Expanding the temporary register to additional overseas-trained nurses

Contents

 

Classification: Official

Publication approval reference: 001559 / C1022

To:

  • Directors of nursing

5 January 2021

Dear Colleagues,

We recognise the acute workforce challenges you are facing. We have therefore agreed that the NMC temporary register will once again be reopened to overseas nurses who are on a pathway to obtaining their OSCE and full NMC registration.

Rationale

We have collaboratively and carefully considered the challenges associated with different routes to expanding the temporary register to overseas-trained nurses. We have agreed an approach that enables a rapid workforce expansion and provides adequate assurance of suitability to practise during this emergency.

Expanding the temporary register will enable overseas nursing applicants already in the UK, who are yet to take their objective structured clinical examination (OSCE), to voluntarily join the temporary register under conditions of practice.

The approach taken will preserve the ‘opt-in’ nature of the temporary register, while enabling its quick expansion, particularly for those services and regions where this is most urgently needed.

We know, following the incredible response by these groups of overseas-trained nurses during the first wave of the pandemic, that many of these professionals want to use their skills and expertise to support health and social care services during this challenging time. Opening the temporary register in an opt-in way enables them to make this decision themselves.

Please note however that the requirements for temporary registration differ from those for permanent registration and therefore your overseas-trained nurses will need to continue with their permanent registration separately even if they join the temporary register.

While we hope this approach will support you with the current extreme pressures, we would like to confirm that, at the time of writing, NMC OSCE centres remain open. We would strongly encourage you to continue to support your overseas-trained nurses in their journey to permanent registration where possible. Your overseas-trained nursing recruits can join the temporary register while they are completing their permanent registration application, including taking the OSCE. We will automatically remove anyone from the temporary register when they join the permanent register.

How we are expanding the temporary register

We are opening the temporary register to two additional cohorts of overseas-trained nurses.

The nurses in both cohorts are current applicants to the NMC’s permanent register:

  1. Those who began their registration applications before October 2019, who have a valid decision letter and have completed all parts of the NMC process, except their OSCE.
  2. Applicants who started their NMC registration after October 2019 and from whom the NMC has received a registration application and all relevant supporting declarations. They may have passed either part of their test of competence (the CBT or OSCE) or not yet taken either.

The NMC will send invitations to the first cohort Tuesday 5 January and will begin to invite the second cohort next week.

Annex A to this letter includes details of what you need to do to support your overseas-trained nurses join the temporary register.

Assurance processes

To be eligible to join the temporary register, the emergency legislation requires the Registrar to be satisfied that individuals are ‘fit, proper and suitably experienced to work in the emergency’.

For those in the first cohort, as the NMC has issued a decision letter, it means that the NMC has assessed their qualification, language, health and character as part of their application to the permanent register. As the NMC has confirmed they meet the standards, the Registrar can be satisfied they are suitable to join the temporary register and to work in this emergency. No additional assurances are required for this cohort.

For those in the second cohort, while the NMC has received their registration application, under the post-October 2019 process, it has not yet assessed whether or not they meet the required standards for language, health and character. It is confident that the majority of these applicants will be suitable to join the temporary register. To date 95% of the 2,600 overseas-trained nurses who joined the temporary register in April have now joined the permanent register. However, to be eligible for the temporary register, as well as being at the right stage in the permanent registration process, the Registrar requires your assurance that they meet NMC standards.

We recognise that we are asking you to provide this assurance at an incredibly busy time for you and your teams. However, we believe that this will be the quickest, most reliable way to identify those individuals who would provide most benefit to you in joining the temporary register now rather than trying to do this centrally. We have tried to minimise the bureaucracy involved and hope that the employment process and OSCE preparation support you already have in place will mean that this is not overly burdensome.

For those in the second cohort we are seeking this assurance in two steps.

  • First, we will ask that a senior permanent NMC registrant certifies that each overseas-trained nurse:
    • is suitable to work in the emergency and that they support their entry to the temporary register
    • has English language (skills for listening, speaking, reading and writing) sufficient to allow them to practise in the emergency
    • has no health conditions or disabilities that prevent them from providing safe care or, if they do have a condition or disability, that it is managed so they can practise in the emergency
    • is not aware of any concerns about their character that prevent them from practising in the emergency
    • has the skills, knowledge and experience to be able to practise in the emergency.
  • Second, we will need you, as the director of nursing, to confirm that you are satisfied that an appropriate, proportionate and objective assessment framework is in place and that it has been followed in each instance by the NMC registrant making the certifications.

The senior permanent NMC registrant who is assessing and supporting each nurse should know them and be in a position to make an informed judgement as to their suitability to join the temporary register.

Details of how to provide these assurances are set out below and in Annex A.

Supporting black, Asian and minority ethnic professionals

While we agree with the need to take this action, we are mindful of the likelihood that a significant proportion of those overseas-trained nurses eligible to join the temporary register will be from black, Asian and minority ethnic backgrounds.

Throughout the pandemic we have been deeply concerned by reports that morbidity and mortality rates from COVID-19 have been higher in ethnic minority groups. With this in mind, when opening the temporary register to overseas-trained nurses it is crucial that partners across the health and social care system take full responsibility for protecting these professionals from any additional risks they may face.

We will continue to support the UK REACH study investigating if, how, and why ethnicity affects COVID-19 clinical outcomes for those working in health and social care. We hope the recommendations of this study can support efforts to protect professionals during the pandemic.

Next steps

  1. The NMC will contact the overseas-trained nurses in the first cohort directly.
  2. For the second cohort of overseas-trained nurses, we have provided a template spreadsheet for you to complete with the details of each nurse you are supporting to join the temporary register. Please complete the template and send to International.Recruitment@nmc-uk.org.
  3. The spreadsheet should be sent to the NMC by the director of nursing or by someone who confirms they have the explicit authority of the director of nursing to do so.
  4. Once we have received the information, the NMC will match the list of nurses you are supporting with its list of eligible nurses – as per the criteria above. Those professionals identified will be sent an invitation to join the temporary register.
  5. We will confirm back to you any names of your nurses that the NMC was not able to identify.

And finally

We hope you find this support helpful given the current pressures and the experience, skills and knowledge of our overseas nursing colleagues.

Further information will be published on the NMC’s COVID-19 hub to help with any queries you might have but please contact International.Recruitment@nmc-uk.org if you need further support.

Yours sincerely,

Andrea Sutcliffe CBE | Chief Executive and Registrar | Nursing and Midwifery Council

Ruth May | Chief Nursing Officer, England | NHS England and NHS Improvement

Annex A: How to support your overseas-trained nursing recruits to join the temporary register

The first cohort with valid decision letters

As the nurses in the first cohort have been issued with a decision letter (please see example attached at Annex B), the NMC has already assessed their registration applications. This means that the Registrar is satisfied that they are fit, proper and suitably experienced to work in the emergency.

On Tuesday 5 January the NMC will send an email invitation to everyone in this first cohort to enable them to join the temporary register should they so wish. Once they complete the application they should be admitted to the temporary register the next day. You can support these nurses by:

  • Identifying who among your overseas-trained nurses has a valid decision letter and let them know they should check their emails – the NMC will use the email address they gave us for the application.
  • Making sure they do not share the emails the NMC send – they include a link that is unique to the individual which helps us process their applications quickly, if they use some else’s email it will delay their application.
  • Reminding them to have their candidate ID handy – this will be on any correspondence they have from the NMC and it will use that number to process their temporary registration application. If they do not have it or give us the wrong number it will delay their application.
  • Asking them to check and double check their application – any information they provide that does not match what the NMC has on record may delay their application. In particular, the NMC will use their name, email address (that they used in their application with us), candidate ID and date of birth for verification purposes.

The second cohort who applied after October 2019

As explained in the letter, the NMC needs additional assurance over nurses in this cohort as it has not assessed their applications to the permanent register.

You should identify which of your overseas-trained nurses have reached the right stage of their permanent registration process to be eligible for temporary registration. To be eligible they must have submitted their registration application to the NMC and the NMC must have received all the relevant supporting declarations. They may have passed either part of their test of competence (the CBT or OSCE) or not yet taken either.

You can use your NMC third party portal to see who is at this stage or check their tracker on their NMC Online account. Below is an example of an eligible applicant’s tracker. While in the example the applicant has passed their CBT, this is not a requirement for entry to the temporary register.

Diagram showing the initial registration process for registered nurses

We have provided a template spreadsheet for you to complete with the details of each nurse you are supporting to join the temporary register. Please complete the template and send to International.Recruitment@nmc-uk.org.

The spreadsheet should be sent to the NMC by the director of nursing or by someone who confirms they have the explicit authority of the director of nursing to do so.

Once it has received the information, the NMC will match the list of nurses you are supporting with NMC’s list of eligible nurses – as per the criteria above – and those it can identify will be sent an invitation to join the temporary register.

We will confirm back to you any names of your nurses that NMC were not able to identify.

As set out for the first cohort, please support the nurses you’re telling us about to submit their temporary registration application.

Annex B: Example decision letter sent to those who applied before October 2019

<Title> <Full Name>
Address Line 1
Address Line 2
City
Country

Date: <Date>

Dear <First name> <Last name>

Assessment of application for registration: <Application type>
Candidate number: <Candidate ID>

I am writing to inform you of the status of your application for registration with the Nursing and Midwifery Council (NMC). Having assessed your application I am satisfied that you meet the minimum requirements to progress to part two of the test of competence: as a result you can now book your Objective Structured Clinical Examination (OSCE). You will need to contact one of our approved OSCE test centres directly to schedule your test.

The contact details of all our test centres can be found on their websites. Please visit trained outside the EU/EEA to access links to the test centre websites.

On the day of your OSCE you will also be required to complete an identity check. You must bring all of the original documents that you submitted via the application portal to the OSCE centre. Failure to produce your correct documentation will delay your registration as your application cannot be progressed until the appropriate information has been received. Please review the enclosed checklist for further details.

If you require any further assistance in relation to this letter, please contact the NMC Registration Centre on 020 7333 9333; one of our oprators will be able to assist you.

Yours sincerely,

Jack Bland | Senior International Registration Manager