How to Hire International Nurses

Jun 11, 2021

How to Hire International Nurses

Recruiting international nurses lets UK-based healthcare organisations cast their nets across the ocean and tap into a wider talent pool. And given the current staffing shortages, why wouldn’t you increase your chances of reeling in a top candidate?

If you hire nurses from overseas, you can also build professional and cultural exchanges that benefit your organisation as a whole. But if you haven’t worked in this space before, it can be daunting. The paperwork can be pretty exhaustive with all the professional registrations and sponsorship applications to consider – and that’s all on top of the usual hiring process!

The good news is that you don’t have to go it alone. Below, we’ll help you get your head around the key steps so you can sail through the process and welcome your new hire in no time.

Step 1 – Register with the Nursing and Midwifery Council (NMC)

Get ready for some acronyms! Yes, this might look overwhelming, but the easiest way to understand is to break this down using a glossary of terms that end with your new hire’s NMC registration. This applies to all nurses who have trained outside the European Economic Area (EEA).

Test of Competence (ToC)

This is the full process an overseas nurse goes through to register with the NMC.

Computer-Based Test (CBT)

The first step in the ToC is an exam made up of 120 multiple-choice questions related to their professional field of practice. The exam itself lasts four hours and results are typically made available 48 hours after the exam is completed. You can read more about the CBT here and access test blueprints to help your new starter prepare for the exam.

Objective Structured Clinical Exam (OSCE)

Only once the nurse has passed the CBT can they move to the next step – the OSCE. This is the practical part of the process and is held in one of the UK’s three university campus test centres in Northampton, Oxford and Ulster. Here, international nurses are introduced to six different stations complete with fictitious patients. The idea is for nurses to demonstrate their capabilities assessment, planning, delivery and evaluation of care in a mock-clinical setting.

Once an overseas nurse has entered the UK, they have 12 weeks from starting their employment contract to complete the OSCE. Until then, they are eligible to work in a pre-registration capacity. During this time, it’s helpful for local healthcare organisations to support their new starter, such as running through the NM nursing blueprints.

While not an official step, candidates are also required to provide a range of paperwork, including evidence of their identity, health and character, professional qualifications and level of English. They will also need to pay a few fees.

Note: A new ToC is launching in August 2021 which includes changes to the testing process. You can read up more on the NMC’s

Step 2 – Apply for a Certificate of Sponsorship

Still with us? Good, because this is an important part. International nurses need to be sponsored, and to apply for a certificate of sponsorship, the nurse must have a job offer plus one of the following:

  • Full registration with the NMC
  • Have passed the CBT (the first step towards full registration) or
  • Have been sponsored for a supervised practice placement (as approved by the NMC)

As part of the sponsorship process, healthcare organisations will need to provide a copy of the employment offer letter as well as email correspondence from the NMC providing evidence of their registration.

If you’re not already set up with a sponsorship licence, you can read through some further tips and advice from our team on how to become a healthcare sponsor.


If that was enough to make your head spin – don’t worry! Working with a trusted international nursing recruitment agency like WESolutions will make the process much easier and less stressful. Our specialist team of recruiters has built a solid reputation as experts in hiring qualified international nurses. We’ve been working NHS Trusts as well as private hospitals and care homes for years, so we know this process like the backs of our hands.

We know how useful hiring international nurses can be for your team and will be here to guide you through every bit of bureaucracy. We even offer a free half-day session to help explain the process to employers wanting to know more about how to hire international nurses.

So what are you waiting for? Give us a call to learn more and sign up for one of our information sessions today!