Working in the UK

Arcadia Nursing will guide you through the application process to becoming a registered nurse in the UK via the Nursing and Midwifery Council (NMC).

The Nursing and Midwifery Council regulates nurses and midwives in England, Wales, Scotland and Northern Ireland. They set standards for nurses and midwives to meet in their working lives. Nurses and midwives have a code of conduct that they must stick to, that states how they must work and behave.

To protect the public, the NMC set standards for education, to make sure nurses and midwives have the right skills and qualities when they start work. The NMC set standards for education throughout nurses’ and midwives’ careers, after they initially qualify.

The NMC keeps a register of all nurses and midwives in the UK who have met these standards and have been admitted to our register.

Registering to practice as a nurse or midwife in UK

If you want to work as a nurse or a midwife in the UK you must register with the NMC. The NMC Register consists of three parts:

  • Nurses.
  • Midwives.
  • Specialist community public health nurses.

The nurse’s part of the Register is divided into four fields of practice:

  • Adult nursing.
  • Mental health nursing.
  • Learning disabilities nursing.
  • Children’s nursing.
  • You can apply to be on the nurses or midwives parts of the Register, as long as you meet the NMC standards.

    If you are a nurse it is likely that you have trained as a general nurse. As a result, you should apply for registration with us as an adult nurse.

Your responsibilities as a registered nurse or midwife in the UK

Before you apply, we think it is important for you to understand the responsibilities of a registered nurse or midwife in the UK.

Becoming a nurse

In the UK, all those wanting to become a registered nurse must complete a pre-registration nursing programme. The NMC sets standards for the length and content of these programmes, which take place in approved education institutions (usually universities). Only nurses who have:

  • Successfully completed an approved programme (or hold a qualification that is of a comparable standard to an approved programme completed in the UK)
  • Met the NMC requirements of good health and good character can apply to join the Register as a nurse.
  • For those trained outside the European Union, to enter the register applicants must have successfully completed a qualification that is of a comparable standard to nursing qualifications awarded in the UK. As part of the registration process we will assess the duration and content of their nursing training programme(s).
  • The requirements for the duration and content of your nursing training programmes will depend on which part of the Register you wish to join.

Requirements for renewal of registration as a nurse with the NMC

Registration must be renewed annually and every three years, evidence of continued professional development must be provided. This standard requires the applicant to demonstrate 450 hours of registered practice activity and undertake a minimum of 35 hours of learning activity relevant to their practice during the three years prior to the renewal of registration. This continuing professional development is known as PREP (Post-registration education and practice) and is the professional standard set by the NMC.

Whatever the terms of nursing employment, every registrant must provide evidence of continued professional development in order to sustain registration as a nurse with the NMC.

Responsibility and sphere of practice

Registered nurses may work in a variety of health related settings including the National Health Service, private hospitals and nursing homes or in the community. In any circumstance the nurse is accountable for his or her own practice.

This responsibility cannot be delegated elsewhere as the nurse is recognised as an autonomous practitioner. However, each nurse must ensure that their sphere of practice is competent and evidence based, by targeting required learning and experience to maintain their expertise, whatever the circumstances of employment.

Practising as a midwife in the UK

Registration on the midwifery part of the NMC register only provides evidence of qualification. Therefore registration alone does not permit registered midwives to practice their profession.

In order to practice, each midwife must have a named supervisor of midwives (SoM) and must notify the local supervising authority (LSA) annually, of their intention to practice. The NMC sends each midwife a personalised Intention to Practice (ItP) form every year. This form enables the local supervising authority to check and monitor that each midwife is eligible to practice.

Completion and submission of the annual ItP form to the local supervising authority is a legal requirement of every midwife who works in the UK.

Mandatory requirements for nurses and midwives applying to join the Register

To enter the register, all nurses and midwives will be required to demonstrate that they meet the following requirements:

Language requirement
English is the main language that is spoken and written in the UK and applicants must be able to show that they can communicate clearly and effectively. They must complete the academic version of the International English Language Testing System (IELTS) and achieve an overall average score of seven (out of a possible nine) and at least seven in each of the academic areas of the test (listening, reading, writing and speaking). This is a mandatory requirement and we will not accept lower scores. There are no exceptions.

We will independently verify the scores with the IELTS organisation. Please note that we consider an IELTS test result to have a validity of no more than two years. We will only accept IELTS test results that are no more than two years old at the time that the application for registration is submitted

Practice Requirements
At the time of the application, the applicant must have been practising as a registered nurse or midwife for at least 12 months (full-time or the part-time equivalent) after qualifying. Also, if the applicant has been qualified for longer than this, they must have also practised for at least 450 hours in the previous three years. The NMC defines ‘practising’ as working in some capacity by virtue of your registration as a nurse or midwife. Practice can include administrative, supervisory, teaching, research and managerial roles as well as providing direct patient care. In addition, this can include volunteer work as long as any practice is registered.

If the applicant is a nurse and has not practised in more than five years prior to their application with us, they will have to undertake a longer version of the Overseas Nurses Programme
If they are midwife but they have not practised midwifery in the five years prior to their application with us, they must do a return to midwifery practice course in their home country,

If you have not been practising as a registered nurse for at least 12 months, then you cannot apply to register with the NMC until you have completed this. This is a mandatory requirement, for which there are no exceptions.

Registration requirements

When you apply you must hold a current registration or license without restriction with a relevant Licensing Authority/Registration Body in the country in which you qualified or have been practicing.

Education Requirements

You must have successfully completed at least 10 years of school education before starting a post-secondary education nursing or midwifery training programme, leading to registration in your home country as a first level registered nurse or midwife.

The Overseas Nurses Programme

Following your initial application, you will have to undertake all or part of the Overseas Nurses Programme in an approved education institution in the UK.

The ONP enables the assessment of your ability to practice in a UK healthcare environment and was developed to be comparable to the requirements made of UK trained nurses. The programme is made up of two elements:

  • Twenty days protected learning, and
  • A period of supervised practice in the UK.

The duration of the supervised practice element can be for any period in excess of three months.
All applicants will be required to undertake at least a three month supervised practice placement before registering with the NMC.

We will provide details of the duration of supervised practice in the decision letter we send you at the end of stage two.

The protected learning time will contain study specifically relevant to the practice of nursing in the UK, for example; covering the structure of the UK health care system, the NMC Code of Professional Conduct and your personal accountability as a registered nurse.

The programme contains competencies designed to ensure fitness for practice in the UK. You will achieve these within the field in which you are qualified to practice (adult, mental health, learning disabilities or children’s nursing). You will receive a list of the competencies in the decision letter we send you at the end of stage two.

You may take the supervised practice in practice settings that have been properly audited by the approved educational institution responsible for the programme. The approved educational institution will arrange those placements as part of the programme as well as an appropriate mentor for you. Your mentor will be a registered nurse on the same sub-part of the Register to the one you are applying for and will meet our standards for mentors.

You will have two years after the date of issue of the decision letter to complete the ONP. If you do not complete the ONP within this timeframe, we will close your application. If after this time you still wish to apply for registration you will have to start the application from the beginning again. If you have started the Overseas Nursing Programme or Midwifery Adaptation but have difficulty in completing it within the two year timescale, you can contact us prior to the deadline to request an extension however, we can only offer a maximum of one extension.

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