Recruitment of overseas nurses and midwives

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19 / 4 / 2016 4pm

Nurses and midwives who have trained outside the EEA (European Economic Area) 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 observed structured clinical examination (OSCE) which will always be held in the UK.

The immigration rules changed in March 2015 to allow for an individual nurse to come to the UK to prepare for the OSCE.   

Rules for employers and overseas nurse applicants

  • All overseas applicants need to pass a computer-based test and comply with all other initial requirements of the NMC overseas nursing process to be eligible to sit the OSCE and complete their registration. In June 2016, the NMC changed how an overseas applicant can meet the required level of seven in the IELTS exam.
  • An individual entering the UK to take a nursing role has up to 3 months from the employment start date noted on the Certificate of Sponsorship 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 1 of the NMC test of competence, and 
    • the individual has been issued with an offer of employment.
  • You are required to provide evidence of the above in any applications for restricted 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 computer-based test (CBT). This evidence should be sent to Tier2limits@homeoffice.gsi.gov.uk to support your application.
  • 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.
  • If an individual fails the OSCE at their first attempt, they will need to obtain a date to re-sit the test within a maximum of eight months from the start date of their visa. This gives potential time for candidates to address development needs and prepare thoroughly for any re-sit. 
  • If an individual fails their OSCE re-sit, they will need to leave the country immediately, as they will no longer have the right to work.
  • 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 included on shortage occupation list

On 15 October 2015 nursing was added to the Home Office list of shortage occupations. This was an interim measure whilst the Migration Advisory Committee (MAC) conduct a review of nurse supply and demand to determine whether nursing should be included on the list beyond this interim period. 

In March 2016, the government announced that nursing will remain on the shortage occupation list, but employers have to carry out a Resident Labour Market Test (RLMT) before recruiting a non-EEA nurse from autumn 2016. Find out more information in our Tier 2 policy changes section.

The continuation of nursing on the shortage occupation list means:

  • applications for Restricted Certificates of Sponsorship (RCoS) will be prioritised by the UK Visas and Immigration (UKVI) points allocation system - increasing the likelihood of nursing applications being granted. Applications have been considered as part of the shortage occupation list since the December 2015 UKVI allocation panel.
  • employers can issue a certificate of sponsorship to an individual from outside of the EEA for a nursing role without the need to demonstrate that a resident labour market test (RLMT) has been carried out (please note that employers will be required to carry out a RLMT when recruiting a nurse from outside of the EEA from autumn 2016).
  • 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

  • The first allocation panel to consider nurses as a shortage occupation was in December 2015. 
  • The Home Office have been really 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 Nursing and Midwifery Council; or
    • have passed the Nursing and Midwifery Council's Computer Based Test (CBT) of competence (part 1); or
    • have obtained Nursing and Midwifery Council permission before 30 April 2015 to undertake the Overseas Nursing Programme, and be sponsored to undertake a supervised practice placement as part of the programme, which has been approved by the Nursing and Midwifery Council.
  • You are required to provide evidence of the above in any applications for restricted 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 computer-based test (CBT). This evidence should be sent to Tier2limits@homeoffice.gsi.gov.uk to support your application.

We are still working within an overall cap of certificates. The inclusion of nursing is likely to have an impact on the success of other applications from health and other business, its therefore really important that we uphold these requirements from the Home Office to ensure we do not create a surplus of unused certificates.  

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