American Nurses in U.K

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Hello Everyone!

It has been a long time since I have been here, so I hope that I am in the right place. I am thinking about nursing in London. All of my kids are adults and I love visiting the U.K. Has anyone worked in the NHS? If so, how was the experience? Thanks, in advance

On 7/14/2018 at 5:08 PM, Coffee Nurse said:

I recently returned to the US after living and working in London for six years. I've written about the experience in a few places, probably most extensively in this thread. Happy to answer any questions you may have, although the registration process has changed substantially (and gotten much more difficult) since I went through it.

Hi Coffee! Were you able to live comfortable with the salary while in the UK?

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Specializes in Emergency Nursing in USA and UK.

@NurseTBSN @We'veGotSpirit

Working conditions are okay. The NHS is underfunded compared to the privatized healthcare system in America so they don't always have the nicest toys/equipment, but they get the job done and heavily utilize evidence based practice to provide the best care they can for the patients. Hospitals can be run-down, depending on where in the country you're working. Generally, in my experience, the north of England is a bit more underfunded and the south better funded.

To be honest, I really enjoy British culture. It's a much more relaxed lifestyle, and the British themselves seem to have a very rigid set of morals and responsibility that makes living here very nice. There's a general attitude of respect for one's community. There are downsides as well, but ones I don't mind living with. Not sure what you mean about culture exactly, but many of the stereotypes in America about the British (stuffy, pompous, etc.) aren't that true, at least where I live.

Pay vs cost of living of course differs based on where you live. Bigger cities like Oxford (where I live) and London will have much higher costs of living than smaller ones. You can still live comfortably, however, especially if you have a roommate. I'm not much of a spender anyway and don't find it difficult to save my money, and I also don't care about nice cars or newest technology or whatever, so it's fine for me. I live just outside Oxford and commute about 20-25 minutes by car and it's much cheaper than living inside Oxford. I do have coworkers, however, who pay the same amount in rent as I do with roommates and live about 10mins walk from work. Seems about the same in England as it is in the US. Also you don't have to pay for health insurance and if you utilize the public transportation, it's cheaper than having a car. Also used cars are cheap here as well.

Don't know best places to work exactly as I've only worked in Oxford, and it depends on your speciality. I'm an Emergency nurse so I went for a large level 1 trauma center because that's what I enjoy. Depending on your specialty, different hospitals would be better for you. The weather is nicer in the south of England, and the hospitals are a bit more advanced down here as well, but sometimes you can find jobs that pay more in the north of England because they're so short staffed. Up to you to do your own research as far as that's concerned. Just depends on what you value.

Agency nursing does pay more just like agency nursing in the US. It has the same drawbacks as the US as well. There aren't really benefits in the UK NHS? Healthcare is free so you don't pay health insurance, dental care you pay a flat rate of like £30-40 for whatever you need. Eye care is part of healthcare. Car insurance is separate? Pension comes out of your paycheck and there are other plans similar to 401k but I haven't looked into that too much. Loads of places will do menial discounts if you're an NHS employee so restaurant/event discounts. You do get paid less but given I don't have to pay health insurance etc it's not too much less money and I can use pool/bank nursing to fill the gaps. This is where you pick up extra shifts on a unit that is short for an increased base rate of pay. Usually 50-100% increase. Sometimes that means you work in a unit that's not your own but I don't mind. Also vacation is 7 weeks in the UK for NHS employees and goes up from there depending on how long you've worked for the NHS. Much better than the 2 weeks you get in America. I don't know wha t to do with all the extra time so sometimes I take a week off (you get paid your regular base pay during vacation time) and then work regular bank/pool shifts to make extra, so it evens out. I don't know what your pay is in NYC but I lived/worked in Atlanta so that's my frame of reference.

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Wow thank you so much!

Do they utilize nurse practitioner?

Did you move by yourself?

How long was the process to move and begin working from start to finish? Did you need to redo any NCLEX type exams?

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Thanks so much @kaitfinder, your post is so helpful! Were you saying that NHS employees get free healthcare? Also regarding agency nursing, there's no benefits or pension, am I correct?

In NYC of course since cost of living is high, you will get no less than 82k base salary working at a private hospital here

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Specializes in Emergency Department.
17 hours ago, We'veGotSpirit said:

Thanks so much @kaitfinder, your post is so helpful! Were you saying that NHS employees get free healthcare? Also regarding agency nursing, there's no benefits or pension, am I correct?

Sorry to butt in here, but...

Healthcare is not free, whether you are an NHS employee or not. Every person who is working pays National Insurance - a percentage of your pay from every pay packet. However, healthcare is free at the point of use and you do not get bills for being in or attending hospital. Have to pay for prescriptions in England/Wales but not in Scotland. (If you are a foreign national NHS will try to recover costs from you but not if you are registered with a GP and otherwise paying into system.)

State pension is paid for through National Insurance and you require to have enough contributions to get state pension - not sure of exact rules. Should also have a workplace pension of some sort in NHS, about 9% of your salary. All other workers are encouraged to join a workplace pension scheme.

Expect to pay approximately one third of your salary for tax, national insurance and pension contribution. Upside to this is no medical bills, 7-10 weeks paid holiday a year and sick pay when you are off for up to 1 year. Agency work is slightly different and would depend on their contract and conditions but a few years ago I did work with an agency who offered holiday pay.

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Specializes in Advanced Practice, surgery.
9 hours ago, GrumpyRN said:

Sorry to butt in here, but...

Healthcare is not free, whether you are an NHS employee or not. Every person who is working pays National Insurance - a percentage of your pay from every pay packet. However, healthcare is free at the point of use and you do not get bills for being in or attending hospital. Have to pay for prescriptions in England/Wales but not in Scotland. (If you are a foreign national NHS will try to recover costs from you but not if you are registered with a GP and otherwise paying into system.)

We don't pay for prescriptions in Wales ?

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Thanks for your input @GrumpyRN, I appreciate it!

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So I get that healthcare isn't exactly free, since you get it taken out of your paycheck- but you can't go medically bankrupt, like you can in America?

I live in the US and part of my paycheck goes into my employer-provided healthcare, but then I have to pay at point-of-service until I hit a deductible, THEN it will start covering most (a percentage) of my services.

With the NHS, a bigger portion of my paycheck would go to the healthcare, but I don't have to pay per service and I don't have to meet a deductible?

It seems like that'd be easier to plan for, financially.

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Specializes in Emergency Department.
11 hours ago, onemoreday said:

So I get that healthcare isn't exactly free, since you get it taken out of your paycheck- but you can't go medically bankrupt, like you can in America?

No healthcare is not free, it is included in the national insurance (NI) payment that every employee (and employer) pays. It is around about 12% for an employee but varies. However also included in this is statutory sick pay and unemployment benefit.- which are what they say they are.

You cannot go medically bankrupt because no one asks for payment when you are in hospital or attending clinics, doctors etc. (unless you are not a UK citizen in which case the NHS is entitled to ask for payment.

There is a thriving private health system if you want to go private but you still have to pay your NI.

I have heard this term "deductible" on other parts of Allnurses but don't really understand it. I am assuming it is like an excess that I pay up front before the insurance kicks in.

I have a dreadful medical history over the years - cancer, heart problems (MI, CABG), bowel problems, meningitis, back surgery. With all that I have never been presented with a bill and I still own my own house and 2 cars. In America I think I would be dead or living under a bridge.

This is what happens when you have socialised medicine.

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Specializes in Emergency Nursing in USA and UK.
On 9/3/2019 at 4:11 AM, onemoreday said:

So I get that healthcare isn't exactly free, since you get it taken out of your paycheck- but you can't go medically bankrupt, like you can in America?

I live in the US and part of my paycheck goes into my employer-provided healthcare, but then I have to pay at point-of-service until I hit a deductible, THEN it will start covering most (a percentage) of my services.

With the NHS, a bigger portion of my paycheck would go to the healthcare, but I don't have to pay per service and I don't have to meet a deductible?

It seems like that'd be easier to plan for, financially.

Oops, sorry, I mispoke! I was working nights at the time and wasn't thorough enough in my explanation, @GrumpyRN explains the healthcare system in the UK very well.

It is free at the point of use, you do end up paying for it through taxes, however you are correct, it is infinitely easier to pay for financially. I had a medical scare in America before I moved where an emergency department visit with CT head, MRI with contrast, labs, and overnight stay landed me with a bill of $14,000. Luckily insurance kicked in, but that's a huge number. I have many praises for the NHS for many reasons, let alone the cost.

Prescriptions I believe you pay £9 for now (per perscription) and if you get repeat prescriptions they have various payment plans etc. to lower the cost as needed if you qualify. No deductibles or co-pays, no caps on how much they'll cover.

And like Grumpy said, 7wks minimum vacation (as opposed to the 2 weeks I got in America) and sick leave and I think 6 months paid maternity leave? Very worth it.

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On 9/9/2019 at 1:50 PM, kaitfinder said:

Prescriptions I believe you pay £9 for now (per perscription) and if you get repeat prescriptions they have various payment plans etc. to lower the cost as needed if you qualify. No deductibles or co-pays, no caps on how much they'll cover.

Just wanted to mention any UK resident can buy a Prescription Prepay Certificate. Unlimited prescriptions for 3 or 12 months, costs £29.10 and £104 respectively. Many people (including Brits) don't know about the existence of these. Even if you only usually have 1 monthly prescription it'll save you money as you won't have to pay extra for additional prescriptions for short term illnesses. https://www.nhs.uk/using-the-nhs/help-with-health-costs/save-money-with-a-prescription-prepayment-certificate-ppc/

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Specializes in NICU.

Keep in mind that as an immigrant, you have to pay an extra 400 pounds per year to use the NHS (relatively new rule) on top of your 20% tax rate (40% if you make over 46k GBP after allowances)

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