The UK and Germany are two top-rated countries for foreign nurses to work in. Both of them have the world’s leading healthcare systems, where medical care is freely accessible to everyone. But where is it better to work as a nurse? Which benefits do these countries have to offer to foreign employees?
The main differences in nursing work in the UK vs. Germany
Let’s start an overview by defining the differences and similarities between nursing jobs and employee benefits. The green color identified which country is better & worst & equal in this aspect.
The UK: £22,128 to £28,746 (€25,373 – €32,961).
Nurses in the UK receive, on average higher salaries than in Germany. The average ranges from £22,128 to £28,746 (€25,373 – €32,961), and £35,000 – £45,000 for senior nurses, when the very common annual salary for German nurses is €27,600 with an increase to €42,000 for senior professionals.
2. Language requirements
The UK: IELTS level 7; OET – B.
Germany: Goethe-Zertifikat level B2; TestDaF – TDN 2; telc – B2.
Nurses are not required to learn a new language to work in the UK. But they need to pass particular exams if not a native speaker.
German is the official language in Germany. Everyone who is willing to work as a nurse in this country must learn a new language and have a certificate to apply for a job.
3. Weekend and night work surcharge
The UK: Sundays/Holidays – 60% of the regular hour fare; Nights and Saturdays – 30%.
Germany: Sundays – 50%, Holidays – 150%, Nights – 25-30%.
If nurses choose to work on bank holidays and Sundays, they will be paid 60% more, while those who opt to work nights and Saturdays will be paid 30% more.
Meanwhile, in Germany night surcharge is between 25% – 30% of the regular hour fare, and 25% is tax-free. As you can see, nurses who prefer to work at night earn, on average, much more than someone working regular hours.
In fact, Sundays are paid 50% (tax-free) more than normal fare, and working on holidays will bring you 150% more than on an average day, plus 40% (tax-free) night fare applicable if working at night hours.
The UK: A minimum of 27 working days plus 8 bank days = 35 per year.
Germany: A minimum of 24 free working days per year.
Nurses in the UK have a minimum of 27 working days off per year and additionally 8 bank days, which brings it to 35 days of vacation. Moreover, after working for 5 years, holidays increase to 29 days. And, after 10 years of service, the original 27 days increase to 33 days.
German nurses enjoy at least 24 free working days per year, but more often, it’s between 25 and 30 days per year since each employer can regulate this independently. Unfortunately, health workers don’t enjoy public holidays as other professions do.
5. Working hours
The UK: 37,5 hours per week, the most common scheme is twelve-hour shifts.
Germany: 40 hours per week, 3 shifts, each 8 hours long.
Nurses in the UK work, on average, 37,5 hours with scheduled shifts. They might be eight, twelve, or even sixteen hours long and may not follow the traditional pattern of the day, evening, and night shifts.
Although the most common scheme is twelve-hour shifts, usually starting at 7 p.m. and ending at 7 a.m., some might start at 3 a.m. and end at 3 p.m.
While in Germany, nurses prefer to work in 3 shifts, each 8 hours long. In total, it brings the working week to 40 hours per week. Each employer can set a schedule for shifts, but often you can see this scheme:
- Morning shift: 6 am to 2:30 pm
- Evening/late shift: 1:30 pm to 10:00 pm
- Night shift: 8:30 pm to 6:00 am
6. Refunds for language courses
The UK: Foreign nurses get reimbursed costs of the IELTS – £170 and OET £349.
Germany: No refunds; nurses pay €210 for Goethe-Zertifikat and €195 for TestDaF.
In the UK and Germany, future nurses will need to pass language exams and tests to pursue their careers. However, compared to Germany, the UK health system will refund the costs of their exams, such as IELTS and OET, which will be paid together with the nurse’s first month’s salary.
Unfortunately, Germany doesn’t refund the costs of language exams to future nurses, for example, examination fees for Goethe-Zertifikat B2 are €210, and the most popular test, TestDaF, costs €195.
7. Nursing qualifications
The UK: University degree is required.
Germany: No university degree is needed, but vocational training.
In most countries in the world, and the UK isn’t an exception, to become a nurse, you will need a university degree. However, Germany is very advanced with apprenticeships or so-called vocational training.
The most common way to get a nursing qualification in Germany is to complete a 3-year nursing apprenticeship that provides a monthly salary of €1,000 during all 3 years.
9. Income tax
The UK: Income tax of 20% plus a foreign fee of €460 per year; €2,099 monthly after-tax.
Germany: Varies between 30% and 42%; €1,610 monthly after-tax.
On average, the UK nurse earns £2,250 (€2,587) gross monthly and £1,825 (€2,099) after tax. As you can see, UK income taxes are just around 20% for the salaries range between £12,501 – £50,000, which is normally the case for nurses.
In addition to the income taxes, migrant workers (incl. nurses) coming to the UK from outside the European Economic Area (EEA) and their relatives have to pay an annual fee of £200 (€230) each.
The annual charge was doubled from £200 to £400 (€460), with the discounted rate for students set to increase from £150 to £300.
That is apparently a heavy financial and mental load for foreigners who also have responsibilities for their families. They can end up paying €1,380 annually and €115 monthly for one kid and the spouse.
In Germany, foreign nurses don’t have to pay any additional fees or taxes in that meaning. Nurses in Germany pay between 30% and 42% of their gross monthly salary in taxes.
So with an average salary of €2,300, income taxes will be around €690. Hence a nurse will receive €1,610 in hands.
Furthermore, all employees in Germany have to pay a solidarity surcharge, which is 5,5% of the gross salary. That’s it. Employees can still live a comfortable life with the rest of the money and various bonuses.
10. Employees benefits
The UK and Germany have different social systems and, therefore, benefits for employees.
Income Protection it’s something Germany doesn’t have. It’s an insurance policy purchased by an employer that will protect the finances of their employees if an illness or injury prevents them from working.
If a nurse is diagnosed with a health problem and needs to take time off work to recover, an income protection policy will pay out monthly benefits to them – 65% of their pre-tax earnings.
Depending on the policy options they choose, nurses can claim these benefits for up to 2 years or until they reach retirement age if their condition is serious enough to prevent them from returning to work continually.
Life Insurance is another insurance Germany doesn’t have. It’s a company-organized group insurance scheme that promises to support an employee’s family if they pass away or develop a terminal illness while employed by the company.
The support is usually made at one time and contains 2-4 times the employee’s annual salary, but it’s up to each company to decide how much they prefer to pay.
This payment can be used to cover a funeral, pay off loans, or help a family cover their everyday expenses while they adjust.
Read more about employee benefits in Germany in this detailed article.
The similarities of nursing work in the UK vs. Germany
Despite all the differences, there are also many similarities between Germany and the UK and the professional pathway of foreign nurses.
You also want to know where life is better in the UK or Germany.
The UK: Nurses can take their spouses with them once the job and visa are confirmed.
Germany: Foreign nurses can also invite their families after they receive a German residence permit.
2. Continual training
The UK: Nurses can do continual training in 4 areas: mental health, adult, child, and learning disability.
Germany: Has an endless range of qualifications and continual training for practicing nurses.
Same as in Germany, nurses in the UK undergo continual training. Therefore they have many opportunities for career progression.
Although UK nurses can specialize in one of 4 areas of care: mental health, adult, child, and learning disability; with additional training, they could also become a midwife, nursing managers, or research nurses.
In Germany, nurses can expand their expertise, career, and salary opportunities by specializing in one of the many fields:
- Anesthesia and intensive care
- Operations and endoscopy service
- Clinical geriatrics
- Rehabilitation and long-term care
- Palliative and hospice care
- Psychiatric care
- General Internal Medicine
- Obstetrics (women’s doctor)
- Maternity and newborn care
3. Sick pay
The UK: Nurses can get £94.25 per week Statutory Sick Pay (SSP) for up to 28 weeks.
Germany: First 6 weeks, nurses get sick pay which is equal to the regular day salary, after – financial support for up to 78 weeks.
Both the UK and Germany pay employed nurses sick days. However, in the UK, most employees are entitled to £94.25 a week after their first 4 days off sick. It’s called Statutory Sick Pay and covers up to 28 weeks of not working.
A nurse can also have additional Sick Pay Insurance, which provides short-term financial support for sickness absence. It can start from as little as one week’s absence and generally pays out for up to one year.
In Germany, nurses are entitled to sick pay equal to regular day salary for the first 6 weeks, and under certain circumstances, the employer has to continue payments for up to 12 weeks.
After the six weeks, there is an option for additional weeks if needed – sickness benefit, which gives you financial support for up to 78 weeks (1,6 years). The exact allowance varies, but it’s surely more than £94.25 per week in the UK, which will be even not enough to pay for your rent.
The UK: A nurse and employer share pension contributions which is between 8% and 9.3% of the monthly salary.
Germany: Fixed pension contribution 19,6% of the gross salary, 9,8% paid by the employer, and 9,8% paid by the nurse.
Both UK and Germany guarantee solid pensions for their nurses, with small differences in pension schemes.
The UK offers one of the best pension plans in the country for nurses. New employees will be automatically enrolled from the first working day, with pension contributions lies between 7,1% and 9,3% depending on starting salary.
Where an employee and their employer each regularly put a set amount of money into the pension account.
On the other hand, Germany has the same fixed pension contribution for all professions, which is 19,6% of the gross salary, 9,8% paid by the employer, and 9,8% paid by the employees.
Read an article about the benefits of working as a nurse in Germany.
Conclusion: The main similarities we have noticed while reading many reviews, experiences, and articles is that Germany and the UK have the same issues with health workers:
Nurses are underpaid, underappreciated, and can’t work independently. For almost every step, they need approval from the doctor or senior nurse/department manager.
Best countries to work as a nurse
Germany and the UK have been two favorite places for foreign nurses. In fact, statistics say that of every 1,000 nurses in England, 869 are British, 55 are from other EU countries, 44 are Asian, 21 are African, and 11 are from other places.
Indians and Filipinos dominate the UK nursing industry. Meanwhile, in Germany, 134,000 nurses from abroad were working in German hospitals (2019).
Germany and the UK are probably the easiest to get a job/visa, and they are very friendly to foreigners. Yet, there are better places for nurses on this planet. Read below the list of the top 5 countries to work as a nurse.
1. United States
The United States
With an average annual salary of approximately $67,490 for a registered nurse and earned respect and responsibility, the US is one of the best countries to be a nurse. After completing a master’s degree, nurses can have salaries almost on the doctor’s level.
The qualifications of many foreign nurses are hard to recognize. Thus, they will need to pass exams and get certifications.
The top five states that have the current highest salaries for nurses are:
- New York
Canada has a well-funded universal healthcare system where nurses with skills and experience in several specializations are in demand.
Internationally educated nurses (IENs) who want to work in the country should get licensed the same way as Canadian registered nurses. They can expect an annual income between $48,000 and $55,000.
Luxembourg is a good place for nurses willing to earn a high salary and live in a very stable and quiet country. Luxembourg surprisingly tops the list when it comes to monthly payments for nurses.
The country has a very small size and population but offers generous pay and low taxes.
The salary is way above average. Even junior nurses start on around $60,000, while the average annual income of experienced nurses is $105,749. The earnings can grow up to $125,000 per year.
If your goal is earning money and having a secure workplace – Luxembourg is one of the places on the planet.
The downside is the almost impossible way of getting a work visa. Openings for nursing jobs take years to happen.
But if the nurse is an EU/EEA citizen, they won’t have a problem getting employment in Luxembourg, a visa isn’t required in this case.
An average annual salary of a registered nurse is around $46,720. However, as their experience increases, their salary increases along with it. Salaries can be as high as $60,000 per year.
If a foreign degree doesn’t get recognition in Australia, nurses have to receive a certificate from the Australian Nursing and Midwifery Accreditation Council (ANMAC) in order to become certified nurses.
The big advantage of Ireland is that it’s an English-speaking coutry and is part of the EU. So if you want to stay in Europe, you have another option apart from the UK.
The drawback is that you can only work and practice as a nurse in Ireland if you are registered with the NMBI or the Nursing and Midwifery Board of Ireland.
So nurses who don’t possess this type of credentials will need to repeat the recognition procedure in Ireland. A certification from the NMBI must be obtained before applying for a nurse position.
The average using salary in Ireland is $48,000, which is higher than in the UK, and the working conditions are good. Yet, junior nurses receive lower remuneration.