Working as a nurse in the UK with an overseas qualification

To work as a registered nurse in the UK with an overseas qualification, you need to join the Nursing and Midwifery Council (NMC) register. That means an online application, proof of English, a computer-based test taken in your home country or elsewhere, and a practical exam (the OSCE) taken in the UK. Most nurses recruited from abroad come on a Health and Care Worker visa sponsored by an NHS employer, start in a pre-registration role, and move to band 5 once registered.

The NMC registration steps

The process runs in a fixed order.

1. Check your eligibility and create an NMC online account.
2. Provide evidence of your English language ability, normally through an approved test (IELTS academic or OET) at the scores the NMC sets, or through an accepted exemption.
3. Pass the computer-based test (CBT), part one of the test of competence. It is a multiple choice exam on nursing knowledge for your field of practice, taken at test centres in many countries.
4. Submit your full application with documents: qualification, registration in your home country, identity, health and character declarations.
5. Pass the objective structured clinical examination (OSCE), part two of the test of competence, at a UK test centre.
6. The NMC makes a decision and, if it approves, you are registered and get your PIN.

The NMC sets the fees for each stage and the English test scores, and changes them from time to time. Check the current figures on the NMC website before you book anything.

What the OSCE is like

The OSCE is a series of timed stations where you show practical skills and decision-making with actors and manikins: assessing a patient, giving medication, carrying out a procedure, planning care and communicating. It tests UK practice standards, including documentation, consent and infection control. Practice differs between countries, so even nurses with years of experience at home can fail stations, and preparation matters.

Most NHS trusts that recruit internationally run OSCE preparation programmes, often with a dedicated education team and practice sessions in a simulation suite. If you fail stations you can resit, though the number of attempts and the gaps between them are limited. Your employer will usually support a resit, but ask what happens to your job and visa if you do not pass in the time allowed.

Visas

Registered nurses and nurses who will register are eligible for the Health and Care Worker visa, a version of the Skilled Worker visa for eligible health and care occupations. The employer must be a licensed sponsor: an NHS body, an organisation supplying services to the NHS, or an adult social care provider registered with the CQC in England.

For healthcare jobs on national pay scales, the salary rule is at least £25,000, or the national pay scale rate if higher. NHS nursing posts meet this at band 5. The visa has lower application fees than the standard Skilled Worker visa, and holders are exempt from the Immigration Health Surcharge. The Health and Care Worker visa guide explains who qualifies now, including what changed for care workers in July 2025.

Your employer must carry out a right to work check before you start. With an eVisa, this goes through the Home Office online service using a share code. The right to work checks guide covers what employers ask for.

Pay before and after registration

Until you are registered you cannot work as a nurse. NHS trusts usually employ internationally recruited nurses in a pre-registration role, often at band 4 or band 3, until they pass the OSCE. In England from 1 April 2026, band 4 runs from £28,392 to £31,157 and band 3 from £25,760 to £27,476. The band depends on the trust.

Once registered, you move onto band 5. From 1 April 2026 in England, band 5 is £32,073 at entry, £34,592 at the intermediate point and £39,043 at the top. Inner London adds a 20 per cent high cost area supplement, subject to a minimum and maximum, so band 5 entry with inner London supplement is £38,488. Scotland pays its own Agenda for Change rates, with band 5 starting at £34,494 in 2026/27.

Costs and repayment clauses

Many NHS employers pay some or all of the CBT, OSCE, NMC registration, visa fees and flights, and provide temporary accommodation. Some include a repayment clause, under which you repay part of those costs if you leave within a set period. Read any clause carefully before signing. A recruiter may not charge you a fee for finding you a job, and if an agency asks you for money, check with the employer directly.

If you are already in the UK on a different visa, such as a student or dependant visa, you may be able to switch, depending on your current visa type. Take immigration questions about your own situation to the employer’s sponsorship team or to an OISC-registered adviser or immigration solicitor.

After you start

New registrants, including internationally educated nurses, usually go through a preceptorship period with extra support in the first months. You will need to revalidate with the NMC every three years. The NMC revalidation guide explains what you need to record from the start, and the band 5 guide covers progression through the band.