBV, you can also ask for Certificate of Good Standing (COGS) which you will need to submit as you go along the application process.

6. Submit State Board Verification to NMC and wait for eligibility decision.

STEP 2:

TAKE THE RECOGNISED EXAMINATION

You may start preparing for the required English test whilst completing the eligibility requirements. I understand how much time and effort you need to exert to achieve the minimum grades so it’s better to start as early as you can if you really wanted to apply as a UK nurse. I know you got this!

I have also gathered opinions from nurses I knew who arrive to UK recently and they recommended passing the English Exam first and take it from there as some may find the English Exam harder to pass than the CBT. Both exams are time sensitive with two years validity, so dealing with the more challenging exam first may be beneficial.

You must get the minimum required score for either IELTS or OET to prove your English Language proficiency. The two language tests accepted by the NMC are the following:

International English Language Test System (IELTS)

• You must take the Academic Module for your NMC registration or also known IELTS UKVI. The test consists of Listening, Reading, Writing and Speaking where the highest score you can get in each category is 9. NMC requires at least 7 for overall score and all subtests except for Writing as 6.5 is acceptable.

• NMC accepts both the paper based and computer based IELTS Academic test delivered at a test centre.

• To know more, click link.

Occupational English Test (OET)

• NMC is now accepting the OET@Home test as evidence of English language competency. The OET@Home test is identical to the test standards of the test venue centres but this allow the candidates to take their OET on their computer at home. This eliminates the need to travel to test centre.

• Computer Test is also available to take in the test centre instead of the previous paper-based test.

• OET consists of the same categories with IELTS but it uses real healthcare scenarios to assess your communication skills. The highest score you can get in each category is A. NMC requires you to get at least a B in all categories and overall score except for Writing as C+ is now acceptable.

I have read comments from nursing applicants that OET may also practice your communication skills in preparation for your OSCE which will come last in your registration process. It's like hitting two birds with one stone but the choice is still yours whatever English test you feel more comfortable to take.

If you failed to get the minimum score for IELTS and OET on your first try, you can combine your scores on your next exam BUT you must fulfil the NMC criteria on combining tests in two sittings.

Step 3:

Take the Computer based test

      Once the NMC verified you to be eligible to apply, you can now complete the Test of Competence and the Registration application. 

    Under the new process, you can take the Test of Competence whilst completing the registration requirements. It is no longer a linear process where you have to finish one step to get to the next. This allows flexibility for the applicants and their sponsors to complete the process that best suit their circumstances.

    The Test of Competence measures the knowledge, understanding and application of professional nursing skills of the applicants. It consists of Computer-Based Test (CBT) and the Objective Structured Clinical Examination (OSCE).

     You can take any of these tests in any order but have to pass both to be fully qualified. Once you pass one of the 2, you have 2 years to pass the 2nd one to retain its validity. Once you pass both, both will be valid for 5 years.

The type of tests you need to take would depend on the part of register you want to join. These can be:

• Adult nurse (RNA)

• Mental health nurse (RNMH)

• Learning disabilities nurse (RNLD)

• Children’s nurse (RNC)

Typically, the first route to take is passing the Computer Based Test.  The NMC will send you an Authorisation to Test after verifying your eligibility to register. Employers hiring nurses require both CBT and English exam in order to process your application and UK working visa. The OSCE takes place as you arrive in the UK and employers normally provide a lot of support in preparation for your examination.

Update- As of August 2021, the new ToC has been launched. The new CBT is split into two parts:

• Part A will cover numeracy

• Part B will cover clinical questions related to nursing.

If you took one of your ToC before August 2021, please check guidance to know which route to take.

To check OSCE, the other Test of Competence, go to Step 5.

Step 4:

Complete your Registration Application

    As I have mentioned earlier, you can start providing the supporting evidence for your registration whilst completing your Test of Competence. You have two years from passing the CBT or OSCE (whichever comes first)  to complete your registration application. So can I just stress, please ensure you keep the momentum of passing all the exams and meeting the necessary requirements within the said time frame.

1. Health evidence

• Self-declaration on your health condition. You must declare any condition that may affect your practise.

• If you have a condition that is managed appropriately, there is NO need to let NMC know about it.

• If you have any condition or disability that is NOT managed, you have to provide further information so NMC can decide if you are fit to practise (further information on NMC website) 

• You must provide details of a qualified medical practitioner that NMC will contact to verify your health condition. The health assessment must have been carried out in the last six months. 

2.   Character evidence

• Self-declaration about your character. You must declare any police charge, caution, conviction or conditional discharges you’ve received as well as determination from regulatory bodies in the UK or overseas. 

• If you declare any offences, NMC will ask you to provide more details about the incident to gain more insight if you are fit to practise safely in the UK.

• Upload police clearance or DBS.

a.) Police clearance

       - required for those who lived overseas for 12 months or more in total (not necessarily consecutive) within the last ten years; must be issued no more than 12 months before uploading. Check the Gov.UK website for more information.  For applicants based in the Philippines, NBI Clearance is required. Click link to know how to apply for NBI Clearance.

b.) Disclosure and Barring Service

- If you lived in the UK for 3 months or more.

- Contact details of your nominated person for supporting declaration

             Your nominated person must confirm whether you are capable to practise safely and effectively or not. Nominated person must not be related to you or previously employed by you. I have categorised below the referees you can nominate based on your registration status.

a.) Registered Nurse or have been in the last 3 years

  - your regulator and current employer will provide supporting declaration. 

b.) Previously Registered (but not registered in the last 3 years) 

    - details of your last regulator AND supporting character declaration from a nominated person.

c.) No Registration

      -  supporting character declaration from nominated person

Who can be the NOMINATED PERSON for supporting character declaration? 

• your recent employer

• education institution where you graduated and gained qualification

• NMC registrant OR other UK regulated healthcare professional whom you have known for a year and been in contact in the last 6 months from submitting your application

• If you cannot provide any of the above, NMC will ask you to give details of two people from their list of approved signatories to provide character reference. 

3.    Language evidence

• Confirm the evidence of your English Proficiency.

a.) IELTS

- provide your TRF number and original certificate 

b.) OET

- provide your candidate number and original certificate

- make sure you updated your myOET account to allow NMC to verify your results

c.) Transcript of Records

    - this evidence is only allowed if your record of training shows 50% clinical interaction and 75% of that interaction with patients, relatives or healthcare professionals must have occured in English. 

d.) Registered Practice in Majority English speaking country

- this is acceptable for those who practiced in these countries for a year. You need to provide your registration details and certificate, how your English proficiency was assessed by that regulator and your employer details. 

4.    Confirm indemnity arrangement

• This is a legal requirement for every UK registered nurse as it will ensure you are covered in case a claim is made against you while you’re in practise.

• Most of the employers such as NHS and some private sectors provide indemnity cover. Make sure you check it is in place, otherwise, you can arrange this with unions such RCN and UNISON. 

5.    Pay for your registration fee - £153.

Step 5:

Take the Objective Structured Clinical Examination

After completion of IELTS, CBT and initial requirements, employers grant an applicant a Certificate of Sponsorship (COS) necessary to obtain a Tier 2 Working Visa so you can move to the UK to complete the OSCE. You only have three months from your employment start date indicated in you COS to sit in the OSCE exam. By February 2022, there will be 5 approved OSCE Test Centres.

At this point, you are legally employed as a pre-registered nurse.  You will also need to show your valid passport for a face to face identity check on the day of the test. 

Fee will be £794 and resit fee is £397.

To prepare for the exam, we recommend you read:

• NMC (2018) ‘The Code’

• NMC blueprints and test specifications

• NMC OSCE Information Booklet

Step 6:

NMC assessment

         Once you have passed the Test of Competence and completed the Registration Application, NMC will contact your referees to verify your information. If NMC needs further information about your supporting details, they will contact you through email. 

All you have to do at this stage is to wait for the registration outcome decision from the NMC.

Step 7:

Registration

Congratulations! You are now a qualified UK RN.

         After receiving your confirmation of registration from the NMC, you will automatically be in the register so you can practice as a Band 5 in the hospital/trust that have employed you. 

Sources:

• NHS employers. https://www.nhsemployers.org/your-workforce/recruit/employer-led-recruitment/international-recruitment/immigration-rules-and-the-points-based-system/overseas-nurses-and-midwives (Accessed: 02 December 2019)

• NMC (2018) ‘The Code’

• NMC blueprints and test specifications

• NMC OSCE Information Booklet

• https://www.nmc.org.uk/registration/joining-the-register/register-nurse-midwife/trained-outside-uk/how-to-guide/check-ready/costs/

Updated as of 01/01/2022