Returning to Nursing Practice: The NMC Return to Practice Route

You only need a return to practice programme or the NMC Test of Competence if you cannot meet the NMC's minimum practice hours. According to the NMC's readmission requirements, that means 450 hours of registered practice in the three years before you apply, or 750 hours in the five years before you apply. If you meet one of those figures, you can apply for readmission directly. If you meet neither, you complete an NMC-approved return to practice (RtP) programme or pass the Test of Competence first, then apply for readmission.

This guide covers the NMC register, which is UK-wide, and applies to nurses, midwives and nursing associates unless stated. It sets out which route fits you, what else the NMC asks for, and how the application works.

Do you need a return to practice programme?

The NMC's return to practice pages say the route is for people who cannot meet the minimum practice hours needed to rejoin, or to stay on, the register. Three situations come up most often:

• Your registration has lapsed and you cannot show enough practice hours to apply for readmission.
• You want to rejoin a different part of the register from the one you left, for example a midwife returning as a nurse. The NMC says you need an approved programme or the Test of Competence in this case.
• You are approaching renewal and cannot meet the practice hours for revalidation. The NMC's return to practice standards also cover registrants who want to renew but cannot meet the hours.

If you were struck off, the NMC says you must first apply for restoration and then complete one of the two routes. If you have conditions of practice and your registration has not lapsed, you do not need either route; completing a programme does not end conditions, which is for a fitness to practise panel to decide.

The practice hours thresholds

Only hours worked while you were effectively on the register count. The NMC also asks you to disclose any unregistered work you did in a role that requires NMC registration. If you have questions about how hours are counted for your own situation, our guide to NMC practice hours and how to record them explains the basics.

Route one: an NMC-approved return to practice programme

Programmes are delivered by approved education institutions (AEIs), usually universities, working with practice learning partners. The NMC approves UK programmes that meet its return to practice standards, and it keeps a list of approved programmes you can search. Check that your chosen course appears on that list before you enrol.

A few points from the NMC's information:

• Length is not fixed. The NMC says hours and length depend on the needs of the individual. Its standards require only a length that is appropriate to support the programme outcomes, so ask each provider what it would expect for you.
• It includes practice learning. You are supernumerary during practice learning, and the experience should cover a range of settings for the area you intend to work in.
• There are routes for each part of the register. The standards require routes for nurses (adult, children's, learning disabilities and mental health), midwives, specialist community public health nurses (SCPHN) and nursing associates.
• You are assessed. You must meet the required standard of proficiency, and your proficiencies are recorded. The programme must confirm you are safe and effective and suitable for readmission.

The NMC does not fund these programmes and says funding questions should go to the AEI running the course. The NMC's return to practice standards were published on 20 May 2019.

After you complete the programme, the NMC says your university sends your details to the NMC. The NMC then writes to tell you to sign up to MyNMC and apply for readmission. You must still show that you meet the other readmission requirements. SCPHN returners must first be registered as a nurse or midwife, because the SCPHN part of the register depends on an active nursing or midwifery registration.

Route two: the Test of Competence

The Test of Competence is the alternative to a programme, available since January 2020 according to the NMC. You can choose whichever is more convenient and appropriate. It has two parts:

• a multiple-choice computer-based test (CBT) of theory, and
• a practical test, the OSCE.

Each part of the register has its own test, and nursing has a separate test for each field. There is no Test of Competence for SCPHN registration, so SCPHN returners need a programme. The NMC emails you the booking details. It says a pass remains valid for up to five years, so you can use it to rejoin within that period. The NMC's Test of Competence page does not state a fee or a limit on attempts, so check the NMC site before you commit.

What else the NMC asks for at readmission

Passing a programme or the test deals with the practice hours. The NMC's readmission checklist adds several other requirements:

• CPD: 35 hours of learning in the three years before you apply. These hours do not have to fall within your registered period.
• Professional indemnity: appropriate cover, or confirmation you will hold it when you practise.
• English language: you meet this if, for example, you were registered with the NMC within the last two years, or you completed an NMC-approved RtP course and rely on it for readmission. Other routes include an accepted English language test.
• Health and character: declarations about health conditions, police charges, cautions or convictions that are not protected, and fitness to practise determinations by other regulators. A health condition or disability does not bar registration; the question is whether you can practise safely, with or without reasonable adjustments.
• Three references: an NMC registrant on the same part of the register who has known you for at least a year in the last three and has been in contact in the last six months; your employer; and someone on the NMC approved signatory list who has known you for the last year.

If you practised overseas, the NMC asks for a certificate of professional standing from that regulator, which you obtain yourself.

If your registration lapsed within six months of your revalidation date

The NMC says you must also meet revalidation requirements: declare that 20 of your 35 CPD hours were participatory, declare five pieces of practice-related feedback and five written reflective accounts, and confirm a reflective discussion with an NMC registrant. For help with these, see our examples of participatory learning and our reflective accounts template.

Applying and what to expect

Most people apply through MyNMC. The NMC readmission page covers nurses and midwives; nursing associates are asked to contact the NMC directly. The NMC says it can only review an application once everything has been submitted. It gives these timescales:

The NMC is clear that you cannot practise as a nurse or midwife until you are readmitted. The NMC's readmission page does not mention fees, so confirm current costs on the NMC site.

Frequently asked questions

How long does a return to practice course take?

The NMC does not set a fixed length. It says hours and length depend on the needs of the individual, so providers vary. Ask the AEI what they would expect for you based on your experience.

Can I skip the course and take the Test of Competence instead?

Yes, if you cannot meet the practice hours, the NMC offers the Test of Competence as an alternative to a programme. SCPHN returners are the exception because there is no test for that part of the register.

Does the course count towards my 35 hours of CPD?

The NMC's return to practice pages do not say this. Ask your provider and confirm with the NMC rather than assuming.

How long is a Test of Competence pass valid?

The NMC says a pass remains valid for up to five years, so you can use it to join or readmit within that period.

Next steps

Returning is mostly a matter of evidence: hours, CPD, references and declarations. Start logging your 35 CPD hours now, line up your referees early, and keep clear records. Our CPD hub has more on building and recording learning.

This article is general information, not regulatory, legal or compliance advice. Rules and fees change, so always check current requirements with the Nursing and Midwifery Council before you apply.