What are NHS pre-employment checks?
Before you start any NHS job, your employer must be satisfied that you are who you say you are, that you can legally work in the UK, that you are properly registered and qualified, that you are safe to work with patients, and that you are fit for the role. In England these checks are set out in the NHS Employment Check Standards published by NHS Employers. Scotland, Wales and Northern Ireland have equivalent arrangements.
The checks are not a sign that the employer doubts you. They protect patients, staff and the organisation, and every new starter goes through them, including UK graduates.
What are the six NHS Employment Check Standards?
| Check | What it confirms | Evidence usually requested |
|---|---|---|
| Identity | You are who you say you are | Passport, proof of address, photographs; names must match across documents |
| Right to work | You are legally allowed to do the job | Online immigration status checked with a share code, or a British or Irish passport |
| Professional registration and qualifications | You hold the right registration and qualifications | GMC, NMC, HCPC or GPhC register entry, qualification certificates |
| Employment history and references | Your experience and conduct | References covering a recent period, explanations for any gaps |
| Criminal record | Your suitability to work with patients | UK criminal record check and, where relevant, overseas police certificates |
| Work health assessment | You are fit for the role, with adjustments if needed | Occupational health questionnaire, immunisation and screening records |
Your recruitment or onboarding team will guide you through each one. Knowing what each check is for helps you send the right evidence first time.
How long do NHS pre-employment checks take?
There is no single fixed timescale. For a UK-based applicant with documents ready, checks can be completed in a few weeks. For international recruits, the process often takes longer because of overseas police certificates, references from abroad, visa steps and a UK criminal record check that may need a UK address. The Royal College of Physicians' guidance for IMGs suggests the whole process can take up to about eight weeks.
The most common causes of delay are not problems with the applicant. They are documents that do not match, referees who cannot be reached, unexplained gaps and incomplete vaccination records.
- Build one document folder: Scan everything as PDFs with clear names, such as 01 Passport, 02 Name change evidence, 03 Degree certificate, and keep an index with issue and expiry dates.
- Check names match: If your name differs between passport, qualifications and registration, include official evidence such as a marriage certificate.
- Line up referees early: Ask permission in advance and give official work email addresses and job titles, not just personal mobile numbers.
- Account for every month: Explain gaps briefly and honestly, for example time spent preparing for exams or caring for a relative.
- Gather health records: Get dated, signed immunisation records and laboratory reports, translated if not in English.
- Send everything together: One complete submission with a covering email listing each document is far quicker than sending items piecemeal.
How does the DBS check work for an NHS job?
Most clinical roles need an enhanced criminal record check because they involve close contact with patients. Some roles also need a check of the barred lists, depending on whether the work is regulated activity. Each nation has its own service.
| Nation | Criminal record service |
|---|---|
| England and Wales | Disclosure and Barring Service (DBS) |
| Scotland | Disclosure Scotland, including the Protecting Vulnerable Groups scheme |
| Northern Ireland | AccessNI |
A DBS certificate has no fixed expiry date, but it only reflects information at the date of issue. If you subscribe to the DBS Update Service when your check is applied for, future employers can, with your permission, check online whether anything has changed. NHS Employers guidance allows an employer to accept a previous certificate after a risk assessment, but they do not have to.
Overseas police certificates
If you have lived abroad, you will usually need police certificates from other countries. For health and care visa applicants, Home Office rules currently require an overseas criminal record certificate for countries where you have lived for 12 months or more in total in the last 10 years while aged 18 or over. Some employers ask for certificates covering shorter periods, so follow your employer's instructions. Certificates can take weeks, so apply early.
What happens at an NHS occupational health check?
Occupational health carries out the work health assessment. It confirms you are fit for the role, identifies any reasonable adjustments, and reduces the risk of infection passing between staff and patients. It is confidential. Your employer is told whether you are fit for the role and about any adjustments, not your detailed medical history.
- A health questionnaire about conditions that might affect your work or need adjustments.
- Evidence of immunity or vaccination for diseases such as measles, mumps, rubella and chickenpox.
- Hepatitis B vaccination history and, where relevant, your antibody response.
- Tuberculosis screening, which may include symptom questions, BCG history and sometimes a blood test.
- For staff who perform exposure prone procedures, additional blood-borne virus testing in line with UK Health Security Agency guidance.
Do not arrange unnecessary tests abroad before checking what your employer accepts. Many international staff complete missing vaccinations through occupational health in their first weeks.
How do I prove my right to work in the UK?
The Home Office now issues most immigration status digitally as an eVisa. You prove your right to work by signing in to your UKVI account and generating a share code, which your employer uses with your date of birth to check your status online. British and Irish citizens usually show a passport instead.
- Check your UKVI account shows the correct name, passport details and conditions before your start date.
- Make sure the passport linked to your account is the one you are using to travel.
- Report any errors through the Home Office's official channels straight away.
- Do not rely on old advice about physical documents; check current GOV.UK guidance.
Your employer will also check your professional register entry directly. Look at your own entry before you start. A missing licence, unpaid fee or wrong register part can delay your start or mean you work in a non-registered role until it is fixed.
A worked example: why one start date kept moving
Grace accepts a post with a start date eight weeks away. She sends documents in stages as she finds them. Her passport is in her married name but her nursing degree is in her birth name, and she does not send her marriage certificate. Her referees are given only as personal mobile numbers. A two-year gap in her CV, when she cared for a relative, is not explained. Her vaccination record is handwritten and undated. Her start date is postponed three times.
Nothing in Grace's history made her unsuitable. Every delay came from documents: the team could not link her identity records, verify her references or account for the gap, and occupational health had to repeat tests.
I will send what I have now and sort out the rest later. They can ring my referees. The gap is personal, so I will leave it off.
I sent one complete folder: passport, marriage certificate, registration, degree, a CV with every month accounted for (including 'March 2023 to February 2025: full-time carer for a family member'), referees' work emails, and a dated, translated immunisation record with blood results.
What should I do in my first weeks after the checks?
- Attend induction and complete required mandatory training before clinical work; ask if online modules can be started early.
- Apply for a National Insurance number if you need one, using GOV.UK.
- Open a UK bank account; your employer may give you a letter to help.
- Register with a GP for your own healthcare.
- Read any relocation or repayment agreement carefully before signing.
- Be alert to scams: real government bodies will not demand payment by gift card or phone transfer.
Keep every training certificate and check document in one place. You will need them for appraisal, revalidation and future job moves.
Where to go next
Our course Moving to the UK: Pre-Employment Checks and First Steps covers each check in more detail, with a document checklist and practical first-week planning. Doctors still working out how to register may find GMC Registration Routes for International Doctors helpful, and Good Medical Practice: Professional Standards for Doctors covers the honesty and probity expectations behind declarations. Always confirm requirements with your employer, NHS Employers, your regulator and GOV.UK.
Frequently asked questions
What checks are done before starting an NHS job?
NHS employers in England follow six Employment Check Standards: identity, right to work, professional registration and qualifications, employment history and references, criminal record, and a work health assessment by occupational health. The devolved nations have equivalent checks. Most job offers are conditional on these being completed satisfactorily, so wait for confirmation before resigning from your current job or making non-refundable plans.
How long do NHS pre-employment checks take?
It varies. With complete documents, UK-based applicants may be cleared in a few weeks. International recruits often take longer because of overseas police certificates, references from abroad, visa steps and a UK criminal record check. Royal College of Physicians guidance for IMGs suggests up to about eight weeks. Sending one complete, consistent document pack is the best way to avoid delays.
Do I need a new DBS check for every NHS job?
Not always. A DBS certificate has no fixed expiry date, and NHS Employers guidance allows an employer to accept a previous certificate after a risk assessment if it is the right type and level. If you subscribe to the DBS Update Service, employers can check your status online with your permission. Many employers still request a new check, so ask your recruitment team.
Which countries do I need overseas police certificates from?
For health and care visa applications, Home Office rules currently require certificates from countries where you lived for 12 months or more in total in the last 10 years while aged 18 or over. Employers may ask for certificates covering shorter stays. Requirements can change, so check GOV.UK and follow your employer's instructions, and apply early because some certificates take weeks.
What does NHS occupational health check?
Occupational health assesses whether you are fit for the role and whether you need adjustments, and reduces infection risk to patients. You will usually complete a health questionnaire and provide immunisation evidence, such as measles, mumps, rubella, chickenpox and hepatitis B, plus tuberculosis screening. Staff doing exposure prone procedures need extra blood-borne virus testing. Detailed medical information stays confidential to occupational health.
Can I fail an NHS occupational health assessment?
It is not a pass or fail test in the usual sense. Occupational health advises whether you are fit for the role, fit with adjustments, or need more assessment or vaccination first. Most health conditions do not prevent work, and the Equality Act 2010 requires reasonable adjustments for disability. Missing vaccinations can usually be completed after you start, depending on the role.
What is a right to work share code?
A share code is a code you generate from your UKVI online account to let an employer check your immigration status. The employer enters it, with your date of birth, into the Home Office online service. Most migrants now have digital status as an eVisa. Check your account details are correct and linked to your current passport before your start date.
Related courses
Moving to the UK: Pre-Employment Checks and First Steps
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Sources and further reading
- NHS Employment Check Standards. NHS Employers.
- Criminal record checks standard. NHS Employers.
- Prove your right to work to an employer. GOV.UK.
- DBS checks: guidance for employers. Disclosure and Barring Service.
- Immunisation against infectious disease (the Green Book): immunisation of healthcare and laboratory staff. UK Health Security Agency.
- Starting work in the NHS: pre-employment checks and preparation for IMGs. Royal College of Physicians.
- Equality Act 2010. UK Parliament.
Practitioner Insight is an independent education provider. It is not affiliated with or endorsed by the GMC, MPTS, NMC, HCPC, GPhC or any NHS organisation, and this information is not legal advice. If you have been referred to a regulator, speak to your defence organisation, trade union or legal representative.
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