Addressing the UK Nursing Shortage: A Comprehensive Guide for Aspiring Overseas Nurses
In 2023, the United Kingdom faces a critical shortage of nurses, with a staggering 46,828 vacant nursing positions. This dire situation has led the UK to rely heavily on overseas nurses to bridge the labor gap. The year 2022 brought significant changes to the nursing application process, particularly with respect to the Objective Structured Clinical Examination (OSCE), and it is expected that English language requirements will undergo further adjustments early this year.
The Nursing and Midwifery Council (NMC) has modernized its online application process, simplifying it with step-by-step instructions and a customized checklist tool. This advancement enables users to submit documents, complete forms, track their application status, and receive comprehensive guidance and support from employers and sponsors.
Step 1: Complete the NMC Eligibility Assessment
Before commencing your application, it's essential to reach out to referees and verifiers who can validate your information and provide consent to share their contact details with the NMC. You must also provide the name, address, and email of your educational institution for verification purposes.
The NMC will contact the regulator of your registered nurse status (PRC) to confirm the registration details you have supplied. It's crucial to ensure that your regulator and educational institution are aware of your NMC registration request, as they may need to submit certain documents for confirmation.
In addition to the above, you will need to provide the following supplementary documents:
1. Proof of Identity
A valid passport, with all pertinent information included in your online account, and a copy of the photo page.
If your name differs from the name on your passport, provide a copy of the documentation supporting the name change. This could be due to events such as marriage, civil partnership, divorce, or deed poll notifications. Ensure that you have a scanned copy available, as the original document may be required for face-to-face verification.
2. Qualification Certificate
A certificate demonstrating that you have achieved an equivalent foundation degree in the UK. This certificate should display your name, qualification title, date of attainment, and the educational institution.
3. Professional Registration
A PRC registration certificate is necessary if you have successfully passed the board exam.
4. Pay the Evaluation Fee (non-refundable) - £140
After making this payment, the NMC will send you a confirmation email. Be sure to note your CRM number, as you will need it for subsequent stages.
5. Obtain a Stateboard Verification (SBV) from PRC and submit it to the NMC for verification
To acquire your SBV at PRC, you may request the Certificate of Good Standing (COGS), which is a requirement during the application process.
In addition to a payment of 200 pesos, you will need to submit your PRC Board Certificate, a copy of your latest PRC license, and the CRM number from the NMC confirmation email.
6. Submit the State Board Verification to the NMC and wait for an acknowledgment of eligibility.
Step 2: Take the Recognized Examination
To apply for a nursing position in the UK, you need to meet certain prerequisites and prepare for the English language test. Both the Computer-Based Test (CBT) and English exams are time-sensitive and valid for two years. To prove your English language proficiency, you must achieve a minimum score in either the Occupational English Test (OET) or the International English Language Test System (IELTS), the two language exams accepted by the NMC:
International English Language Test System (IELTS)
The Academic Module, also known as IELTS UKVI, is mandatory for NMC registration.
NMC accepts the IELTS Academic test, which can be taken on paper or computer at a testing facility.
Occupational English Test (OET)
The NMC now recognizes the OET@Home test as proof of English language proficiency, allowing applicants to complete it from the comfort of their homes.
A computer-based test is also available as an alternative to the paper-based test, and it can be taken at a testing facility.
Both IELTS and OET assess communication skills in healthcare settings, with grade A being the highest in each category.
If you don't achieve the required IELTS and OET scores on your first attempt, you have the option to combine scores on your subsequent exam, provided you meet NMC requirements. The NMC has introduced a new standard for combining test results, allowing retakes and combining results with less than 0.5 or half a grade difference.
Step 3: Take the Computer-Based Test
Once the NMC confirms your eligibility for the Test of Competence and Registration application, you can proceed with this step. The Test of Competence comprises the Objective Structured Clinical Examination (OSCE) and the Computer-Based Test (CBT), both of which evaluate candidates' knowledge, comprehension, and application of professional nursing skills. To become fully qualified, you must pass both exams. Note that the validity period for the second test is two years, and both tests are valid for five years.
The specific examinations you need to take will depend on the area of nursing you wish to pursue, such as:
Adult nurse (RNA)
Mental health nurse (RNMH)
Learning disabilities nurse (RNLD)
Children's nurse (RNC)
The first step in applying for a UK working visa for nurses is passing the Computer-Based Test. Following this, you will receive an Authorization to Test from the NMC. Employers usually require candidates to have completed both the CBT and the English exam.
Step 4: Complete Your Registration Application
After successfully passing the Test of Competence, you can proceed to submit supporting documentation for your registration. This step can take up to two years, so it's important to maintain momentum. You will need to provide the following documents:
1. Health Evidence
A self-declaration of your health status, including disclosure of any medical conditions that might impair your practice. You do not need to inform the NMC about conditions that are properly managed. If you have an uncontrolled illness or disability, you may be required to provide additional information to the NMC to assess your fitness to practice. For details, refer to the NMC website. To confirm your physical condition with the NMC, you must provide the contact information of a registered healthcare professional who conducted a health assessment within the last six months.
2. Character Evidence
A self-declaration of your character, including disclosure of any police charges, warnings, convictions, conditional releases, or findings from UK or foreign regulatory authorities. The NMC may request additional information from individuals who report offenses to assess their suitability for safe practice in the UK. You should also upload your police clearance or Disclosure and Barring Service (DBS) certificate.
Police Clearance:
Police clearance is mandatory for those who have lived abroad for at least 12 months in the past ten years, and National Bureau of Investigation (NBI) clearance is mandatory for applicants based in the Philippines.
Disclosure and Barring Service (DBS):
If you have resided in the UK for three months or longer, provide the contact information for your nominated person. This individual must vouch for your practice ability, and they cannot be a relative or a former employer. Referees can be recommended based on their registration status:
Registered Nurse or have been in the last 3 years: A supporting declaration will be provided by your regulator and current employer.
Previously Registered (but not registered in the last 3 years): Information about your most recent regulator AND a character reference letter from a nominated person.
No Registration: A supporting character declaration from a nominated person.
Language Evidence:
Verification of your proficiency in English through documentation. This can include:
IELTS: Share your Test Report Form (TRF) number and the original certificate.
OET: Provide your candidate number and the original certificate. Make sure your myOET account is updated so the NMC can verify your results.
Transcript of Records: The evidence is accepted if the training record shows 50% clinical interaction and 75% English engagement with patients, family members, or healthcare professionals.
Registered Practice in Majority English Speaking Country: For those who practiced in these countries for a year, provide registration information, a certificate, English language proficiency assessment results, and job details.
3. Confirm Indemnity Arrangement
UK registered nurses are required to have indemnity coverage to ensure their protection in case of a claim being brought against them while practicing. Most employers, including the NHS and private sectors, provide indemnity coverage. If not, you can establish arrangements with unions like the Royal College of Nursing (RCN) and UNISON.
4. Pay the £153 Registration Fee
Step 5: Search and Apply for Jobs
You can either begin your job search and applications at this stage or do it as Step 1. However, if you have completed Steps 1-4, you will be better prepared to identify job opportunities and secure offers. Look for nursing vacancies through POEA-accredited recruitment agencies, which major UK employers, including the NHS, often use to identify qualified nurses and facilitate the processing of their application documents. Some employers may also hire directly, so be sure to check if they have an obligation to sponsor employees if you plan to apply directly.
Step 6: Take the Objective Structured Clinical Examination (OSCE)
Employers will issue Certificates of Sponsorship (COS) to candidates, enabling them to apply for a Tier 2 Working Visa for the UK in order to complete the OSCE. You typically have three months to take the exam at authorized test centers.
The OSCE consists of 10 stations, divided as follows:
4 stations are linked with APIE (Assessment, Planning, Implementation & Evaluation).
4 stations are associated with testing skills, divided into two pairs of two skills.
2 stations are designed to evaluate the candidate's values, behaviors, and adherence to evidence-based practice.
The OSCE assesses communication abilities, including written, verbal, and nonverbal skills, by observing the candidate's interactions with patients and nursing records at each station. As a pre-registered nurse, you are now officially employed and must provide a valid passport for a face-to-face identity check during the test. The fee for the OSCE is £794, and the resit fee is £397.
Step 7: NMC Assessment
After successfully passing the Test of Competence and completing the Registration Application, the NMC will review your information and may request additional supporting documentation. The NMC is currently in the process of making a decision regarding the outcome of your registration.
Step 8: Registration
Congratulations! You are now a registered UK nurse. Once you receive confirmation of your NMC registration, you will be immediately registered and able to practice as a Band 5 nurse in the hospital or trust where you are employed. This marks the successful completion of your journey to becoming a nurse in the United Kingdom.
The UK offers an exciting opportunity for overseas nurses to contribute to the healthcare system while enjoying personal and professional growth. By following these steps and fulfilling the necessary requirements, you can embark on a fulfilling nursing career in the UK, making a meaningful impact on patient care and the healthcare industry.
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