Internationally Educated Nurses in the NHS: Pay Before and After NMC Registration

NHS trusts in England recruit many nurses who trained outside the UK. The pay is the same Agenda for Change scale as for nurses trained here, but there is usually a short period at a lower band while you complete the final steps of NMC registration. This guide explains how that works, and what to look for in a job offer.

Pay before NMC registration

Before you can work as a registered nurse in the UK, you must be on the NMC register. Most internationally educated nurses take the computer-based test before arriving and the OSCE, a practical exam, after arriving.

While you prepare for the OSCE and wait for your registration, you are usually employed in a non-registered role, often called a pre-registration nurse or international nurse in training. This is commonly paid on Band 3 or Band 4:

Take-home is for full-time hours with the NHS Pension and tax code 1257L. Your tax code may be an emergency code at first, which can mean too much tax in your first months. See our tax code guide.

Pay after you get your NMC PIN

Once you are registered, you move to Band 5 as a registered nurse:

Some employers recognise previous nursing experience abroad with a higher starting pay point. This is at the employer's discretion, so ask before you accept the offer.

OSCE support

Most trusts that recruit internationally run OSCE preparation programmes, with training, practice sessions and mentoring. Many pay for your first OSCE attempt. Check what happens if you need a resit: who pays for it, and whether there is a limit on attempts before your contract is affected.

What a relocation package often includes

Packages vary, but commonly include:

• visa application fees for you, and sometimes your family
• flights to the UK
• temporary accommodation for the first weeks or months
• OSCE fees and preparation
• an NMC application fee contribution

Under the Health and Care Worker visa, eligible health workers do not pay the Immigration Health Surcharge, and the visa fee is lower than for many other work visas. Rules change, so check GOV.UK for the current position.

Repayment clauses: read carefully

Many international recruitment contracts include a clause requiring you to repay some relocation costs if you leave within a set period, often two or three years. Ethical recruitment guidance for the UK says such clauses should be proportionate and clearly explained. Before signing, check:

1. the total amount you could be asked to repay
2. whether it reduces over time, for example by a set amount each month
3. what happens if you leave for reasons outside your control

Your NHS benefits from day one

As an NHS employee, you get the same terms as UK-trained colleagues:

• 27 days of annual leave plus 8 public holidays to start
• NHS sick pay, building up with service
• the NHS Pension, with a large employer contribution
• unsocial hours enhancements for nights, weekends and public holidays

Common questions

Does overseas experience count for annual leave? Usually only NHS service counts automatically. Some employers recognise other experience at their discretion.

Can my family join me? The Health and Care Worker visa allows eligible dependants. Check GOV.UK for the current rules.

Will I have to pay back my visa fee if I leave? Only if your contract includes a repayment clause covering it.

Your first months: a money checklist

Setting up your finances quickly helps you get paid correctly:

1. Apply for a National Insurance number if you do not already have one. You can usually start work while you wait, but tell payroll as soon as it arrives.
2. Open a UK bank account so your salary can be paid. Your employer can often provide a letter to help.
3. Check your tax code on your first payslips. Without a P45, you may be on an emergency code until HMRC has your details.
4. Set up access to your eVisa, the online record of your immigration status, and keep your details up to date.
5. Register for council tax at your new address. Discounts may apply in some cases, such as living alone.
6. Keep records of any relocation payments and conditions.

If you have family members joining you, plan the costs of their visas and travel early, because they are often not covered in full by a relocation package.

Check your figures

Use the take-home pay calculator to see your pay on Band 3, 4 or 5.