Working overseas | Advice guides |

Royal College of Nursing

Contents
Country research
Language
Qualifications
Professional registration
Finding a job
Taxation and salary deductions
Visas and work permits
Joining a union/nurses'
association
Professional indemnity
Revalidation and working
overseas
Pensions
Returning to the UK
Employment contract checklist
Useful contacts for popular
destinations

Country research
Check with the International Council for Nurses (http://www.icn.ch/) (ICN) and
any relevant nurses' association for information on the minimum requirements
and regulatory framework in the country where you intend to work.

Obtain background information on nursing and health care in overseas

countries. Learn about the culture, religious beliefs and laws of the country that
you are travelling to. This will help prepare you for differences of culture and
legislation, minimising the risk of you running into difficulties during your stay.

If you're interested in working within the European Union or European Economic

Area, go to www.europa.eu (http://www.europa.eu) where you'll find
information on living and working in the EU.

Country profiles can also be found at the Foreign & Commonwealth Office
(https://www.gov.uk/government/organisations/foreign-commonwealth-office)
and the World Health Organisation (http://www.who.int/en/)

Carry out a 'working overseas' literature search (https://www.rcn.org.uk

/library)of the RCN's Library of eBooks and eJournals.

Language
One obstacle to employment as a qualified nurse or midwife overseas may be
language. Prospects of employment are generally poor if you do not have a
good command of the language of the country you wish to visit.

Some 'British' and 'American' hospitals in Europe welcome applications for

employment from UK-trained nurses and midwives. However, the working
language of these hospitals is generally the language of the country in which
they are located (except in the case of British Military hospitals which have their
own nursing staff).

Qualifications
The UK nursing qualification which is generally transferable in every other
country is the 'Registered Nurse: Adult'. Not all countries have equivalents to
the UK qualifications in mental health, learning disability, children’s nursing,
health visiting and the enrolled nurse. If there is no equivalent to your nursing
qualification in the country you would like to visit then you will not be able to
work there as a qualified nurse. Please check the full qualification requirements
for your chosen country with that country's regulatory body (see useful
information below).

There is no formal mechanism for recognising UK post-registration qualifications

such as, for example, intensive care nursing but employers may take them into
account.
Overseas employers and recruitment companies will be specific about the
experience and qualifications required for a particular job.

Registered general/adult branch nurses and midwives moving between EU/EEA

countries will be able to register their qualifications according to the Directives
covering the mutual recognition of general nursing and midwifery qualifications.
Nurses on other parts of the NMC register such as child health, learning
disability and mental health may be able to take advantage of the 'General
systems provisions' of EU Directive 2005/36/EC to obtain recognition of their
UK nursing qualifications in another EU/EEA country. Not all EU/EEA countries
have the same variety of nursing qualifications as the UK and some countries
have qualifications that have no equivalent in the UK. Further information can
be obtained from the NMC or the registering authority of your chosen country.
Please note although Switzerland is not a member of the EU or EEA it does
have mutual recognition of nursing qualifications.

It is in your own best interests to gain at least six months to one year's
experience in the UK after registration before taking up employment abroad. It
will be an opportunity to consolidate your pre-registration education, access
preceptorship and make the transition from being a student to being a
registered accountable practitioner. A prospective overseas employer will be
able to request a reference relating to your ability as a qualified nurse. It will
also be easier for you to provide references to overseas employers if you
already have experience.

Many non-EU countries/employers have specific requirements around

post-registration experience. For example, employers in the Middle East usually
require at least two years’ post-registration experience. Voluntary Service
Overseas (VSO) require three-five years' post-registration experience.

Professional registration
Most countries have their own nurse registration or licensing authorities and
you will most likely be required to obtain registration in the host country before
you are take up employment.

Registration as a nurse in another EU country is through the relevant EU

directive. Full details, including a list of registering bodies, can be found on the
NMC website (https://www.nmc.org.uk/registration/working-outside-the-uk/).
Nurse registration authorities in other countries may require transcripts of your
training and proof ('verification') of current NMC registration. Please contact the
registering body directly for more information about the registration process.

Nurse registration processes vary enormously from country to country and can
be lengthy and time consuming. The process may involve passing an
examination or assessment, i.e. submitting an application including records of
your nursing education and qualifications. For example, you will have to pass
the English language proficiency test to register to work in Australia.

You may find that your nursing education does not fully meet the requirements
of the nurse registration authority in the country where you wish to work.
Making up this shortfall requires negotiation by the individual nurse with a UK
university. It can be very difficult to arrange and universities may charge a fee
for providing such a course. You would also need to use annual leave or
negotiate unpaid leave for this period.

The NMC will provide verification of registration direct to nurse registration

authorities for a fee. If the verification requires translation you will be
responsible for arranging this. Once the document has been translated by a
professional it has to be posted to the registration authority with the original
document. Please fill in the relevant form on the NMC wesbite
(http://www.nmc-uk.org). You will then be sent the appropriate application
pack.

In addition to your verification of registration you may also need a transcript of

your training. Please contact your original school of training for this.

Please note: If you wish to stay on the register whilst practising abroad, see
'professional registration' section of this guide.

Finding a job
You can find vacancies through advertisements in nursing journals such as
Nursing Standard and Nursing Times. These vacancies are placed by overseas
employers or their recruiting agencies. Some countries regularly run
recruitment events in the UK. To subscribe to the Nursing Standard log on to
www.nursing-standard.co.uk (http://www.nursing-standard.co.uk). You could
also try to seek work through the Government's Universal Jobmatch scheme
(https://www.gov.uk/jobsearch).

Overseas employers or recruitment agents often have detailed procedures for

processing your application, interviewing you and making arrangements for you
to take up your post. It is still your responsibility to:
• find out all you need to know in order to decide whether you want the job
• assess whether you are competent to do it
• confirm that you meet the legal requirements involved such as work permits
and registration as a nurse in the host country.

If you decide to send speculative letters enquiring about overseas employment

you will need to prepare a detailed curriculum vitae (CV)
(https://www.rcn.org.uk/professional-development/find-a-job/cv-writing) that
can easily be understood by someone unfamiliar with UK nursing qualifications,
scope of practice and abbreviations. Our careers service can only offer
personalised feedback on CVs if you are planning on working in the UK.

Your covering letter will need to make it clear whether you need the employer
to obtain a work permit on your behalf.

An interview for employment abroad may be very different to interviews for

employment in your own country. A thorough interviewer will look for evidence
that you have the personal qualities needed to cope with and successfully
complete a contract in a foreign country, perhaps working in a foreign
language. If the interview is successful, an informal job offer may be made to
you. Responsible employers and recruiters will give you time to consider before
making a definite commitment. The employment contract checklist in this guide
will help you to evaluate job offers and contracts of employment.

Take at least 24 hours to reflect on the offer before you accept it - take your
time to research the country, check your contract and ensure that you are
happy with the details.

Taxation and salary deductions

As taxation is a complicated matter you should seek professional advice about
your obligations at home and abroad. Contact Her Majesty's Revenue and
Customs (https://www.gov.uk/government/organisations/hm-revenue-customs)
for further information.

Please note: if you are not paying UK tax whilst abroad you cannot claim tax
relief on your RCN subscription during this time.

Visas and work permits

You should always check visa requirements when planning to undertake work
abroad. This is a complicated issue which varies from country to country.
Further information can be found at www.gov.uk/foreign-travel-advice
(http://www.gov.uk/foreign-travel-advice).

Work permits are usually obtained by the employer from the immigration
authorities of the host country. Where work permits are a requirement, you will
be unable to take up paid employment in that country if you cannot find an
employer who is able to obtain a work permit for you.

Joining a union/nurses' association

The RCN is not a trade union outside of the UK, Channel Islands and Isle of
Man and we do not have representatives in other countries. Although we may
be able to provide general advice to help you deal with an employment problem
we are unable to offer formal advice or representation for matters arising in
your host country. Please note UK law is applicable in the UK only and you will
be bound by the laws of your chosen country.

We strongly recommend that you join a trade union or professional

association as soon as you arrive in your chosen country just in case you
require employment relations or legal advice. Employees of the UK armed
forces are not permitted to join a trade union but may join a professional
association such as the RCN.

Contact details of national nurses' associations which are members of the

International Council (ICN) can be obtained from the ICN website
(http://www.icn.ch).

If you choose not to become a member of a trade union or professional

association and you subsequently need legal or employment relations support
you should contact the national nurses' association of that country. They may
be able to help or recommend an organisation that can. Please be aware that
not all organisations will be able to provide advice and support if you were not
in membership at the time of the incident for which you require support.

The RCN is able to offer support to members working for Soldiers, Sailors,
Airmen and Families Association (SSAFA) (/get-help/rcn-advice/soldiers-sailors-
airmen-and-families-association)working within military establishments in
Europe. SSAFA recognises the RCN as a trade union. If you require employment
advice, please contact us.

If you wish to maintain your RCN membership you will continue to have access
to number of member benefits, for example:

RCN advice (http://www.rcn.org.uk/advice)

RCN Forums (/get-involved/forums)

RCN Xtra (http://www.rcn.org.uk/membership/benefits/rcnxtra)

The best method of paying your RCN subscription while abroad is via direct
debit from your UK bank account. You can also make an annual payment by
credit card.

Professional indemnity
Please see our Indemnity scheme terms and conditions (/get-help/indemnity-
scheme) for more information. If you are involved in an incident that you think
might lead to a patient or colleague making a claim against you, you must
contact us on 0345 772 6100 (tel:+443457726100). You must never admit
responsibility for an incident or submit a written statement about it until we
have agreed for you to do so.

Revalidation and working overseas

In 2016 the Nursing and Midwifery Council (NMC) introduced Revalidation - the
process that all UK nurses and midwives must go through every three years in
order to renew their registration and continue practising legally in the UK.
Revalidation applies to all nurses and midwives, regardless of the role or sector
in which they are operating and across all fields of practice.

If you are a nurse or midwife practising overseas and want to maintain your UK
registration, you will have to comply with the revalidation process every three
years and continue to pay your annual retention fee to the NMC. Your
revalidation application is due on the first day of the month in which your
registration expires e.g. if your renewal date is 30 September 2017, your
revalidation application date will be 1 September 2017.

In order to revalidate, you must demonstrate that you have met the following
requirements:

• Practised for a minimum of 450 hours over three years

• Undertaken a minimum of 35 hours of Continuing Professional Development
(of which 20 hours are participatory i.e. face to face)
• Obtained five pieces of practice-related feedback
• Produced five written reflective accounts
• Had a reflective discussion with a NMC registered nurse or midwife
• Provided a health and character declaration
• Declared that you have, or will have when practising, an appropriate
indemnity arrangement in place
• Obtained confirmation from an appropriate third party that you have met the
requirements

If you are working overseas (or have worked overseas for part of your three
year renewal period) as a nurse or midwife you can meet the practice hours on
the basis of your registration with the NMC. The NMC advises that you should
always register with the appropriate regulator in the country in which you are
practising.

If you work wholly overseas you can seek confirmation from your line manager
where you undertake your work. If you do not have a line manager, you will
need to decide who is best placed to provide your confirmation. The NMC
advises that wherever possible your confirmer is a nurse or midwife regulated
where you practise, or another regulated healthcare professional. The NMC
online confirmation tool (http://revalidation.nmc.org.uk/information-
for-confirmers/confirmer-tool) provides further guidance about who can act as
your confirmer.

If you are asked to provide ‘verification’ information to support your revalidation

application, in relation to practice hours you need to provide information about
whether you are registered with the appropriate regulating body.

It is important that the NMC has an up to date address for you and you should
register with NMC online (https://www.nmc.org.uk/registration/nmc-online/) to
ensure that you know your revalidation date and that the NMC can send you
relevant information.

More information is available from the NMC on ‘How to revalidate’

(https://www.nmc.org.uk/globalassets/sitedocuments/revalidation/how-to-
revalidate-booklet.pdf) and working outside the UK (http://www.nmc.org.uk
/registration/working-outside-the-uk/).

Pensions
Nurses in the NHS pension scheme who leave the scheme may have their
pension benefits frozen. If you are moving to a new non-NHS employer,
whether in the UK or abroad, you should seek independent advice as to
whether you are able to transfer your membership into your new employer’s
scheme.

Contact the relevant NHS pension agency for further details about the options
available as follows:

England and Wales: NHS Business Services Authority www.nhsbsa.nhs.uk

(http://www.nhsbsa.nhs.uk)

Northern Ireland: Health and Social Care Northern Ireland www.hscni.net

(http://www.hscni.net)

Scotland: Scottish Public Pensions Agency www.sppa.gov.uk

(http://www.sppa.gov.uk)

For further information, or if you have a non-NHS pension please go to:

The Pension Service (https://www.gov.uk/contact-pension-service)

The Pensions Advisory Service (http://www.pensionsadvisoryservice.org.uk/)

The Pensions Regulator (http://www.thepensionsregulator.gov.uk/)

Lighthouse Financial Advice is able to provide free financial advice to members

planning employment abroad. This is particularly useful if you have financial
commitments in the UK such as a mortgage, pension, savings plan etc. Their
contact details can found on the RCN Xtra website (http://www.rcn.org.uk/xtra)

It is a good idea to make a will particularly if you have dependants and financial
commitments. The legal situation is very complicated if a person dies overseas
without having made a will. You could take advantage of the RCN’s free legal
advice scheme. For further information please see our application for free legal
assistance (https://www2.rcn.org.uk/support/legal
/application_for_free_legal_assistance2) page.

Returning to the UK
Your nursing career is a long-term investment. We recommend that you plan
your return to practice in the UK before you leave. You will need to consider
how to present your overseas experience in a positive light to UK employers
and to demonstrate that you are broadly in touch with general developments in
nursing and health care in the UK. The RCN has a number of resources
which may help you when you return to the UK. These include:

• RCN careers service (https://www.rcn.org.uk/careers)**

• RCN jobs bulletin (http://www.rcnbulletinjobs.co.uk/)
• The Nursing Standard (http://journals.rcni.com/journal/ns)

Add any qualifications you have obtained overseas both to your CV and your
personal professional portfolio. If you have completed education equivalent to a
qualification for another part of the register (for example, as a midwife) you
may apply to the NMC to have the qualification registered. Your application may
be assessed through the 'overseas' route and compared to the UK course and
you might be required to undertake supplementary training in the UK. When
you return to the UK and are planning further study, you may be able to obtain
credit for this study through schemes such as Assessment of Prior Learning
(APL) and Assessment of Prior Experiential Learning (APEL). General
information concerning APL/APEL is available from UCAS
(https://www.ucas.com/).

The NMC is not involved with recognition of academic qualifications such as first
or higher degrees. You can check the comparability of degrees obtained
overseas with an organisation called NARIC (https://www.naric.org.uk/naric/).

**Please note: the Careers service can only check CVs for members working
within the UK and are unable to provide advice about working overseas.

Employment contract checklist

This checklist may help you evaluate the contents of any contract of
employment before committing yourself.

Remember:

• Never sign a contract until all the blank spaces have been completed.
• Never sign a contract that is in a foreign language that you do not
understand.
• Never place any reliance on verbal promises. How would you be able to
prove the commitment later?
• Always ask for copies of any documents referred to within the contract and
ensure that you understand these before agreeing.
1. Pre-employment agreement
You may be asked to sign a document which covers the period between
accepting the job offer in the UK and taking up employment in the host country.
It may commit the employer or recruiter to providing a language or
examination revision course, facilitating your application to take an
examination, or even paying for you to fly abroad to take the examination. In
addition, it usually includes details of any financial penalty you would incur if
you withdrew your application.

Think carefully before you commit yourself, as it may be expensive to change

your mind later. Be clear about the kind of post you would be willing to accept
and the length of time you are willing to wait for a placement. Please ensure
that all of this information is contained within the pre-employment agreement.

2. Job description
The job description should be detailed enough to give you a good idea of what
the job involves.

Your nursing education and experience to date should have provided you with
the necessary knowledge to undertake the role. If not, will this be covered in
any orientation/induction programme?

3. Orientation/induction programme
This is a crucial part of any overseas post and should include information about
the new workplace, the whole health care system and nursing practices within
the country.

You should ask for written confirmation of the following:

• How long will the induction last?

• Does it include training in tasks which you may not have done before?
• Will you be on full pay during the programme and is the programme included
in the time period of your contract

4. Probationary period
• Is there a probationary period?
• What support will you get?
• How do the termination of contract arrangements differ during this period?
• Does the employer have the right to terminate employment without any
reason and with immediate effect during this time? If so, would you still be
entitled to benefits such as a paid flight home?

5. Premature termination of the contract

• If you terminate your contract early then you may face a penalty such
as having to pay for your own flight home or having to reimburse the
employer for your outward airfare. Under these circumstances would your
employer give you a reference and would you be given a copy of the
reference for your records?

6. Change of employment
• Does the contract state the nursing specialty and site you will be working in?
• Does the contract allow the employer to change this without your
agreement? Could you be required to work for the employer in any part of the
host country?

7. Salaries
• Will you be paid the same salary as a nurse originating from the host
country?
• Is the salary you have been offered on a scale or is it a fixed salary?
• What will your net salary be?
• Where will the salary be paid - in the UK, host country or part in both? If you
intend to send money back to the UK on a regular basis e.g. to meet
mortgage repayments, remember that currency fluctuations could affect the
amount of sterling you receive.

8. Hours of work and overtime

• The exact hours of work should be written into your contract. The working
week is longer than 37.5 hours in many countries.
• Does the contract state that you may be asked to do overtime?
• What shift pattern will you work and does it include breaks?

9. Annual leave and time off

• Annual leave entitlement varies widely from country to country and may be
 much less than you have been used to. Public holidays may or may not be
included
• Will you be allowed to take your annual leave when you want, or do you
have to take it after a waiting period (common in Australia) or at the end of
your contract? Are you entitled to emergency or compassionate leave?

10. Length of contract

• The commencement and termination date should be clearly stated on the
contract. If you are signing a standard contract for permanent employment
used by the host country employer, there may be no termination date. In this
situation the termination date of your work permit would apply.
• Is there a possibility of renewing the contract if both sides wish to do this?
Would this involve a change of work permit? Would an increase of salary be
offered?

11. Healthcare and health insurance

• Does the employer provide you with private health insurance as part of the
employment package? If not, will you be required to arrange your own? How
much does this cost?
• Is a UK passport holder entitled to use the public health service on the same
terms as residents of the country?
• Does your health insurance cover the cost of repatriating you to the UK if
necessary and who decides whether this is necessary?
• Consider taking out personal injury accident insurance subject to the
conditions of cover being applicable to your working situation.

12. Other contract considerations to research

• sickness policy and entitlement
• grievance/disciplinary procedures and trade union representation
• language training
• accommodation
• transportation
• responsibility of costs of the return airfare from the UK to the host country
• laws of the host country
• overseas employment contracts are usually interpreted according to the laws
of the host country
• cost of living in that country.

Useful contacts for popular destinations

You can contact these organisations directly for advice:

Working inside the EU

A full list of the EU member states registration authorities can be found on the
NMC website (https://www.nmc.org.uk/registration/working-outside-the-uk
/working-in-the-eu/eu-registration-authorities/).

Working outside the EU

Australia

Australian Nursing & Midwifery Council (http://www.anmc.org.au)

Royal College of Nursing, Australia (http://www.rcna.org.au)

Australian High Commission (http://www.uk.embassy.gov.au)

British High Commission Canberra (https://www.gov.uk/government/world

/organisations/british-high-commission-canberra)

Nursing & Midwifery Board of Australia

(http://www.nursingmidwiferyboard.gov.au)

Australian Health Practitioners Regulation Agency (http://www.ahpra.gov.au)

Bahrain

Ministry of Health (http://www.moh.gov.bh)

Bahrain Embassy (http://www.bahrainembassy.co.uk)

British Embassy Bahrain (https://www.gov.uk/government/world/organisations

/british-embassy-manama)

Canada

Canadian Nurses Association (http://www.cna-aiic.ca)

Canadian High Commission (http://www.canadainternational.gc.ca)

British High Commission (https://www.gov.uk/government/world/organisations
/british-high-commission-ottawa)

Hong Kong

College of Nursing Hong Kong (http://www.cnhk.org.hk)

Nursing Council of Hong Kong (http://www.nchk.org.hk)

British Consulate-General Hong Kong (https://www.gov.uk/government/world

/organisations/british-consulate-general-hong-kong)

Hong Kong Immigration Department (http://www.immd.gov.hk)

Jamaica

Nurse Association of Jamaica (http://www.naj.org.uk)

Jamaican High Commission (http://www.jhcuk.org)

British High Commission (https://www.gov.uk/government/world/organisations

/british-high-commission-jamaica)

Kenya

National Nurses Association of Kenya (http://www.nnak.or.ke)

Kenya High Commission (http://www.kenyahighcom.org.uk)

British High Commission (https://www.gov.uk/government/world/organisations

/british-high-commission-nairobi)

Malaysia

Malaysian Nurses Association (http://www.mna.org.my)

Ministry of Health (http://www.moh.gov.my)

Ministry of Foreign Affairs (http://www.kln.gov.my)

British High Commission (https://www.gov.uk/government/world/organisations

/british-high-commission-kuala-lumpur)

New Zealand

Nursing Council of New Zealand (http://www.nursingcouncil.org.nz)

Midwifery Council of New Zealand (https://www.midwiferycouncil.health.nz/)

New Zealand Nurses’ Organisation (http://www.nzno.org.nz)

New Zealand Embassy (http://www.nzembassy.com)

British High Commission (https://www.gov.uk/government/world/organisations

/british-high-commission-wellington)

Nigeria

National Nurses Association of Nigeria (http://www.nannm.org)

Nigeria High Commission (http://www.nigeriahc.org.uk)

British High Commission (https://www.gov.uk/government/world/organisations

/british-high-commission-abuja)

Saudi Arabia

Royal Embassy of Saudi Arabia (http://embassies.mofa.gov.sa)

British Embassy (https://www.gov.uk/foreign-travel-advice/saudi-arabia)

Ministry of Health (http://www.moh.gov.sa)

Singapore

Singapore Nurses Association (http://www.sna.org.sg)

Singapore Nursing Board (http://www.snb.gov.sg)

High Commission for the Republic of Singapore (http://www.mfa.gov.sg/london)

British High Commission (https://www.gov.uk/government/world/organisations

/british-high-commission-singapore)

South Africa

South African Nurses Association (http://www.denosa.org.za)

South African Nursing Council (http://www.sanc.co.za)

High Commission of the Republic of South Africa

(http://www.southafricahouseuk.com)

British High Commission (https://www.gov.uk/government/world/organisations

/british-high-commission-pretoria)

United Arab Emirates

Emirates Nursing Association (http://www.ena.ae)

Embassy of the United Arab Emirates (http://www.uaeembassyuk.net)

(http://www.uaeembassyuk.net/)www.uaeembassyuk.net
(http://www.uaeembassyuk.net/)

British Embassy (https://www.gov.uk/government/world/organisations/british-

embassy-abu-dhabi)

United States of America

American Nurses Association (http://www.nursingworld.org)

National Council of State Boards of Nursing (http://www.ncsbn.org)

Embassy of the United States (http://www.usembassy.gov)

British Embassy (https://www.gov.uk/foreign-travel-advice/usa)

Zambia

Zambia High Commission (http://www.zambiahc.org.uk)

British High Commission (https://www.gov.uk/government/world/organisations

/british-high-commission-lusaka)