Best of times, worst of times for RNs in the UK


THE UK needs nurses – badly, urgently as in yesterday – that’s on the “Best of Times” column.

The National Health Service (NHS) and the Royal College of Nursing (RCN) confirm the nursing shortage, and threat to patient care for lack of qualified and competent nursing staff.

Overseas or non-EU nurses in the UK are overworked and underpaid. In addition, they face deportation and extreme difficulty in qualifying for permanent residency. Chalk that on the “Worst of Times” column.

In between the “worst” and the “best” comes a temporary sigh of relief.

After widespread condemnation of the UK rule threatening to deport nurses and other skilled workers who have stayed in the UK for five to six years, Home Office Secretary Theresa May begrudgingly agreed to let nurses be sponsored and stay – until either the furor dies down or anytime the Home Office mood changes.

Tens of thousands of openings
The RCN warns continued nursing shortages would “severely jeopardize” the success of the whole NHS modernization agenda.

With an aging workforce, shrinking pool of RNs (24 percent are set to retire in the next five years) and up to 20,000 nursing vacancies in England, the nation’s healthcare will be at risk.

Overseas nurses have become a “vital” source of new entrants, making up 40 percent of new RNs last year, the RCN reported, but getting them into the UK has become a Sisyphusian endeavor.

How to qualify
Assuming there are qualified and eligible UK sponsors, a nurse from the Philippines, India or anywhere overseas, the Nursing and Midwifery Board (NMB) of the UK sets the standards for competency.

Canada and the US require the passing of the NCLEX exam. The NMB has its own set of theoretical and clinical experience exam stages: Part one is a multiple-choice type of examination and part two is a practical examination called an OSCE (objective structured clinical examination). The first part may be taken in any overseas Pearson VUE test site, but the second part has to be completed in the UK – a “face-to-face identification check at the University of Northampton’s test center on the day of the OSCE exam.”

The applicant must score a minimum of 7.0 in each of the IELTS language components; and must have three years of specialist pre-registration education and practice. The application costs 1,415 pounds sterling or PhP98,273.00.

Under POEA rules, the employer or the licensed recruitment agent cannot and should not charge the applicant. It is understandable that the UK employer or sponsor would have to select the best RN applicants who would likely pass the NHS OSCE exam. Otherwise, it will be a costly and wasteful recruitment effort.

What’s the passing rate of overseas RNs?
rn20160208Back to our sponsor
The UK employer must be on the Registry of UK employers allowed to recruit nurses from overseas under the Tier 2 (General Worker) category.

This is the link to the updated and complete registry listing –

After being registered, the employer then appoints a POEA licensed recruitment agency to assist with the authentication and accreditation of the job order with the Philippine Overseas Labor Office. These authenticated documents are submitted to the POEA by the licensed agency for accreditation, registration and listing. The the approved or available job orders are published.

The approved/available job orders as of time of writing show that more than 90 percent of the orders are for nurses. Check this link –

POEA approved job orders for nurses in the UK
Almost all of the job orders are for RNs, 2 specialist software; 17 radiographer diagnostics; 25 specialist aircraft modification and manufacturing; 1 audit executive/auditor; 11 engineering-related; 6 leading hand transmission; 3 supervisor lineman foreman and 20 erectors; 10 pipe fitter; 20 welder pipe; 95 fitters; 90 platers and 30 technicians.

Applicant’s responsibilities
While the UK employer and/or appointed licensed agency shall pay for the costs of recruitment and deployment, it is fair to require applicants to be qualified when they apply for the available job orders.

This means each applicant must have a current and valid passport, NBI clearance, medical exam and the required IELTS exam results of 7.0 minimum for the speaking, writing, reading and listening parts.

So much demand, but so few openings
While there are tens of thousands of vacancies for RNs now and in the immediate future (at least five years hence) the registered UK employer would have to contend with the limited number of sponsorships issued by the Home Office.

As of January 2016, there were only 2,135 available for this month (February) – and that allocation is worldwide, not just for the Philippines.

What happens if the Overseas Nurse Fails the OSCE?
The rules require the sponsor to report the results of the OSCE within 10 working days. The tier 2 guidance states that:

The RN may retake or “re-sit “if the sponsor still want to sponsor . The sponsor must report the results if the RN fails the second time.

The sponsor is no longer eligible to sponsor if the RN does not pass the OSCE within eight (8) months of the start date on the Certificate of Sponsorship (CoS).

The date the RN passed the OSCE, the sponsor reports the results to NMC and start working becomes the start of the five-year work or stay limit under the tier 2 category.

Under new immigration rules applicable from 6 April 2011, set to be introduced next year (2017), up to 3,365 nurses could be forced to leave the UK in 2017 immediately.

The rule change means that people from outside the European Economic Area (EEA) must be earning 35,000 pounds or more before they are allowed to stay in the UK after six years. By 2020, at current levels of international recruitment, the number of nurses affected could rise to more than 6,000. If levels of international recruitment rise, the Royal College of Nursing estimates that this figure could hit over 29,000.

Temporary sigh of relief not a permanent prescription
After the damning NHS report and widespread criticism within the healthcare industry October last year, the UK government relented – again begrudgingly. This report and video of a Filipino nurse working in the UK is available through this BBC link –

The official word followed with Health Secretary Jeremy Hunt announcing the “temporary changes to restrictions on nurse recruitment from outside European Economic Area to ensure safe staffing levels across the NHS.”

The announcement included a grim reminder of the provisional nature of the concession. “The Independent Migration Advisory Committee will review the change and present further evidence to the government by February 2016.”

Health Secretary Jeremy Hunt also emphasized that the UK is already ”recruiting more home-grown nurses than ever to deliver a truly seven day NHS. There are already more than 8,000 additional nurses on our wards since 2010 and we are investing in our future workforce with a record 50,000 nurses currently in training.”

So is it is the “best” or “worst” time for the Filipino and overseas nurse?

If you have at least two to three-year experience, the opportunity is good. As long as the UK rules remain the same, your life should be better. Best if your employer remains a qualified, eligible and sponsor willing to retain you.

Remember you only have five years to remain or stay in the UK. You also need the same number of years to be qualified to apply for permanent residency or settlement.

If you fail the OSCE, that would be bad. If the sponsor agrees to have you take the OSCE again and you failed the exam, that’s worse. Being asked to leave or deported takes the “worst” prize.

Unlike Canada, New Zealand or Australia, you can change category from student to working and vice versa. Not in the UK.

That makes the UK the worst place to be – at this time.


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1 Comment

  1. Wow you are criticising the uk. I ask you why do you worry that the uk has so few nurses. It doesnt affect you one iota. But let me tell you once a foreigner stays in the uk for the required time they can apply for british citizenship & once they get that its forever. Now compare how the Philippines treats foreigners. They can never ever get filipino citizenship. No every year ( if they have an i-card ) they have to pay an annual registration fee of P310 & every 5 years they have to go through the whole rigmarole of meeting the requirements needed for an i-card. So a quick recap become a brit & get all the benefits associated with it, live in the Philippines & nothing is ever guaranteed for you, for ever & a day they want more & more money off you. Plus once out of the country you cant pay your annual P310 in london at your embassy. So if the uk has any faults they are nothing compared to the Philippines. ( nurses salaries range from £21,000 to £28,000, thats P1,470,000 to P1,960,000, not bad hey, now tell me the salaries in the Philippines )