To work as a registered nurse in the UK, you must be on the register of the Nursing and Midwifery Council (NMC). This is true for every nurse, wherever you trained. If you trained outside the UK, you follow the NMC’s international route. Midwives follow the same route, with a midwifery version of the tests.
This guide explains each step, what it costs and how long it takes. It also covers the Health and Care Worker visa, which most nurses from outside the UK need. Fees and scores were checked on the official NMC and GOV.UK pages in October 2026.
The NMC route in five steps
The NMC’s step-by-step guide has these stages (NMC):
- Check you are ready. Look at the costs and the time it takes, and collect your documents.
- Eligibility and qualification application. You send proof of identity and details of your nursing qualification, and pay the evaluation fee. The NMC aims to assess your qualification within 14 days.
- Test of Competence. If the NMC asks you to, you pass the two parts: a computer-based test (CBT) and a practical exam (OSCE).
- Registration application. You send evidence of your health, your character and your English, and confirm you have professional indemnity cover (insurance for your practice).
- Final checks and decision. The NMC contacts your referees. It aims to decide within 30 days once it has everything it needs.
Once the NMC confirms you are eligible to apply, you have two years to finish your registration. Applications that do not move forward within three months of being opened are closed (NMC timescales).
You also need a face-to-face ID check, done at a Test of Competence centre (NMC).
The Test of Competence
Part 1: the CBT
The CBT is a computer test with two parts (NMC CBT):
| Part | What it tests | Questions | Time |
|---|---|---|---|
| Part A | Numeracy | 15 | 30 minutes |
| Part B | Clinical knowledge for nursing or midwifery | 100 | 2 hours 30 minutes |
Pearson Professional Assessments runs the CBT. It has test centres in most countries, so most people take the CBT at home before they travel.
You have three attempts in one application, with at least 10 days between sittings. All attempts must be within one year. After three fails, your application closes and you must wait six months before you apply again.
Part 2: the OSCE
The OSCE is a practical exam with 10 stations: four linked to a patient scenario, four that test clinical skills, and two on professional values and evidence-based practice (NMC OSCE).
You take it in person in the UK. In October 2026 the NMC lists three test centres: the University of Northampton, Ulster University and Leeds Teaching Hospitals NHS Trust. You book with the test centre after the NMC confirms you can.
You can take the OSCE up to three times, with at least 10 days between sittings. After three fails, you must wait six months.
NMC fees (checked October 2026)
These are the NMC’s own figures for nurses and midwives trained outside the UK. The evaluation and registration fees went up on 1 October 2026, so older websites may still show £140 and £153 (NMC costs):
| Fee | Amount |
|---|---|
| Qualification evaluation (not refundable) | £167 |
| CBT, first sitting | £83 |
| OSCE, first sitting | £794 |
| Registration fee | £182 |
| Total | £1,226 |
Resits cost extra:
| Resit | Amount |
|---|---|
| CBT, both parts | £83 |
| CBT, Part A (numeracy) only | £50 |
| CBT, Part B (clinical) only | £70 |
| OSCE, 7 or fewer stations | £397 |
| OSCE, 8 or more stations | £794 |
The evaluation fee is not refunded, even if you are not eligible or do not get registered (NMC). These figures do not include visa, travel or accommodation costs.
Once you are registered, you pay an annual fee to stay on the register. It rose from £120 to £143 on 1 October 2026 (NMC).
Some employers pay or refund some of these costs. Ask the employer before you accept an offer, and get the answer in writing.
English language
You must show the NMC that your English is good enough to practise safely. There are three types of evidence (NMC):
- An accepted English test with the required scores.
- Qualified in English: your nursing or midwifery programme was taught and examined in English.
- Recent practice in English: one year of recent practice as a nurse or midwife in a country where English is the majority language.
Some applicants can also add a reference from their employer, called supporting information from employers (SIFE). Check the NMC page to see if it applies to you.
Minimum test scores (checked October 2026)
| Skill | IELTS Academic | OET |
|---|---|---|
| Listening | 7.0 | B (350 or above) |
| Reading | 7.0 | B (350 or above) |
| Writing | 6.5 | C+ (300 or above) |
| Speaking | 7.0 | B (350 or above) |
Source: NMC accepted tests.
Rules for test results:
- Scores are valid for two years.
- You can combine two sittings of the same test if you took them within 12 months of each other, were tested in all four skills each time, and both are no more than two years old when the NMC assesses your full application.
- You cannot mix IELTS and OET results.
- The speaking test must be done with a person, not a computer.
The Health and Care Worker visa
Unless you already have the right to work in the UK, you will need a visa. Most nurses use the Health and Care Worker visa (GOV.UK). To get it you need:
- A job offer from a UK employer approved by the Home Office as a sponsor. You can check an employer on the register of licensed sponsors.
- A certificate of sponsorship (CoS) from that employer. It is an electronic record with a reference number, not a paper document. You must apply for your visa within 3 months of getting it.
- An eligible job. Nursing and midwifery jobs are in occupation codes 2231 to 2237.
- The right salary (see below).
- English at level B2. If you already passed an English test accepted by the NMC, you do not need to prove your English again for the visa (GOV.UK).
Salary (checked October 2026)
You will usually need to be paid at least £25,000 a year. If the “going rate” for your job is higher, you must usually be paid at least the going rate. For nurses, the going rate comes from the national pay scales, by NHS band and region (GOV.UK).
Visa costs (checked October 2026)
| Item | Amount |
|---|---|
| Visa fee, up to 3 years | £324 per person |
| Visa fee, more than 3 years | £628 per person |
| Immigration health surcharge | None for this visa |
| Savings | £1,270 for 28 days in a row, unless your employer certifies your maintenance |
The fee is the same from inside or outside the UK (GOV.UK). You and your family do not pay the immigration health surcharge. You usually get a decision within 3 weeks after your identity check. The visa lasts up to 5 years, and you can then extend it or apply to settle.
Your employer pays the sponsor licence fee, the CoS fee and the immigration skills charge. You should never be asked to pay these (GOV.UK).
Family
Your partner and children may be able to join you as your dependants. The rules are stricter for care worker jobs, so check the GOV.UK family page for your role before you plan.
Practical tips
- Apply on the employer’s own website. On this board, every job links to the employer’s own page.
- Check the sponsor. Make sure the employer is on the register of licensed sponsors before you accept.
- Read the contract. Some UK contracts have a repayment clause if you leave early. Ask what you would have to repay, and for how long.
- Never pay for a job or a CoS. See our guide to ethical recruitment and scams.
Frequently asked questions
How much does it cost to register with the NMC if I trained abroad?
The NMC says fees and tests cost £1,226 in total: £167 for qualification evaluation, £83 for the CBT, £794 for the OSCE and £182 for registration. Resits cost extra. This does not include visa, travel or accommodation. Once registered, you pay an annual fee of £143 (checked October 2026).
What IELTS or OET score do I need for the NMC?
For IELTS Academic you need 7.0 in listening, reading and speaking, and 6.5 in writing. For OET you need B (350) in listening, reading and speaking, and C+ (300) in writing. Scores are valid for two years. You can combine two sittings of the same test taken within 12 months.
Where do I take the CBT and the OSCE?
You take the CBT at a Pearson test centre, and there are centres in most countries, so most people take it before they travel. The OSCE is in person in the UK. In October 2026 the NMC lists three OSCE centres: Northampton, Ulster and Leeds.
How many times can I take the NMC tests?
You have three attempts at the CBT in one application, at least 10 days apart and all within one year. You can take the OSCE up to three times. After three fails at either test, you must wait six months before trying again.
Do nurses pay the immigration health surcharge on the Health and Care Worker visa?
No. On the Health and Care Worker visa, you and your partner or children do not pay the immigration health surcharge. The visa fee is £324 for up to 3 years or £628 for longer (checked October 2026). Your employer pays the certificate of sponsorship fee and the immigration skills charge.