Working In The NHS

Getting started, pay and rotas

The Basics

Some of you may be moving to the UK for the first time, and may have never worked within the NHS before. The National Health System is a publicly-funded healthcare system, which was established in 1948.  The founding principles include providing a service which is comprehensive, universal and free at the point of delivery.

The general ethos is to work as a team in order to deliver the best care to each individual patient. Within the hospital setting you will generally work as part of a multidisciplinary team (MDT). This is typically made up from:

Doctors looking at a computer screen
  • Doctors of varying grades
  • Nurses
  • Pharmacists
  • Social Workers
  • Dieticians
  • Physiotherapists
  • Occupational therapists
  • Specialist nurses- eg. Diabetic nurses, respiratory nurses etc.

The following diagram is to help illustrate the various training pathways for doctors, and therefore highlight the senior support available to you.


National Insurance Number

To work in the UK you will need a National Insurance number as you are required to pay ‘Pay As You Earn’ income tax and National Insurance contributions (NICs).  A NI number is a unique identifier which is issued by the HMRC that allows them to track the NIC payments made for all individuals. 

You may have a NI number printed on the back of your Biometric Residence Permit (BRP), if this is the case you do not need to take any further action.  If you have been issued with a digital visa and don’t have a national insurance number, you will need to request one as soon as possible.  You can do this through the following link:  National Insurance number and Non-UK Nationals | nidirect



Rotas and on-call shift patterns vary greatly between specialties and hospitals. Therefore, it is not possible to give you a standard rota template, as this may not reflect every job, and may give you a false impression. Generally, you will have day shifts (9am-5pm), long days (9am-9pm), and night shifts (9pm-9am). The amount of anti-social hours you work should be reflected by your banding. Ideally, rotas should be sent out 6 weeks prior to starting. If this is not the case, try contacting the rota co-ordinator to make them aware you have not yet received your rota. If you have signed up to the buddy scheme, your buddy may have worked in that job previously, and may have an email address they could share with you

Pre-employment health assessment

Before you start your post an appointment will be made for you to attend a pre-employment health assessment. All new health care workers who will have contact with patients/clients must be screened for Tuberculosis (TB), and any who will be carrying out exposure prone procedures must also be screened for HIV and Hepatitis-B & C.

When attending Occupational Health Services (OH) you must produce the following:

  • Original Photographic Identification
  • Any Previous Screening/Vaccination Details
  • A fully completed Pre-Employment Health Questionnaire (this will be sent to you by your employer)
  • You will not be permitted to take up clinical duties until your employer receives confirmation that OH has cleared you to work.

Professional pathway

Your employer will provide you with information about the Trust, and where you will be working.  A professional pathway will have been established within the Trust which will cover areas such as:

  • Induction
  • Mandatory and Statutory Training
  • Additional training to assist you with integration into the workplace
  • A period of shadowing
  • A named Consultant mentor/supervisor

Still have questions?

Call us: 028 9536 0224

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