Nurses wishing to work in the United Kingdom are required to register with the UK Nursing & Midwifery Council (NMC) . In summary, there are 4 main stages you must go through to become registered:
Step 1: English Language Proficiency
Nurses who live and are educated in an English-speaking country maybe except from this criterion. All candidates must demonstrate a high level of English communication. Overseas candidates can demonstrate this by passing either the Academic IELTS (7 in all categories and no less than 6.5 in writing) or OET Tests (score at least a B+ in all categories, For further information, click here.
Step 2: Computer Based Test (CBT)
Once completed, you are required to submit your interests to enter the register, by going to the NMC website, It is at this point employers in the UK would be happy to receive your application. Click here To find a legitimate nursing agent who can support you through the process. Within 2 weeks of submitting your interest, you will receive an invitation from the NMC to undertake a nursing competency multiple choose test called the CBT. Many nurses feedback that it takes at least 2 weeks of reading and study against the NMC’s recommended reading list to prepare for the test. The test is facilitated at a Pearson VUE test centre which are located in most countries around the world.
Step 3: Application Pack
Once you have passed the CBT, the NMC will send you an application pack, it is essential you gain all the information required and return as one complete pack. Many nurses have feedback that delays can occur if the pack is not returned correctly or missing documents.
Step 4: Objective Structured Clinical Examination (OSCE)
Once the NMC has assessed your application, you will receive a decision letter inviting you to attend a clinical OSCE in one of the accredited testing centres in the UK. You will be required to act out scenarios which you are likely to encounter in clinical environments in the UK. The pass rate is approximately 72%, many nurses feedback the ability to pass heavily depends on the preparation provided by the employer, it is therefore important me assess the employers OSCE preparation programme and ask for their pass rate. If you don’t pass within 3 attempts, you have no choice but to return home. For more information about the OSCE.
It is important that you take the time and read all the information provided by the NMC and secure a job through a legitimate recruitment agent and a good employer who can financially sponsor and support you throughout the process. The total cost of registering in the UK is £1,415 ($1,820 USD). This is paid directly to the registration body and accredited universities in the UK, therefore you must not pass any money to the recruitment agent. From April 2018 the NMC allows overseas nursing graduates to join the register.
According to the NMC, the process appears to be working well with good quality nurses entering the UK workforce from all backgrounds and nationalities. Even though the process is a bit clunky, the process doesn’t take as long as other developed countries and is relatively cheap. Endorse scores the UK registration process 3 out of 5.
Nursing salaries in the UK start at (band 5) £23,023 ($29,614 USD), most overseas nurses entering the register will start at the bottom of the PayScale, which reflects the knowledge, skills and experience within the UK health service, however many nurses feedback that once they gain full registration and demonstrate their competent skills, they can quick progress to a senior staff nurse (band 6) position quickly. To view the UK PayScale. Nurses from developed countries can often gain a senior nursing role at the point of registering due to the similarities of education, technology, communication and health systems.
Salaries in the UK are advertised as ‘basic’ and don’t include the additional payments nurses are entitled, this could include unsociable hours payment , weekends, bank holidays provide additional pay supplements, many nurses reporting it contributes to an additional 30% to their salary.
It is also recognised that working and living in London is more expensive, therefore the employer will provide an additional 5%-20% to your salary depending on the hospital’s location within the Capital. The United Kingdom has a shortage of nurses, therefore it is easy to gain additional shifts (overtime/bank), this can also significantly supplement your salary. Click here, to search for casual nursing agencies in the UK. Whilst the UK nursing graduate salary is below the national average household income, it is compensated by the additional supplement payments that can significantly benefit a nurse and comparing the salary to other developed countries. For the above reasons Endorse has scored UK salaries a 3 out of 5.
The private and public sector offer various paid annual leave, therefore we have only assessed the public sector as the majority of overseas nurses entering the UK enter the public sector. Everyone in the public sector is offered the same paid annual entitlement of 27 annual leave days and 8 bank holidays. When added together and divided by 5 (annual leave is calculated by a 5 day working week), nurses are entitled to 7 weeks annual leave. When comparing this to other developed countries, it is still very generous. For further information regarding UK paid annual leave,
Employers are flexible about when nurses can take time off and make requests through their line manager. It is important to note that employers need nurses on the wards, so cannot give everyone annual leave at the same time. Most nurses advise to ensure annual leave is secured early to prevent disappointment. Endorse has scored the UK 5 out of 5 for paid annual leave.
All UK tax paying residence are entitled to free healthcare on the National Health Service, this includes free visits to your local doctor (General Practitioner) who can refer you onto a specialist consultant. You will be covered for all aspects of treatment from dental, medical, surgical, oncology and maternity services. The NHS is regarded by many as the best national health service in the world.
All employers want you to remain healthy and are proactive in promoting workers wellbeing. They know that if your well and happy, you will be happier at work. Whilst all employers wouldn’t want you to fall unwell, when you are unable to come into work, employers in the UK will provide paid sick days. Managers are very supportive of legitimate sickness and you will be supported throughout. Employers become concerned with medium and long-term sickness and are keen to support you, many will refer you to occupational health for assistance and guidance and will put in place return to work plans to support anyone struggling with their health that is affecting their work. To view sickness entitlement. Compared to other developed countries, the UK has a very generous system supporting all contributing residence, for these reasons, Endorse has scored the UK 5 out of 5 for sickness and health.
The United Kingdom offers free maternity support throughout pregnancy for all contributing residence. This includes regular maternity check-up, delivery and post-natal care as long as the employee has completed at least 12 months continuous service. Employees are offered 52 weeks maternity leave that can be shared between parents. Paid maternity leave for up to 26 weeks. Fathers can have up to 2 weeks paid paternity leave once the child is delivered. Click here For further information.
During maternity leave, staff are also updated by their employers to keep in touch, including progression opportunities to ensure patents on leave don’t miss out. The maternity leave policies and legislation in the UK is generous compared to other developed nations, Australia only offer 18 weeks paid maternity, New Zealand only 14 weeks paid maternity and the USA is one of three countries in the world in which there is no statutory paid maternity leave. However, nurses can take up to 12 unpaid leave. For these reasons, Endorse scores the UK, 5 out of a possible 5.
The public and private sector differs slightly, however most employers contract nursing staff at 37.5 hours per week (150 hours per months), this is more than France at 35 hours per week, however less then the US, Australia, New Zealand at approximately 40 hours per week.
Many nurses work 12.5-hour shifts (3 days a week) which allows them to choose how to spend their free time. Many nurses enjoy the time to travel, care for their families, undertake further education and many undertake additional shifts to supplement their salaries. All employers offer their staff flexible working, which allows staff to request a bespoke working conditions to reflect their lifestyle, this could include reduced hours or to work specific shifts to support their family routine. The NHS views flexible working as a good initiative to support staff retention.
The National Health Service has invested heavily into new hospital since 2000, in which many Victorian hospitals being replaced with modern facilities. Hospitals have also invested in the latest technology in becoming more efficient to reduce paperwork and increase time nurses spend with patients. This is improved working conditions for nurses and patients.
Nursing leaders in the UK are very conscious about patient to nurse ratios and the research that demonstrate the impact it has on patient mortality rates. Critical Care units across the country stick to a strict 1:1 nurse, patient policy and specialist areas average 1:4. Only on the wards has there been some flexibility with an from 1:6 to 1:8, however wards increase staff numbers in accordance to the dependency of patients. Qualified nurse’s vs unqualified nurse ratios have remained at 80% registered nurses, however with the introduction of registered nurse associates, this may change slowly over time.
The NHS have a long history in investing in its staff, ensure the safe and evidence-based delivery of compassionate patient care. All staff attend a list of mandatory free training and It is unusual to find a nurse in the UK has hasn’t been offered a post-graduate university programme by their employer. When it come to generous continuous education, there is an expectation that nurses must demonstrate continuous study at a degree or master’s level to progress in their careers, for example most new critical care nurses in the UK are expected to complete a 60 credit post graduate programme within their first year that can demonstrate their level of competency.
There are some amazing opportunities in the UK for career progression and many overseas nurses have been shocked about the level of support and encouragement they receive to support their progression up the career ladder, this is visible across both the public and private sector with overseas nurses sitting in senior staff nurse, managers and nurses sitting in executive positions. Click here for further information. about career opportunities in the NHS. Nurses in the UK continue to be a strong voice of reason and often become Chief Executives within the NHS.
Nurse leadership is strong and when asked what are the most frustrating part of their job, many feedback that hospital management can often distract them away from patient care. Endorse scores the UK 4 out of 5.
Quality of life in the UK is regarded by many expats to very good. The United Kingdom is truly a great country who has strong social values that all residence is looked after. This can be seen with free primary and secondary education for all children, free healthcare for all contributing residence. The World Economic forum ranking the UK 9th behind Scandinavia, Australia and Canada, however beating New Zealand, the US and Ireland.
The United Kingdom performs well in most measures of well-being relative to most other countries in the Better Life Index. The United Kingdom ranks above the average in personal security, environmental quality, civic engagement, social connections, health status, jobs and earnings, income and wealth, education and skills, and subjective well-being.
Whilst money cannot buy happiness, is an important means to achieving higher living standards. In the United Kingdom, the average household net-adjusted disposable income per capita is USD 28,408 a year, therefore nurses do well in comparison. Housing in the UK is regarded as expensive and this is particular in the capital. Rent rates have increase by 3% each year which is faster than the rate of income.
In terms of health, life expectancy at birth in the United Kingdom is 81 years. Life expectancy for women is 83 years, compared with 79 for men. There is a strong sense of community and a moderate level of civic participation in the United Kingdom, where 93% of people believe that they know someone they could rely on in time of need. In general, people in the United Kingdom are just as satisfied with their lives. When asked to rate their general satisfaction with life on a scale from 0 to 10, British people gave it a 6.7 grade on average, slightly higher than other nations of 6.5, click here for further information. For these reasons the UK scores a 3 out of 5.
Immigration policy in the UK has hardened over the last 10 years, with politicians trying to reduce the number of migrants to the UK. However due to a continued nursing shortage, the UK’s doors are wide open for overseas registered nurses. Nursing has been placed on the ‘Shortage Occupation List’, allowing nurses to easily gain work permits, the most popular route is by gaining a ‘Tier 2, Employer sponsored visa’. . To gain a work permit, you must proceed in gaining UK Nursing Registration. It recommended that nurses should only seek employment once they have completed the NMC’s English proficiency. Most employers are happy to arrange a video interview whilst you are abroad and will provide you with Offers of Employment and commence the visa application process once nurses have completed the CBT and received a decision letter from the NMC. Nurses from some commonwealth countries will have the option to apply for a Tier 5, Work Mobility Visa, the applicants applies for this directly and entitles the worker to live and work in the UK for 2 years.
Most employers will sponsor nurses for an initial 3-year period. Due to the shortage of nurses, employers will likely extend this for a further 2 years 3-6 months prior to the end of their initial 3-year term. Once nurses have completed 5 years of continuous employment, they are entitled to apply for settlement in the UK- ‘Indefinite leave to remain’, this allows the nurse to become of permanent resident, allowing the nurse the freedoms as all other citizens, except no right to public funds. For further information, click here.
Once you have been for 10 years, you can apply for permanent settlement (citizenship) in the UK. This will require you to pass the ‘Life in the UK Test’ a short multiple choose test which consists of 24 questions that must be answered within 45 minutes, followed by Completing the Application Form and attending a UK Citizenship Ceremony. For further information about applying for citizenship in the UK, click here. The process in gaining permanent residency and then citizenship in the UK is relatively easy compared to many other developed countries, for this reason, Endorse scores the UK a 4 out of 5.