Nursing in the UK
by Simon Wright
Monster Healthcare Expert
Many employers are keen to recruit nurses and midwives from overseas. However, those coming from outside the European Union must meet a number of requirements to work in the UK.
What do you need to know?
If you are not a UK citizen, and qualified as a nurse or midwife outside the UK, this article answers some frequently asked questions about seeking employment in the UK. The information falls into three main areas:
- Registering with the Nursing and Midwifery Council (NMC)
- Getting a work permit
- Getting a job
Will your qualifications be recognised?
The qualifications of nurses and midwives who are citizens of EU or European Free Trade Area (EFTA) countries are recognised under an agreement between all member states. However, you need to register with the Nursing and Midwifery Council (NMC) - the UK's regulatory body - unless you only want to work in the UK temporarily. Your qualifications will not be recognised automatically if you are not part of the European Union.
The process of registering with the NMC can take months. At the time of writing the NMC are experiencing delays in processing overseas registrations, although it aims to process them in 135 days. Applications for entry to the NMC's register are considered on the basis of education, training and registration outside the UK, as well as the ability to communicate effectively in English. For those outside the EU or EFTA they are considered on an individual basis, therefore it’s not possible to say whether an application will be accepted immediately, or might involve a long wait and further work or study. However, training in some countries may lead to rapid acceptance providing certain criteria have been met. These countries are the USA, Canada, New Zealand, Australia, South Africa, the West Indies and Hong Kong.
How do you find out?
The NMC's registration department has a dedicated team to handle overseas registrations. You can telephone the department on (+44) 20 7333 6600 between 08.00 and 17.00, weekdays, or email OverseasReg@nmc-uk.org.
Alternatively, you can write to:
Registrations Department
NMC
23 Portland Place
London
W1B 1PZ
Where can you get further information?
Information for nurses and midwives trained outside the European Community is contained in the NMC booklet Registering as a nurse or midwife in the UK. To obtain a copy write to the NMC, or email publications@nmc-uk.org. You can also download it at www.nmc-uk.org.
How do you apply?
The NMC has an application pack. Before it will send the pack out, however, you will need to provide information on your:
- title (for example: Miss, Mr, Mrs, Dr etc.)
- forenames
- surname (or family name)
- date of birth (dd/mm/yyyy)
- country of origin/training
- whether you wish to be registered as a general nurse and/or a mental health nurse and/or a nurse for the mentally handicapped (learning disabilities) and/or a sick children's nurse and/or a midwife
Write to the NMC or email overseasreg@nmc-uk.org to request an application pack.
Will you have to pay?
Yes. If you are an overseas (non EU or EFTA) applicant you will be asked to pay a non-returnable fee of £117 to receive the full application pack. You should not send this until you are asked to do so by the NMC. If you are accepted, you will have to pay £93 for your first three years' registration.
What is a 'supervised placement'?
Nurses and midwives from some countries are advised by the NMC to obtain a supervised placement in a hospital or approved nursing home, where their clinical abilities can be assessed. You will work as an unqualified care assistant for a set period, then, following correspondence with your employer, a decision will be made regarding your registration. Any NHS trusts looking to employ nurses and midwives from overseas is worth approaching.
UK employers have a fair degree of freedom in how they organise these placements. To find an arrangement that suits you approach more than one potential employer. You will not have to pay any commission or fees, and you will be giving them the benefit of your experience, if not your registration, so they should be generous!
The NMC website lists all nursing homes that are currently approved to offer supervised placements. If you do a placement at an unapproved home the NMC will not accept you onto the Register.
What is a work permit for?
The work permit scheme permits British employers to hire people from outside the EU or EFTA; who would otherwise be prevented from working in the UK. Work permits are issued only where there is a clear benefit to employment and the economy in Britain. Typically, they are only issued to senior managers, highly skilled professionals or personnel with rare technical skills; when the employer demonstrates that they cannot fill the vacancy with a British, EU or EFTA national. The current shortage of nurses and midwives in the UK means that most overseas applicants are unlikely to have problems getting a work permit.
Who needs a work permit?
Everyone except:
- European Free Trade Area (EFTA) nationals, which includes British citizens, nationals of member states of the EU or Iceland, Norway, Gibraltar and Sweden.
- Commonwealth citizens given leave to enter or to remain in the UK on the basis that a parent or grandparent was born here.
How does it work?
A work permit is only issued for a specific employer and post. If you apply for a post with a different employer or for a different occupation, then your new employer must make another application (for change in status). To apply for a work permit for a prospective employee the employer must:
- be able to give reasons why they have not been able to recruit within the EC
- have advertised the post nationally (within the last 6 months) in a national newspaper or in a recognised trade or professional journal.
- provide the advertising details and the response rate, with reasons why other prospective candidates were not suitable.
Once the need for a work permit has been established, the employer will then arrange the application for the permit. Applications typically take between 6-8 weeks to be processed. If there is any doubt over a person’s work status, the employer will not make the application, as it is unlawful to employ someone without a valid work permit. So the paperwork, however complex, must be completed correctly!
How do you get a job?
Nursingtimes.net contains a collection of Careers Advice Articles, and the widest range of nursing Jobs. It may be worth approaching employers who advertise, even if you do not see a post that interests you. It may be that they have other posts, yet to be advertised.
How does clinical grading work?
The UK has a system of clinical grading for nurses and midwives, which aims to allow an easy comparison in scales of pay in very different places. Although there is some variations in the way employers interpret the grades, they are broadly defined as follows (nursing posts are listed, but the equivalents apply for midwives):
- Grade A: Nursing assistant, nursing auxiliary, care assistant, health care assistant ... with no training or recognised qualification
- Grade B: As above, but may hold a National Vocational Qualification (NVQ) which will have involved some on the job and classroom tuition.
- Grade C: State Enrolled Nurse - an old qualification, no longer issued. There are still many enrolled nurses, but many have 'converted' to Registered Nurse status. Many others will have earned a higher grade through experience or post-enrolment professional development.
- Grade D: Basic staff nurse. Registered Nurse (RN), Registered General Nurse (RGN) State Registered Nurse (SRN) plus all the mental health, learning disability and other equivalents. This is the grade given to newly qualified nurses and those returning after a break in service or those changing speciality. An employer would not expect much experience or any post-registration qualifications.
- Grade E: Staff nurse. Registered Nurse (as above), but an employer would expect either some relevant experience (about a year is typical) or a post registration qualification - such as a clinical course - in the speciality. Can be asked to take charge of the ward/department for a shift, but should not be expected to take continuing responsibility in such a way.
- Grade F: This may be advertised as senior staff nurse, team leader or junior charge nurse. Whatever the title, the holder will be an experienced nurse, with relevant clinical qualifications, who is willing and able to deputise for the ward sister/charge nurse/manager.
- Grade G: Charge nurse/sister/ward manager.
- Grade H: Clinical specialist - an expert in a speciality such as infection control or a clinical manager responsible for several related wards/departments (perhaps two wards, a clinic and a procedures room..)
- Grade I: Senior version of H. This is still a clinical grade, so it is the top nursing post within a speciality, and may cover more than one hospital or a wide stretch of community.
Many newer types of posts do not fit well into the grading system, such as nurse practitioner, nurse consultant and modern matron. It is useful to check what the employer wants in terms of experience, qualifications and responsibility, and see if the grade seems fair compared to other jobs. Employers are increasingly expecting nurses to have a degree, and for senior posts, a master's degree or to be 'working towards one'. That's fine - but the salary should recognise this and be a grade higher than the non-degree equivalent. If, however, a degree is 'an advantage' or 'desirable but not essential', then this should probably be interpreted as an employer expecting hundreds of applications who wants to reduce the numbers!
Does the NMC provide indemnity?
No. 'Professional Indemnity Insurance' is not provided by the NMC with registration. Most UK nurses are members of a union, and they provide insurance as part of the membership package. The union with the largest number of qualified nurses is the Royal College of Nursing, Unison and the Community Practitioners and Health Visitors are the other big nursing unions, while many midwives are members of the Royal College of Midwives. Most nurses and midwives are also covered by their employers' vicarious liability insurance.
Contact Address:
Nursing and Midwifery Council (NMC)
23 Portland Place
London, W1B 1PZ
Tel: (+44) 20 7637 7181
www.nmc-uk.org
This information may change without notice, so you are urged to check with the sources cited in the text.
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