NMC Test of Competence

NMC Competence Test - Legal StatusNMC Test of Competence – a guide for nurses and midwives

In August 2021, the Nursing and Midwifery Council launched an alternative to the Return to Practise Course for nurses or midwives who had been out of practice and did not have enough practice hours to be eligible for readmission to the register.

The Test of Competence 2021 has been updated. All candidates must take the new version of the Test of Competence as from January 2023.

Who can apply

The Test of Competence applies to those who have been out of practice for some time and those who have been struck off the register and are applying for restoration.

It is also used to assess the skills and knowledge of people applying to join the register from overseas, unless the qualification was automatically recognised by the Nursing and Midwifery Council, in which case, there was no need to complete the Test of Competence.

Any nurse or midwife applying to sit the Test of Competence must take the test that is specific to the part of the register they are applying to join or rejoin. These are:

  • adult nurse (RNA)
  • mental health nurse (RNMH)
  • learning disabilities nurse (RNLD)
  • children’s nurse (RNC)
  • midwife (RM)
  • nursing associate (NAR)



The Test of Competence is split into two parts.

  • A multiple-choice computer based test (CBT).
  • A practical Objective Structured Clinical Examination (OSCE).


The CBT is divided into two parts. Part A tests numeracy skills and Part B tests clinical knowledge relating to nursing or midwifery.

The OSCE has ten stations. A candidate’s clinical skills, values and behaviours and evidence-based practice are assessed.


The CBT and OSCE can be sat in any order but must be passed within two years of each other.

Once passed the Test of Competence is valid for a period of five years.

Taking the CBT

A candidate will need to confirm with the Nursing and Midwifery Council that they need to take the test.

The Nursing and Midwifery Council use Pearson Vue as the provider for the CBT test. Once confirmation is received from the Nursing and Midwifery Council that a candidate is required to sit the Test of Competence, Pearson Vue will set up an account.

Once an account is set up, a candidate may book the CBT online or over the phone.

Pearson Vue have various venues around the United Kingdom and indeed in many countries around the world.

The numeracy test (part A) takes 30 minutes and comprises of fifteen questions.

The clinical knowledge (part B) section takes 2 1/2 hours and comprises of one hundred questions.

The cost for Part A and B is £83.

The results are provided in a report on the day. It will appear in the candidates account within 48 hours.

Part A and Part B of the CBT are taken together in a single sitting but are passed or failed separately.

A candidate only needs to resit the part that he/she has failed.

The Nursing and Midwifery Council allows three attempts as part of one application.

Each time a candidate sits the test it counts as one attempt.

There is a minimum of ten days between each sitting.

The three attempts will need to be taken within one year. After this period, a candidate will need to resit both modules again.

After three failed attempts, the application will close.

A candidate will then have to wait six months to submit a new application and sit the CBT again.

Costs for resitting the CBT are £83 for both parts, £50 for part A and £70 for part B.

The Nursing and Midwifery Council recommends that in preparation for the CBT, candidates read the Code of Conduct, the booklet for the Test of Competence 2021 test-of-competence-2021-cbt-information-booklet-for-nurses and test-of-competence-2021-cbt-information-booklet-for-midwives. Practice tests can be found of the Pearson Vue website. https://home.pearsonvue.com/nmc/practicetests

Taking the OSCE

The Nursing and Midwifery Council have granted contracts to 5 providers to deliver the OSCE assessments.

These are:

Oxford Brookes University

University of Northampton

Leeds Teaching Hospitals NHS Trust

Northumbria University

Ulster University

The ten OSCE stations will be set up as follows:

  • Four stations are linked together around a scenario: (1) assessment, (2) planning, (3) implementation and (4) evaluation
  • Four stations to test skills
  • Two stations to assess the candidate’s values and behaviours and evidence-based practice.

The results will be sent by the provider within five working days.

The costs of the OSCE is £794

If a candidate fails seven stations or less, the resit cost is £397.

The Nursing and Midwifery Council advises that in preparation for and OSCE, candidates read The Code and the information booklets as well as the preparing-for-your-osce–all-nursing-fields-2021 and preparing-for-your-osce-midwifery 2021.


A candidate who is not satisfied with the result of an OSCE may appeal to the provider.

The appeal is a level 1 university appeal.

The appeal must be lodged within five days of the results. The decision should be notified to the candidate within twenty days.

The decision can be either upheld, partially upheld or not upheld.

It can be reviewed at a level 2 university appeal.

A review must be lodged within ten days. The decision will be notified to the candidate in twenty days.

The decision will be upheld or not upheld.

The appeal process is complete after a level 2 review.


Preparation materials

The Nursing and Midwifery Council’s website provides a link to preparation materials to assist in preparing for the Test of Competence, https://www.nmc.org.uk/registration/joining-the-register/toc/toc-2021/resources/


If you would like legal advice or legal representation in relation to a competence concern, call Nurses Defence Service on 0800 0122 506 or use our contact form.



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Nurses Defence Service - Legal Services for UK Nurses