Update: overseas registration of nurses and midwives

Published on 11 March 2013

The Nursing and Midwifery Council (NMC) is committed to reviewing all its policies and procedures to ensure it acts to a high standard of regulation, protecting the public.

The NMC announced suspension of overseas registration on 1 February 2013 while it conducted a review, involving external expertise.

Although the review is not complete, the NMC can state the two issues identified at this point.

Jackie Smith, NMC Chief Executive said:

“We need to offer the public a high degree of confidence in overseas registration. We recognise that what has been done has not been as robust as it should have been and we’re sorry. However we are moving quickly to redress this and produce a strong and consistent system to protect the public. We intend to resume overseas registration as quickly as possible.

“The new leadership of the NMC is determined to address all areas where we have fallen short.”

Issue one: concerns over training requirements from four countries
In nursing, generally the practice has been to allow applicants from Australia, Canada, New Zealand and the US to register after a 20 day course. Most other applicants have needed a three or six month adaption training course.

The policy meets the NMC’s Order, the EU Directive and equalities legislation. However it is not clear what was done in practice followed the policy.

No evidence has come to light as to why this has been done.

It is likely that the distinction will be replaced by an assessment based on the training programme and work experience involved in each country, to ensure a level playing field in terms of standards.

In midwifery, the policy has been applied consistently.

Issue two: concerns about validating identity information
Although a substantial amount of identity, training and registration material is required, the approach in how this information has been certified as correct is inconsistent.

The NMC will resume overseas registrations 2 April 2013 with consistent policies and procedures, a robust approach involving a high standard of proof, to protect the public.

The review still needs to scope the scale of issues and the legal and proportionate remedies which might be taken for individuals already on the register.

The NMC can confirm that it is considering requiring applicants to attend an NMC office in person with their identity documents, as the General Medical Council does. No decision has been taken as yet and such a system, if introduced, could not be brought in immediately.

Further information

The NMC should and will ensure its register is robust. However other checks exist on identity. It is illegal to hire someone who is not entitled to work in the UK. The UK Borders Agency sets out clearly best practice, under which potential employees need to provide originals of ID documents to their employer. Following this best practice is the only valid excuse for an employer, if found to have hired someone not entitled to work in the UK.

The NMC insists that all non EU nurses provide evidence of a high standard of written and spoken English. The NMC’s legal powers to test the language skills of EU nurses are limited and it has called for new powers to do this. The Health Select Committee agrees this is “a significant weakness” in the NMC’s current legal powers.

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