Supporting nurses from overseas to achieve their registration: update to the Nursing and Midwifery Council requirements


This update outlines concerns raised by providers in regards to obtaining registration for overseas nurses and the Nursing and Midwifery Council (NMC) response given in November 2016.

International English Language Testing System (IELTS)

Provider issues:

  • no significant impact from the Introduction of combining scores from two IELTS tests 
  • how relevant the English Language test is to the healthcare setting
  • it takes between 12 and 18 months for a candidate to move from 6.5 to 7.0

NMC response:

Following public consultations and evidence from the British Council, NMC has determined that a score of 7 was the appropriate level for overseas trained nurses and midwives to achieve as part of their application for registration. The British Council considers those achieving a level 7 score to be a good user of the English language, with operational command over it. This is the level NMC would expect from those working in a regulated healthcare role.

Objective Structured Clinical Examinations (OSCE)

Provider issues:

  • providers have raised concern in regards to booking candidates at Northampton university
  • one provider identified that 50% of candidates pass on the first attempt
  • if nurses fail the first OSCE, providers report they get limited feedback on where they have gone wrong so find it difficult to identify what they should work on before their second attempt

NMC response:

NMC is working closely with the OSCE test centre and has commissioned two further test centres to explore how they can support those taking the test to increase pass rates. Additionally: 

  • they have created a ‘top tips’ and candidate guidance booklet which includes information for candidates and employers on the most common reasons for failure in the OSCE
  • each candidate who fails is now given specific feedback on the areas in which they have failed and signposted relevant materials that can help them update their knowledge and prepare for a further test 
  • they have introduced a change allowing candidates to share their feedback with their employer or sponsoring body so that they can work together to address any shortfalls

NMC to issue familiarisation materials in December 2016 to help prepare candidates and set expectations. These will be shared with candidates preparing for the exam, employers and recruitment agencies.

Processing applications

Provider issues:

  • providers report that the assessment queue can take anything up to 3 weeks before the file moves into the assessment stage
  • one provider reported several occasions where documents are lost in the NMC even if they have been submitted online or taken via courier 
  • if a candidate needs to submit extra material to the NMC they go back to the assessment queue (which can take anything up to 70 days again)

 NMC response:

  • once in receipt of all necessary documents NMC aims to process applications from overseas nurses and midwives within 68 calendar days
  • following work to streamline processes and improve the training and support for staff, the NMC reports that the average time to process applications has improved to 23 days
  • the international team that manages the application process is moving towards a case ownership approach when assessing applications which will mean customers get a named contact to provide assistance throughout the application process
  • the team is spending more time speaking to applicants on the telephone to support them to get their documents right first time
  • a programme of work starting in January 2017, which will review the clarity of the guidance and letters related to registration requirements

If you would like more information or to raise a query, contact Zoë Packman, Head of Professional Development:

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