International Nurses
Visa requirements
There are no specific immigration requirements relating to skills or qualifications to apply for a Health and Care visa. The sponsor must still be satisfied that the person they are sponsoring can do the job, and an application can be refused if they are not.
Nurses and AHP’s are allowed to bring their dependants to UK if they meet the income threshold of £38,700 as per the new guidelines.
Check if you need a UK visa – GOV.UK (www.gov.uk)
Health and Care Worker visa: Overview – GOV.UK (www.gov.uk)
Recruiting people from outside the UK – GOV.UK (www.gov.uk)
NMC Registration
The Nursing and Midwifery Council (NMC) updated its overseas registration process in October 2019, putting the whole application and streamlining requirements online.
Applicants create an NMC online account that will stay with them throughout their registration with the NMC. They will use the account to submit their registration application, upload copies of evidence required and pay relevant fees. They are also able to track the progress of their application through their account.
Once in receipt of a completed eligibility application, the NMC will confirm eligibility with the applicant’s regulator (and where necessary their training institute) and they will be invited to take the two-part test of competence process and submit their full registration application.
Detailed information about the overseas registration process can be found on the: Register as a nurse or midwife if you trained outside the UK – The Nursing and Midwifery Council (nmc.org.uk)
The Test of competence is a test against the NMC’s proficiency standards and has two parts:
The CBT (Computer Based Test) is a multiple-choice examination that assesses theoretical knowledge and, is accessible around the world for applicants to access in their home countries administered by Pearson Vue. In the new test of competence, the CBT will be split into two parts (part A focusing on numeracy, and part B on theory).
The NMC have launched a hub that contains all the information candidates, recruiters and employers prepare for the ToC such as:
• Candidate handbooks
• Test specifications.
• Blueprints
• Practice tests for the new CBTs.
• An OSCE prep resource pack.
Guidance and information booklets are available on the Test of Competence 2021: Preparation materials – The Nursing and Midwifery Council (nmc.org.uk) . This includes CBT and OSCE guides for nurses and midwives, blueprints and specifications. These pages include detailed booking instructions and course/module information. If an incorrect CBT has been sat, applicants will be required to resit and pass the correct CBT.
English Language Tests
Health and care workers applying to the Health and Care and Skilled Worker visa must complete an English language test. IELTS (International English Language Testing System) is one of the accepted examinations. This test assesses general language skills and is seen to be more academically focused.
To register with the NMC via IELTS, the overseas nurse must ensure they achieve the following grades:
- Grade 7.0 or above in speaking, listening and reading.
- Grade 6.5 or above in writing.
- Overall grade of 7.0.
- When combining, 6.5 for listening, reading, and speaking, or 6 for writing.
English language test centres are available in the UK and around the world. Details can be found here:
The OET (Occupational English Test) is an alternative test, which has been accepted by the NMC since 2017. It assesses language skills more specific to healthcare workers, including the ability to communicate effectively in medical scenarios, write a referral letter or understand a patient consultation.
The overseas nurse must ensure they achieve at least a grade B in the reading, listening and speaking sub-tests and at least a grade C+ in the writing sub-test. Documentation evidence is required for successful completion of an English language test.
If the candidate’s degree was taught in English, they can rely on that to meet the English language requirement and do not need to take a separate test. They will need to apply for English proficiency confirmation through Ecctis if their degree was awarded outside the UK:
The Guidance for Nurses: A Step-by-Step Process
International Nurse demonstrates English Language Proficiency
Applicant takes the IELTS or the OET to demonstrate their appropriate level of English.
Test can be taken before arriving in the UK. The NMC requires evidence when the applicant submits their application* (step EIGHT).
International Nurse completes NMC Qualification Application
Applicant will create online account and complete eligibility and qualification application. Evidence of identification and qualification is submitted, and a nonrefundable evaluation fee is paid.
NMC confirms eligibility for registration within 14 days of receipt of all required information.
International Nurse sits Computer-based Test(CBT)
CBT assures the NMC that the applicant has the right knowledge and skills to practise nursing in the UK.
CBT test results are available 48 hours after the actual test and must be sat before arriving in the UK. It can be taken in a number of overseas locations.
Certificate of sponsorship (CoS) from the Employer
The Health and Care Visa application requires the details of employer who will be sponsoring the applicant to work in the UK.
This is supplied as a reference number(CoS) in the application. This is given to the applicant upon passing the CBT test.
Submission of the VISA application
Applicants submit their health and care visa application and provide biometric information.
The earliest an applicant can apply for their visa is up to three months before their commencement of employment as stated on the certificate of sponsorship.
Decision on visa usually within three weeks.
Visa approval and Nurse arriving in UK
UKVI approves the Health and Care Visa application.
The new immigration system is becoming digital by default. EU/ EEA and Swiss overseas nurses will receive an eVisa while overseas nurses from the rest of the world will still need to collect their biometric residence permits (BRPs) on arrival in the UK.
Objective Structured Clinical Examination (OSCE)
OSCE will assess applicants clinical knowledge and can only be completed in the UK.
Applicant has up to 12 weeks from employment start date noted on CoS to sit the OSCE exam for first attempt.
Results emailed within five working days from OSCE test date.
Candidate has three attempts at the OSCE as part of one application, with a minimum of ten days in between each sitting.
Completion of NMC registration application
If applicant has passed OSCE they will submit health, character and language evidence and pay registration fee via their online portal.
NMC will aim to assess the application within 10-15 days and issue registration number (Pin).
Applicant has gained registration and can work as a registered nurse in the UK.
Employer must tell the UKVI within 10 working days of the individual’s full registration confirmation.
Timeline for an Ideal Scenario
