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We use the Test of Competence (ToC) to assess the skills and knowledge of people wanting to join our register from overseas or rejoin our register after a long period away from practice.

Throughout 2019 and 2020 we've been working in partnership with AlphaPlus to develop a new Test of Competence that reflects our new standards for nurses and standards for midwives.

This was scheduled to go live in summer 2020. However, we've decided to postpone the launch of the new Test of Competence until April 2021 to give candidates, employers and recruiters time to prepare for the new test.

When is the new test launching?

We'll start testing candidates with the new Test of Competence from April 2021 onwards.

Ahead of this time, we'll publish more details of the new test and supporting resources to help people prepare.

How the test will be changing

The computer-based test (CBT) will be split into two parts - Part A: Numeracy and Part B: Theory 

The objective structured clinical examination (OSCE) will have 10 stations:

  • Four stations will continue to be linked together around a scenario: the APIE (one station for assessment, planning, implementation and evaluation)
  • Four stations will test skills
  • Two new stations will be introduced - one will assess the candidate’s values and behaviours and the other will assess evidence-based practice

OSCE marking criteria - each station will be assessed against specific criteria and with a holistic judgement

Test content – as well as developing new content, we completed a thorough review of the current test content - where it was appropriate and safe to do so, we have updated and included existing content

Candidate support – we will be improving the range and quality of preparation materials available to candidates and those who support them

New CBT question trial

We’ll be trialing some of the new CBT questions which will help us determine the pass mark for the new tests in preparation for the new ToC going live in April 2021.

To help us set a pass mark, candidates taking the current adult nursing CBT will complete an additional 10 questions. These questions will be unscored, this means they will not count towards their CBT result. We'll use the results of the questions to help set the pass mark for the new CBT which is introduced in April 2021.

We're grateful for candidates who will be completing the additional 10 questions; we appreciate that it means more questions, however we're confident that candidates will have sufficient time.

Learn more about the changes

We're grateful for everyone who has engaged with us so far and been so positive about the new test.

To help candidates, recruiters and employers prepare, we held some webinars covering different aspects of the new test. 


Webinar Date Links

Test of Competence update

21 February 2020

Download webinar slides

Download  information document

Watch recording

The new Test of Competence - an overview

9 November 2020

Download webinar slides

Watch recording

The new Test of Competence - the computer based test (CBT)

12 November 2020

Download webinar slides

Watch recording

The new Test of Competence (nursing) - OSCE APIE (assessment, planning, implementation, evaluation) stations 

19 November 2020

Download webinar slides

Watch recording

The new Test of Competence (nursing) - OSCE skills stations

26 November 2020

Download webinar slides

Watch recording

The new Test of Competence (midwifery) - OSCE APIE and skills stations

30 November 2020

Download webinar slides

Watch recording

The new Test of Competence (nursing associates) - OSCE APIE and skills stations

3 December 2020

Download webinar slides

Watch recording

Supporting resources

We've published blueprints and test specifications for the Test of Competence 21.

The test specifications show how the test is designed, what it will assess and how, and how results will be produced and presented.

The blueprints show how the standards of proficiency and associated skills and procedures may be tested in either the CBT, OSCE or both parts.

Test specifications


Sign up for updates

This email update will keep you up to date with all the developments and announcements about the new Test of Competence.

Register for updates

Who is AlphaPlus?

AlphaPlus is a specialist education and assessment consultancy whose work spans the public and private sectors, schools, colleges, vocational and professional learning.

They work with many professional certification agencies similar to NMC and ensure their clients’ assessments are valid, reliable and fair to the candidates.

We have been working extremely closely with AlphaPlus and our CBT and OSCE delivery partners to plan and prepare for the new test.