2026-02-24 · NextMigrate Team
I'm a Filipino Nurse. Here's What Actually Happened After I Moved to the UK
This is the story of Joy, a registered nurse from Cebu who moved to Birmingham in 2023. She asked us to use a different name, but every detail is hers.
The Decision That Broke My Heart Before It Changed My Life
I was earning PHP 18,000 a month at a private hospital in Cebu City. That is roughly GBP 250. After rent, food, and sending a little to my parents in Leyte, I had almost nothing left. I had been a nurse for six years. I was good at my job. And I could not afford to get sick myself because I had no savings.
My tita in London kept telling me about the NHS. "They are begging for nurses," she said. I did not believe her at first. It sounded too simple. But I started reading forums on Reddit, Facebook groups, and I saw real Filipinas posting their NMC registration numbers, their first NHS payslips. The numbers were real. A Band 5 nurse starting at GBP 29,970. More than ten times what I was making.
I want to be honest from the start: the decision to leave was not exciting. It was terrifying. My nanay was 62 with high blood pressure. My younger brother was still in college. I was the eldest daughter in a Filipino family. You know what that means. You do not just leave.
But I also knew that staying meant nothing would change. Not for me, and not for them.
The Salary Reality in the Philippines vs. the UK
Before going further, here is the cold financial comparison that pushed me over the edge:
| Factor | Cebu (Private Hospital) | Birmingham (NHS Band 5) |
|---|---|---|
| Monthly gross salary | PHP 18,000 (GBP 250) | GBP 2,498 |
| Annual gross salary | PHP 216,000 (GBP 3,000) | GBP 29,970 |
| Night shift differential | PHP 1,800/month | GBP 184/month (30% unsocial hours) |
| Overtime rate | PHP 140/hour | GBP 18.50/hour (time-and-a-half) |
| Annual leave | 5 days (first year) | 27 days + 8 bank holidays |
| Pension contribution (employer) | None | 20.6% of salary (NHS Pension) |
| Health coverage for self | Limited PhilHealth | Full NHS access, free |
The pension line is the one nobody talks about. The NHS pension is one of the best defined-benefit schemes in the UK. At Band 5, the trust contributes roughly GBP 6,174 per year toward your retirement. In Cebu, I had zero pension.
The Paperwork: Twelve Months of My Life I Will Never Get Back
People talk about moving abroad like it is a single brave decision. It is not. It is hundreds of small, exhausting steps over months.
Here is what the NMC registration process actually looked like for me:
Step 1: IELTS Academic. I needed a 7.0 overall with no band below 6.5 (7.0 in reading, listening, and speaking). I studied for four months using free YouTube videos and a PHP 3,500 review class. I took the test twice. The first time I got 6.5 in writing. The second time I passed. Total cost: roughly PHP 28,000 (about GBP 390).
Step 2: CBT (Computer-Based Test). I took this at a Pearson VUE centre in Manila. I studied for two months using the NMC test of competence materials. I passed on the first attempt. Cost: GBP 83.
Step 3: NMC Application and Document Submission. Gathering my transcript of records, verification from the Philippine Regulatory Commission, police clearances, and getting everything notarised and apostilled. This took three months because of delays at the PRC. I spent roughly PHP 15,000 on documents alone.
Step 4: OSCE (Objective Structured Clinical Examination). This is the practical exam you take after arriving in the UK. My NHS Trust sponsored my flight and provided accommodation for the first eight weeks, so I did not pay for the OSCE directly. But not all trusts do this. Some nurses pay GBP 794 out of pocket.
Step 5: Health and Care Worker Visa Application. My employer handled the Certificate of Sponsorship. The visa fee was reduced because nursing is on the Shortage Occupation List. I paid roughly GBP 284 for the visa and GBP 624 for the Immigration Health Surcharge (now waived for health workers, but it was not when I applied). My trust reimbursed the IHS later.
From starting my IELTS review to landing in Birmingham, the entire process took fourteen months. Some nurses do it in nine months. Some take two years. It depends on how fast you pass your exams and how quickly the bureaucracies move.
Complete Cost Breakdown: Decision to Departure
Here is every peso and pound I spent, so you can budget accurately:
| Item | Cost (PHP) | Cost (GBP) | Notes |
|---|---|---|---|
| IELTS test (1st attempt) | 14,000 | 195 | Failed writing by 0.5 |
| IELTS test (2nd attempt) | 14,000 | 195 | Passed all bands |
| IELTS review class | 3,500 | 49 | Local review centre in Cebu |
| CBT exam fee | — | 83 | Paid in GBP directly |
| NMC application fee | — | 153 | Non-refundable |
| PRC verification | 2,500 | 35 | Board of Nursing verification |
| Transcript of Records | 500 | 7 | Per copy, I got 3 copies |
| Police clearances (NBI + local) | 1,200 | 17 | NBI valid 1 year |
| Document apostille (DFA) | 1,000 | 14 | Per document |
| Notarisation fees | 3,000 | 42 | Multiple documents |
| Medical exam (TB test, chest X-ray) | 7,500 | 104 | Required for visa |
| Visa application fee | — | 284 | Reduced rate, Health & Care Worker |
| Immigration Health Surcharge | — | 624 | Reimbursed later by trust |
| OSCE exam fee | — | 0 | Trust-sponsored (otherwise GBP 794) |
| Flight to UK | — | 0 | Trust-sponsored (otherwise GBP 450-600) |
| Warm clothing purchased pre-departure | 5,000 | 70 | Still not enough |
| Total out-of-pocket | ~52,200 | ~1,872 | Before any trust reimbursement |
After my trust reimbursed the IHS (GBP 624), my net cost was approximately GBP 1,248 or PHP 90,000. I recovered that entire amount within my first month of NHS salary.
Timeline: Decision to First Paycheck
Here is exactly how long each phase took for me:
| Phase | Duration | Running Total |
|---|---|---|
| Deciding to start, initial research | 2 weeks | 2 weeks |
| IELTS preparation | 4 months | 4.5 months |
| IELTS 1st attempt + results wait | 2 weeks + 13 days | 5.5 months |
| IELTS 2nd attempt + results wait | 3 weeks + 13 days | 6.5 months |
| CBT preparation + exam | 2 months | 8.5 months |
| NMC application + PRC verification + document gathering | 3 months | 11.5 months |
| NMC decision letter | 3 weeks | 12 months |
| Employer matching + interview | 2 weeks | 12.5 months |
| Certificate of Sponsorship + visa application | 3 weeks | 13 months |
| Visa processing | 3 weeks | 13.5 months |
| Flight + arrival + settling | 2 weeks | 14 months |
| OSCE preparation + exam | 6 weeks | 15.5 months |
| NMC PIN issued, start working | 1 week | 16 months |
| First full payslip | 4 weeks | 17 months total |
Seventeen months from "I should look into this" to the first deposit in my Lloyds bank account. That is the honest timeline. You can compress it to 12 months if you pass every exam on the first attempt and your PRC moves quickly, which happens for maybe 1 in 5 nurses I know.
The First Six Months: Nobody Tells You About This Part
I arrived in December 2023. It was 3 degrees Celsius. I had never experienced cold like that. I owned one jacket.
My trust arranged shared accommodation with three other Filipino nurses. We had a small flat in Erdington. It was clean but bare — no curtains, a mattress on a bed frame, a kettle. That was it. I remember sitting on that mattress the first night and just crying. Not because anything was wrong. Because everything was different.
The loneliness was the hardest part. I want to be specific about this because I think people underestimate it.
At work, my colleagues were kind. The senior nurses were patient. But the culture shock was real. Patients called me "love" and I did not know if they were being sincere or patronising. I could not understand the Brummie accent for weeks. I smiled and nodded through conversations I did not follow. One patient asked me where I was "really from" three times in one shift.
Outside of work, I had no community. Church helped. I found a Filipino Catholic group in Birmingham and started attending Mass on Sundays. That was my lifeline. But for the first three months, I was profoundly lonely in a way I had never experienced in Cebu, where you cannot walk ten metres without seeing someone you know.
I also underestimated the emotional toll of night shifts. In my first rotation, I worked seven consecutive night shifts. I would come home at 7:30 AM, try to sleep with sunlight coming through those thin curtains, and call my nanay at 3 PM Manila time. She would ask me if I was eating. I would say yes. I was mostly eating instant noodles because I did not know where to buy Filipino groceries yet.
OSCE: The Exam That Nearly Broke Me
The OSCE deserves its own section because it is the single biggest point of failure for Filipino nurses in the UK. The pass rate for internationally educated nurses taking the OSCE hovers around 68% on the first attempt (NMC data, 2023-2024). One in three nurses fails on their first try.
The OSCE costs GBP 794 if your trust does not cover it. If you fail, the resit costs another GBP 794. I have met nurses who spent GBP 2,382 on three attempts before passing.
The exam has six stations:
- APIE station (Assessment, Planning, Implementation, Evaluation) — You get a patient scenario and must demonstrate the full nursing process. 20 minutes.
- Four clinical skill stations — Covering tasks like medication administration (drug calculations, injection technique), wound assessment, vital signs assessment with NEWS2 scoring, and catheterisation. 10 minutes each.
- Evidence-based practice station — You answer questions on clinical guidelines and rationale for care decisions. 10 minutes.
The gotchas that trip up Filipino nurses:
- NEWS2 scoring: The Philippines does not use the National Early Warning Score system. You must memorise the scoring parameters cold. A pulse of 91-110 scores 1 point, 111-130 scores 2, above 130 scores 3. Respiratory rate 12-20 is 0, 21-24 is 2, above 25 is 3. You will be failed if your NEWS2 calculation is wrong.
- Drug calculations: The UK uses different units and rounding conventions. Practice calculating infusion rates in mL/hr and dose calculations in mg/kg until you can do them in your sleep.
- Communication style: Filipino nurses are trained to be deferential. The OSCE requires you to be assertive, introduce yourself by name, explain every action, and gain explicit consent. Saying "I'm going to take your blood pressure now, is that alright?" before every single intervention.
- Aseptic Non-Touch Technique (ANTT): This must be performed precisely. If you contaminate a key part (touch the tip of a syringe, for instance), it is an automatic fail for that station.
My advice: find a paid OSCE preparation programme in your city. Northwick Park OSCE training centre in London charges GBP 500-700 for a 5-day course. The University Hospitals Birmingham trust offers free prep for their sponsored nurses. If your trust does not offer free prep, budget for a paid course. It is worth every pound.
The Financial Turning Point
My first full payslip arrived in late January 2024. After tax and National Insurance, I took home approximately GBP 1,950. I sat on my bed and stared at it.
In the Philippines, it would have taken me nearly eight months to earn that amount.
NHS Band 5 Salary Breakdown (2024/2025)
Here is exactly what happens to your GBP 29,970 gross salary:
| Deduction | Monthly Amount | Annual Amount | Notes |
|---|---|---|---|
| Gross salary | £2,498 | £29,970 | Band 5, starting point |
| Income tax | -£252 | -£3,024 | Personal allowance: £12,570 |
| National Insurance | -£168 | -£2,016 | 8% on earnings above £12,570 |
| NHS Pension (employee) | -£128 | -£1,540 | 7.1% contribution rate at this salary |
| Student loan | £0 | £0 | Not applicable for overseas nurses |
| Take-home pay | £1,950 | £23,390 | Before any enhancements |
But your actual take-home is higher because of shift enhancements:
| Enhancement | Rate | Typical Monthly Extra |
|---|---|---|
| Saturday (after 20:00) | +30% | £80-120 |
| Sunday (all day) | +30% | £100-150 |
| Night shifts (20:00-06:00) | +30% | £150-200 |
| Bank holiday | +60% | £50-80 (if you work one) |
Working a typical rotation with nights and weekends, my actual take-home averaged GBP 2,100-2,250 per month. During months with bank holidays (December, April), I earned up to GBP 2,500.
My Monthly Budget: Birmingham 2024
Here is what my monthly finances looked like after I settled in:
| Category | Monthly Amount (GBP) | Notes |
|---|---|---|
| Rent (shared flat, Erdington) | 450 | 2-bed shared with 1 other nurse |
| Council tax (share) | 65 | Band A property, 50% share |
| Gas and electricity (share) | 55 | Higher in winter (Oct-Mar: £75) |
| Food and groceries | 250 | Aldi/Lidl + Filipino store monthly |
| Transport (bus pass) | 65 | National Express West Midlands |
| Phone (SIM only) | 12 | Giffgaff, 15GB data |
| Internet (share) | 13 | BT broadband, 50% share |
| Remittance to family | 600 | Via Wise (lowest fees: 0.6%) |
| Savings (UK account) | 300 | Lloyds easy saver |
| NMC annual registration | 10 | £120/year, budgeted monthly |
| Personal spending | 130 | Clothes, haircut, social |
| Total | £1,950 | Matches base take-home exactly |
When I work nights or weekends, the extra GBP 150-300 goes entirely into savings. By month 12 in the UK, I had accumulated GBP 4,800 in savings. By month 18, I had GBP 8,200.
That GBP 600 I send home every month is roughly PHP 43,000. My nanay's blood pressure medication (PHP 3,500/month), my brother's tuition fees (PHP 15,000/semester), a new roof for the house (PHP 120,000 lump sum) — I was covering all of it. Within six months of arriving, I had sent more money home than I had earned in the entire previous year in Cebu.
The Remittance Math: Which Service to Use
This matters because fees eat into what your family receives. I tested all of them:
| Service | Transfer Fee | Exchange Rate Markup | Total Cost on GBP 600 | Family Receives (PHP) |
|---|---|---|---|---|
| Wise (TransferWise) | £3.60 | 0.4-0.6% mid-market | ~£7 total | ~PHP 42,600 |
| Remitly (Express) | £0.99 | 1.5-2.0% markup | ~£12 total | ~PHP 42,200 |
| Western Union (online) | £4.90 | 2.0-3.0% markup | ~£18 total | ~PHP 41,800 |
| Bank transfer (Lloyds) | £9.50 | 3.0-4.0% markup | ~£28 total | ~PHP 41,100 |
Wise saves roughly GBP 21 per transfer compared to a bank transfer. Over 12 months, that is GBP 252 — almost a week of groceries. I use Wise exclusively.
What Nobody Warns You About the Guilt
The money helps. It changes your family's life. But it does not remove the guilt.
My nanay had a blood pressure spike in April 2024. My tita called me. I was on a night shift. I stood in the staff toilet and called home and my nanay said, "Huwag kang mag-alala," — do not worry — and I thought: I am 10,000 kilometres away. How can I not worry?
There is a specific kind of guilt that comes with being a migrant from a culture where family is everything. You carry it every day. You carry it when your cousin gets married and you are not there. You carry it when your lola gets weaker and you see it only through a video call screen. You carry it when you are laughing with friends in Birmingham and then remember that your mother ate dinner alone.
I am not saying this to discourage anyone. I am saying this because nobody told me, and I wish someone had. The guilt does not go away. You learn to live alongside it.
The Career Progression Nobody Talks About
In the Philippines, career progression for nurses is almost non-existent. You go from Staff Nurse I (PHP 18,000-22,000) to Staff Nurse II (PHP 23,000-26,000) over 5-8 years, and that is essentially it unless you move into management, which has very few openings.
In the NHS, the structure is completely different:
| Band | Role | Annual Salary (2024/25) | Typical Timeline |
|---|---|---|---|
| Band 5 | Staff Nurse (starting) | £29,970 - £36,483 | Entry point |
| Band 6 | Senior Staff Nurse / Sister | £37,338 - £44,962 | 2-3 years from Band 5 |
| Band 7 | Ward Manager / Specialist Nurse | £46,148 - £52,809 | 4-6 years from Band 5 |
| Band 8a | Matron / Advanced Practitioner | £53,755 - £60,504 | 7-10 years from Band 5 |
| Band 8b | Head of Nursing (department) | £62,215 - £72,293 | 10-15 years from Band 5 |
I am currently working toward a Band 6 role. My trust funded my IV therapy training and mentorship qualification. The total value of training I have received for free in 18 months is roughly GBP 3,000 — courses that in the Philippines I would have had to pay for myself and would not have been able to afford.
At Band 6, my take-home after tax and NI would be approximately GBP 2,450/month — a 25% increase from Band 5. At Band 7, it would be GBP 2,900/month. These increases are on top of the annual NHS pay review, which has been 5-6% in recent years.
10-Year Financial Projection: Philippines vs. UK
| Year | Philippines (annual, PHP) | Philippines (USD equiv.) | UK (annual, GBP) | UK (USD equiv.) |
|---|---|---|---|---|
| Year 1 | 216,000 | $3,900 | 29,970 | $38,100 |
| Year 3 | 264,000 | $4,600 | 37,338 (Band 6) | $47,500 |
| Year 5 | 300,000 | $4,900 | 41,000 (Band 6 mid) | $52,200 |
| Year 7 | 324,000 | $5,000 | 46,148 (Band 7) | $58,700 |
| Year 10 | 360,000 | $5,200 | 52,809 (Band 7 top) | $67,200 |
| Cumulative (10 years) | ~PHP 2.9M | ~$47,000 | ~£413,000 | ~$525,000 |
The 10-year cumulative earnings gap is over $478,000. Even accounting for the UK's higher cost of living, the savings and remittance gap is enormous.
Was It Worth It?
Yes. But not for the reasons I expected.
I thought it would be worth it because of the money. The money is important — it is the reason I can give my family a life they could not otherwise have. But what surprised me is that it was worth it because of who I became.
In the Philippines, I was a good nurse who felt invisible. Here, I am a nurse who is valued, professionally developed, and compensated fairly. I have completed two specialist training programmes. I am on track for a Band 6 role. I have a pension. I have rights. I have a GP who does not charge me when I am unwell.
I have a life that I built myself, and that matters in a way I cannot fully articulate.
What I Would Do Differently
Five things:
-
I would have started the IELTS earlier. I wasted six months thinking about migrating before doing anything. Start the IELTS the moment you are considering it. Even if you decide not to go, having a 7.0 IELTS score opens other doors.
-
I would have brought more warm clothes. This sounds trivial. It is not. I spent my first month shivering because I packed for Manila weather. Buy thermals before you fly. Uniqlo HEATTECH innerwear is available in Manila and costs PHP 800-1,200 per piece. Buy 4-5 sets. You will thank yourself.
-
I would have joined the Filipino nurse Facebook groups sooner. The community support is incredible. People share OSCE tips, recommend towns with good Filipino communities, warn you about dodgy agencies. I found my current flat through a Facebook group. Key groups: "Filipino Nurses in the UK (Official)" (45,000+ members), "NMC OSCE Preparation" (30,000+ members).
-
I would have opened a Wise account before leaving the Philippines. Setting up international transfers from the UK takes time if you do not have the apps ready. Create your Wise, Remitly, and UK banking app accounts as soon as you have a UK address.
-
I would have negotiated harder with my agency. Some trusts pay for flights, first 8 weeks of accommodation, OSCE fees, and a settling-in allowance of GBP 1,000-2,000. Others pay for nothing. Ask specifically what is included before signing. Get it in writing. I have met nurses whose agencies promised reimbursement verbally and then refused to honour it.
Edge Cases and Gotchas
Things I wish someone had told me before I applied:
- NMC registration expires if your OSCE is not passed within 12 months of CBT. If you arrive in the UK and fail the OSCE twice, you may need to retake the CBT. Budget time accordingly.
- Some trusts have "clawback" clauses. If the trust pays for your flight and OSCE and you leave within 12-24 months, you must repay those costs. Read your contract carefully. Typical clawback amounts: GBP 2,000-5,000.
- Your NMC PIN must be renewed annually. The fee is GBP 120/year. If you forget, you cannot legally practice. Set a calendar reminder.
- Preceptorship (probation) lasts 6 months. During this time you are supernumerary on some shifts. This is normal and not a reflection of your competence. Use it to learn the systems — EMIS, SystmOne, Electronic Prescribing.
- If you have a gap of more than 5 years in nursing practice, the NMC may require additional supervised practice hours (450-750 hours). This applies if you left nursing to work in another field.
- Tax code errors are common for new arrivals. You may be put on an emergency tax code (1257L M1 or W1) and overtaxed in your first 2-3 months. Check your payslip. If the tax code is wrong, call HMRC on 0300 200 3300 to correct it. You will receive a refund, but it can take 8-12 weeks.
- The NHS Pension auto-enrols you, but you can opt out. Do not opt out. The employer contributes 20.6% of your salary. That is free money. Even if you plan to return to the Philippines eventually, you can claim your pension or transfer it.
A Final Word for the Nurse Reading This at 2 AM in Manila
I know you. You are on a night shift, or you just finished one. You are scrolling through your phone, reading stories like mine, wondering if you could do it too. You are scared. You are not sure you are good enough. You are worried about your family.
You are good enough. The NHS needs you — not in an abstract way, but urgently and specifically. The UK has approximately 43,000 nursing vacancies as of 2025 (NHS Vacancy Statistics). International nurses filled over 26,000 of the 50,000 new NMC registrations in 2023-2024. Filipino nurses are the second-largest group of internationally recruited nurses in the UK, after Indian nurses.
And your family will be okay. Better than okay, because you will be able to provide for them in ways that staying never allows.
The process is long and hard and lonely at the beginning. But if you are the kind of person who became a nurse in the Philippines — who survived the board exam (passing rate: 45-55% nationally), who worked double shifts for PHP 18,000, who held patients' hands through the worst moments of their lives — then you already have everything it takes.
Start with the IELTS. Just that. One step.
If you are a nurse considering migration and want help understanding which pathway fits your situation, NextMigrate can walk you through your options — no pressure, no sales pitch, just clarity.
