Registered nurses and midwives trained outside the UK seeking employment

To practise as a nurse or midwife in the UK you must be registered with the Nursing Midwifery Council (NMC), the regulatory body for nurses, midwives and specialist community public health nurses.

Overseas Nursing Programme (ONP)

Nurses and midwives trained outside the European Economic Area (EEA) who wish to register in the UK will have to successfully complete the ONP, a compulsory 20-day period of protected learning and, where appropriate, a period of supervised practice.

The programme includes UK law, health and safety issues, record-keeping, drugs administration and the NMC Code of Conduct. A list of approved ONPs is available on the NMC website.

International English Language Test (IELTS) 

All overseas nurses who trained outside the EEA will have to sit the International English Language Test (IELTS).

From the 1 February 2007 the following scores have to be achieved by all nurses and midwives.

  • at least 7.0 in the listening and reading sections
  • at least 7.0 in the writing and speaking section
  • an overall average score of 7 (out of a possible 9).

If you are resident in the UK, information about sitting the IELTS examination can be found on the IELTS website at: www.ielts.org. If you are living abroad, full details can be found on the British Council’s website at: www.britishcouncil.org

NMC assessment and registration

Each applicant is assessed on an individual basis, taking into account their basic nurse training. The NMC charges £140 for processing your application.

Once you have completed the ONP, and if necessary a supervised placement, you will be required to pay a registration fee to the NMC. You will then receive a card showing your Personal Identification Number (PIN).

Qualifications

All nurses who have undertaken a basic nursing programme that lasted 18 or 24 months are not eligible to get onto the NMC register. An enrolled nurse, licensed practical nurse and vocational nurse (in the USA), community nurse, state certified nurse, staff nurse (in South Africa), mother craft nurse and nursery nurse, are all not recognised as first level registered nurses in the UK.

A person with one of these professional nursing qualifications would not be able to work in the UK as a qualified nurse, since these are considered to be second level qualifications and are not accepted by the NMC.

Part of the NMC Register

Information can be downloaded from the NMC website at: www.nmc-uk.org

Qualifed nurses and midwives who do not meet NMC requirements

For overseas trained nurses and midwives living in the UK the only method of upgrading overseas nursing qualifications to the European first level nurse criteria is by going to a school of nursing based at a university.

The first year of the training will be credited on the basis of prior experience and learning, that is by going through a process of Accreditation of Prior Experience and Learning (APEL). Every university should have a system in place to help individuals in the APEL process. This option is only available to people living in the UK for over three years.

Go to log the Nursing and Midwifery Admissions Service (NMAS) website for a list of universities or telephone 0870 1122 206.

For information on how to find a supervised placement in the UK contact the International office for our factsheet:

Nurses and midwives who are trying to locate a supervised placement within the UK should not have to pay agency fees for the service of finding a supervised placement.

Nurses who are trying to locate an ONP/supervised placement within the UK should not have to pay agency fees for the service of finding an ONP/supervised placement.

Recruitment agencies

If you would like to come and work in the UK, it is important to check first what assistance, if any, recruiting employers offer in regards to relocation, obtaining NMC registration and finding accommodation.

A UK employer wishing to employ a registered nurse from overseas will apply for their work permit. If the work permit is approved, it will cover both the 20-day protected learning programme and if necessary a period of supervised placement followed by employment as a nurse.

If you would like to work for a NHS employer (the NHS is the largest health care employer in the UK) you can apply directly on NHS online www.nhsjobs.net.

Membership of the RCN

Membership for those on supervised placements is available at a special rate of £10 for the duration of their programme, ie; until they obtain an NMC PIN number (registration with the NMC), at which point the concessionary rate of £135.39 (£105.30 after tax relief) will apply for the first year.

Nurses working as health care support works (HCSWs) who are not on supervised practice placements can also join the RCN as HCSWs for £90.26 (£70.20 after tax relief) for the first year. Payments can be made on a monthly basis.

To join the RCN, telephone RCN Direct on 0845 772 6100, or if you are ringing from outside the UK +44 20 7647 3456 or go to the Membership section of this site for more details.

Relevant publications

You should read the NMC booklet Registering as a nurse or midwife in the UK before applying for registration. Further information on the application process can be found on the NMC website: The application process.

The DH publication, Code of Practice for NHS employers involved in the International recruitment of Healthcare Professionals lists countries that do not intend to recruit nurses to work in the NHS, because this may damage the local health care system, if nurses started leaving those countries in significant numbers. Available on the DH website.

The Standing Committee of Nurses (PCN)'s publication, which is available online: read the PCN Good Practice Guidance for International Nurse Recruitment is available at: www.rcn.org.uk/downloads/press/PCN.doc

The Commonwealth Secretariat's publication Commonwealth Code of Practice for the International Recruitment of Health Workers is available on the Commonwealth Secretariat website.

RCN publications

The following RCN publications are available from the publications section of site:

Success with internationally recruited nurses’ – RCN good practice for employers in recruiting and retaining. 

Internationally recruited nurse - Good practice guidance for health care employers and RCN negotiators www.rcn.org.uk/publications/pdf/IRN.pdf

Here to stay? International nurses in the UK, J Buchan 2003
www.rcn.org.uk/publications/pdf/heretostay-irns.pdf

Useful contacts

The website for online health information for health professionals - Health for Asylum Seekers and Refugees Portals (HARP) also offers advice. Go to: www.harpweb.org.uk

The NHS Learning and Development Service can give you advice on further training in the UK:

UK hospital addresses (public and independent) can to be found in the Institute of Healthcare Management Year Book on the website: www.ihm.org.uk. This reference book can to be found in public libraries in the UK and may be found in the British Embassy of your own country.