Nurses and midwives who have trained outside the European Economic Area (EEA) and want to work in the UK as a nurse or midwife must gain professional registration with the Nursing and Midwifery Council (NMC). Applicants are tested for competence through a two-part process to gain registration.
Part one - computer-based multiple choice examination which is accessible around the world for applicants to access in their home countries.
Part two - practical objective structured clinical examination (OSCE) which will always be held in the UK.
Rules for employers and overseas nurse applicants
All overseas applicants need to pass a computer-based test (CBT) and comply with all other initial requirements of the NMC overseas nursing process (including achieving language capability requirements) to be eligible to sit the OSCE and complete their registration. NMC guidance is available on how an overseas applicant can meet the required level of English language capability.
An individual entering the UK to take a nursing role has up to three months from the employment start date noted on the certificate of sponsorship (CoS) to sit the OSCE exam. During this period they can be legally employed as a pre-registration candidate.
Employers must ensure that before a certificate of sponsorship is applied for:
the individual has passed part one of the NMC test of competence
the individual has been issued with an offer of employment, and
the individual has achieved the required level of language capability.
In any applications for certificates of sponsorship, you are required to send the following evidence to Tier2Limits@homeoffice.gsi.gov.uk in support of the application:
a copy of the employment offer letter
a copy of the email confirmation from the NMC to show the individual has passed the CBT, and
evidence that a Resident Labour Market Test (RLMT) has been carried out.
The general Tier 2 minimum salary requirement of £20,800 is temporarily removed in these circumstances, though employers are still advised to place nurses in an interim position with a salary at least equivalent to that of a band 3 role.
Applicants may sit the OSCE up to three times as part of one application (applies to applications started after 06 April 2017).
Applicants must pass their OSCE within eight months from the start of their visa.
If an applicant is unsuccessful at their first or second OSCE attempt, they must wait a minimum of 10 working days before they can take the examination again. Previously, applicants had to wait three months before they could take the OSCE for the third time.
As of July 2018, applicants now only have to re-sit the parts of the exam they previously failed. There is now a reduced re-sit fee of £496 to all applicants who have failed four or fewer stations, regardless of which part of the exam they failed.
If the applicant is unsuccessful after their permitted attempts, the employer must stop sponsoring them and as a result their leave to remain period will be shortened.
Upon successful completion of the OSCE and awarding of NMC registration, employers need to commit to ongoing employment of the individual as a registered nurse on a salary of at least £20,800.
Employers must be able to provide evidence of the above arrangement if requested.
Employers or individuals with queries about individual NMC registrations are advised to contact the NMC directly.
Nursing on shortage occupation list
Nurses remain on the shortage occupation list, but employers have been required to still carry out a RLMT before recruiting a non-EEA nurse. Find out more information in our Tier 2 policy changes section.
The continuation of nursing on the shortage occupation list means the requirement to earn £35,000 or more to qualify for permanent settlement in the UK (indefinite leave to remain) will not apply to individuals for whom nursing has appeared on the shortage occupation list at any time during their employment in a nursing role - they will still need to meet all the other settlement criteria.
Applying for a certificate of sponsorship - need to know
Applications will still be subject to the resident labour market test and all other requirements of Tier 2.
The Home Office has been clear that employers must only apply for certificates when you need them and when you are certain they will be used. The individual being sponsored must have a job offer from you and either:
have obtained full registration with the NMC
have passed the NMC's CBT of competence (part one)
be sponsored to undertake a supervised practice placement as part of the programme, which has been approved by the NMC.
You are required to provide evidence of the above in any applications for certificates of sponsorship. You must send a copy of the employment offer letter and a copy of the email confirmation from the NMC to show the individual has passed the CBT. This evidence should be sent to Tier2limits@homeoffice.gsi.gov.uk to support your application.