Updated May 14, 2026 • Reading Time: ~12 Minutes
From 23 February 2026, the Nursing and Midwifery Council (NMC) introduced new stations across the OSCE to align the Test of Competence with current NHS clinical practice. The headline additions: a Deep Vein Thrombosis (DVT) APIE scenario, two new clinical skills (Anti-Embolism Stockings and Pre-Operative Checklist), two new Professional Values stations (Deteriorating Patient and Patient Private Details), and three new Evidence-Based Practice topics (Cholesterol and Coffee, Honey and Propolis for HSV, and Osteoporosis and Exercise). The structure remains 10 stations over roughly 3 hours, with the fee at £794 and the reduced resit fee at £397.
If you are sitting your OSCE on or after 23 February 2026, you may be tested on any of these new stations. The good news: the underlying marking principles – safe practice, clinical rationale, communication, professional behaviour – have not changed. The exam got more realistic, not harder. This guide walks through each new station, the critical fails that will end your attempt instantly, and the operational details (including the Northumbria centre closure) you need before you book.
🩺 NMC OSCE 2026 – Quick Reference
Effective date for new stations: 23 February 2026
OSCE fee: £794 (full) / £397 (resit of 7 stations or fewer)
Total stations: 10 (4 APIE + 4 Clinical Skills + 2 Silent Written)
Total duration: approximately 3 hours
Maximum attempts: 3, with at least 10 days between attempts
Results timeline: 3–5 working days by email
Approved centres after Feb 2026: Ulster, Northampton, Leeds, Oxford Brookes (Northumbria closed)
Marking approach: borderline-compensatory; one catastrophic station failure can fail the whole exam
1. Don’t Panic – the OSCE Got More Realistic, Not Harder
If you have just passed your CBT and are now facing the OSCE, the talk of “exam changes” can send your heart rate up faster than a frantic shift on a busy ward. Take a breath.
The NMC reviews and refreshes the OSCE station bank periodically. The aim is to retire stations that have been in circulation for some time and introduce skills candidates are likely to encounter in real NHS clinical practice. The February 2026 update did exactly that – it brought in DVT recognition, anti-embolism stocking application, a structured pre-operative checklist, NEWS2-based deterioration recognition, and patient confidentiality scenarios. None of this is unusual nursing. All of it reflects what you will actually do on a UK ward.
The marking principles have not changed. You are still being assessed on: safe decision-making, clinical rationale, professional behaviour, clear communication, and the basics that apply to every single station – check identity, check allergies, gain consent, maintain dignity. Get those right and the new stations are entirely manageable.
2. The New APIE Scenario: Suspected Deep Vein Thrombosis
This scenario has been added to the Assessment, Planning, Implementation, and Evaluation cycle. You will encounter a patient presenting with calf pain or swelling, often post-surgery or after a period of immobility (long-haul flight, prolonged bed rest, recent orthopaedic surgery).
What you do
A holistic A–E assessment with specific attention to the affected limb. Inspect for unilateral redness, warmth, tenderness, and swelling. Use a measuring tape to compare calf circumference between limbs (a difference of more than 3cm is clinically significant). Many candidates will be expected to apply or reference the Wells score for DVT probability. Calculate observations and document on the appropriate chart.
Top tip to pass
Verbalise everything. The examiner can only mark what they observe you doing or hear you saying. State: “I am inspecting the limb for unilateral swelling, redness, and warmth. I am measuring the calf circumference 10cm below the tibial tuberosity to compare both legs. I am palpating gently along the calf for tenderness, avoiding any massage of the area.”
⚠️ CRITICAL FAIL – DVT
Do not massage the leg. Rubbing or massaging the affected limb risks dislodging the clot and causing a pulmonary embolism. This is an immediate fail regardless of how well you perform the rest of the station. Treat the limb gently throughout the assessment.
3. New Clinical Skills Stations
Anti-Embolism Stockings (TEDS)
This is a technical station. The marking sheet is not just about getting the stocking on the patient – it is about safety, accurate sizing, and skin integrity.
What you do: Assess the patient’s skin integrity before fitting, measure the limb accurately to choose the correct stocking size (calf and thigh circumference, plus length), apply the stocking smoothly without any folds, wrinkles, or tourniquet effect, and educate the patient on the purpose, signs to report (numbness, discolouration, increased pain), and how long they should wear it.
| Equipment | Purpose |
|---|---|
| Tape measure | Essential for measuring calf and thigh circumference and leg length |
| Manufacturer’s sizing chart | Used to select the correct stocking code from your measurements |
| Stockings | The actual garment – do not open the packet until you have sized |
| Talc (optional) | Sometimes available to ease application – check local guidelines |
Top tip to pass: smooth out every wrinkle. A wrinkled or rolled stocking acts as a tourniquet and causes skin breakdown – the examiner watches for this closely. After fitting, run your hands along the full length of the stocking and verbalise: “I am checking for any wrinkles or folds that could cause pressure damage.”
⚠️ CRITICAL FAIL – STOCKINGS
You will fail if you do not measure the leg. Guessing the size is unsafe. You must demonstrate measuring calf and thigh circumference, checking the length, and matching your measurements against the sizing chart before opening the stocking packet. Skipping the measurement is treated as a patient safety failure.
Pre-Operative Checklist
A formal checklist station for a patient about to go to theatre. This is a safety-gate skill – examiners are looking for thoroughness, not speed.
What you must verify:
- Consent: signed, dated, for the correct procedure, on the correct side
- Identity: wristband present, matches notes, patient verbally confirms
- Allergies: red allergy band visible, allergies documented on the chart
- Fasting status: NPO time confirmed (typically 6 hours food, 2 hours clear fluids)
- Jewellery and dentures removed (or noted if cannot be removed and why)
- Pre-op medications given as prescribed and documented
- Site marked by the surgeon if the procedure involves laterality
- Latest observations and any abnormalities flagged
Top tip to pass: work through the list systematically and verbalise each check. Do not skip the “obvious” items – the marking sheet expects every item, every time.
4. New Professional Values Stations
The Deteriorating Patient (NEWS2)
You will encounter a patient whose observations are worsening – rising respiratory rate, falling oxygen saturations, dropping blood pressure, or rising heart rate. The expected response: calculate the National Early Warning Score (NEWS2), decide the escalation level, and act.
What you do: record vitals accurately on the NEWS2 chart, calculate the total score, identify the appropriate escalation response per the NEWS2 protocol (single parameter scoring 3, or aggregate score of 5+, both trigger escalation), and verbalise your handover using SBAR (Situation, Background, Assessment, Recommendation).
Top tip to pass: do not just record the vitals – act on them. State: “The patient’s NEWS2 score is 7, which requires urgent review. I am escalating to the medical team and the critical care outreach team immediately. I will continue observations every 15 minutes and prepare the patient for potential escalation in care.” Common failure points are an incorrect NEWS2 calculation, a vague or incomplete SBAR handover, and failing to state a clear escalation plan.
Patient Private Details (Confidentiality)
A scenario where confidentiality is at risk – a relative asks you about the patient’s diagnosis, notes have been left where visitors could read them, or a colleague casually mentions a patient’s information in a corridor.
What you do: be the guardian of confidentiality. Politely decline to share information with unauthorised people (including family members, without the patient’s consent). Secure any open notes or screens immediately. Reference the NMC Code – “preserve safety” and “promote professionalism and trust.”
Top tip to pass: phrase your refusal kindly but firmly. “I understand you’re concerned about your father, and I want to help. I’m not able to share his clinical details without his consent, but I can ask him whether he’d like me to discuss things with you, and I can support that conversation if he agrees.” Empathy plus boundary – both must be present.
5. Evidence-Based Practice (EBP) – Three New Topics
The NMC has introduced three new EBP topics for the silent written station. You will be given short research summaries and asked to interpret the findings and explain them in patient-centred language.
Cholesterol and Coffee
Research on the impact of coffee consumption on lipid profiles. Your summary must reflect what the article says – not your personal opinion on coffee. Focus on the specific findings (which lipid markers were affected, the magnitude of effect, the limitations the authors note).
Honey and Propolis for HSV (Herpes Simplex Virus)
Research on the efficacy of medical-grade honey and propolis for cold sores and other HSV lesions. The key learning point: honey and propolis preparations have fewer side effects than aciclovir and may be viable alternatives for patients with adverse reactions to standard antivirals. Explain this in language a patient would understand.
Osteoporosis and Exercise
Research on the role of weight-bearing and resistance exercise in osteoporosis prevention and management. Cover the type of exercise studied, the population (post-menopausal women, older adults), the duration of intervention, and the outcomes (bone mineral density, fracture risk). Patient-facing explanation again – not academic critique.
Top tip to pass all three: read the abstract and conclusion of the provided material carefully. Your written response must reflect what the research found, expressed in plain language a patient could follow. Overly academic responses, or explanations that go beyond the nursing role into doctor’s territory, lose marks. Examiners look for clear understanding, simple explanation, and patient-centred communication.
6. The Marking Shift: Why You Are Doing It Matters as Much as How
The clearest change in the 2026 marking criteria is a deeper focus on rationale. Examiners are no longer just checking whether you completed a task – they are checking whether you can articulate the reason for it.
Example: when you measure the calf for anti-embolism stockings, do not just measure. State: “I am measuring the calf circumference to select the correct stocking size and prevent the stocking from acting as a tourniquet or causing pressure damage.” When you check allergies, do not just check. State: “I am checking allergies because the patient’s prescribed medication includes a beta-lactam antibiotic, and a missed allergy could trigger anaphylaxis.”
This is also why the NMC chose stations that mirror real clinical risks – DVT massage, stocking sizing, deterioration recognition. Each one is a scenario where understanding the why protects a real patient. Memorising steps without rationale will get you partial marks at best.
7. The “Silent Killer”: Documentation Timing
The 2026 update placed heavier emphasis on timely, accurate documentation. The principle: if you didn’t write it, you didn’t do it – but if you write a novel, you won’t finish the exam.
Keep documentation concise and use standard nursing terminology. Aim to document key actions as you go rather than leaving everything to the end. Many candidates fail not because their care was unsafe but because they ran out of time to record what they did. Time discipline is part of the assessment.
8. Operational Updates: Northumbria Centre Closure
One practical change every candidate needs to know: the OSCE centre at Northumbria University closed on 19 February 2026. Candidates who had booked their OSCE or resit at Northumbria must now transfer to another approved centre.
The four remaining NMC-approved OSCE centres are:
- Ulster University
- University of Northampton
- University of Leeds
- Oxford Brookes University
To transfer, email your preferred replacement centre with “Northumbria Transfer Request” in the subject line. If the centre can accommodate you, they will confirm the booking and notify the NMC. The centre you choose for your resit becomes your new OSCE centre – any further resits must be at the same location.
9. Fees, Attempts, and Results
The headline financials and process points, verified directly from NMC:
OSCE fee: £794 for the full exam. Reduced resit fee of £397 applies if you need to resit 7 or fewer stations.
Maximum attempts: three attempts as part of your NMC application, with a minimum 10-day wait between sittings.
Results timeline: the test centre emails your results within 5 working days of your OSCE date. If you pass, you receive guidance on the next steps in registration. If you do not pass, you receive feedback on which stations and elements were unsuccessful – use that feedback to focus your resit preparation specifically on the failed areas.
The marking principle: the NMC does not publish a simple numerical pass mark. Each station is scored against a competency framework with a borderline-compensatory approach. Failing one station catastrophically – typically a patient safety error such as the DVT massage, an unmeasured stocking, or an unchecked allergy – can result in failure of the whole exam even if other stations were passed.
10. Frequently Asked Questions
When did the new OSCE stations start?
23 February 2026. Candidates sitting on or after this date may encounter any of the new stations (DVT, anti-embolism stockings, pre-operative checklist, deteriorating patient, patient private details, and the three new EBP topics).
How much does the OSCE cost in 2026?
£794 for the full exam. £397 for a resit of 7 stations or fewer.
Is the marking criteria different in 2026?
Yes – there is a clearer emphasis on rationale. You still need to know how to perform a task, but the examiner is also grading you on why you are doing it. Verbalise your clinical reasoning throughout.
Do I need to check ID and allergies in every station?
Yes. In every single station – whether you are administering medication, fitting stockings, summarising research, or working through a checklist – check the ID and check for allergies. This is the foundation of safe practice and a missed check can cost you the station.
What if my OSCE centre was Northumbria?
Northumbria closed on 19 February 2026. Email your preferred replacement centre (Ulster, Northampton, Leeds, or Oxford Brookes) with “Northumbria Transfer Request” as the subject line. Your chosen centre becomes your new OSCE centre for any future resits.
How many attempts do I get?
Three, as part of your NMC application, with a minimum 10-day wait between attempts. If you fail three times you will need to take additional steps before reapplying.
How long do I wait for my results?
The test centre emails your results within 5 working days.
What is the single biggest cause of OSCE failure?
Patient-safety errors. Massaging a leg with suspected DVT, applying stockings without measuring, missing an allergy check, failing to escalate a high NEWS2 score, breaching confidentiality. Any one of these can fail a whole station catastrophically, and a catastrophic station failure can fail the exam.
The Bottom Line
The February 2026 OSCE update was not designed to trick candidates. It was designed to bring the exam closer to real NHS clinical practice. Every new station reflects something you will actually do as a nurse in the UK – recognise DVT, fit stockings safely, work through a pre-op checklist, calculate NEWS2 and escalate, protect patient privacy, interpret research for patients.
The candidates who pass on the first attempt are not the ones who memorised the most. They are the ones who can articulate why they are doing each step, who check identity and allergies in every station without thinking, who treat the silent stations with the same care as the active ones, and who keep their documentation concise enough to finish on time. Build those habits, practise the new stations specifically, and the OSCE becomes what it is meant to be: a fair assessment of a new UK nurse’s readiness to practise.
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Disclaimer: This article is for informational purposes only and does not constitute educational or professional examination advice. OSCE station content, marking criteria, fees, and approved test centres are determined by the Nursing and Midwifery Council (NMC) and are subject to change. Always verify current information directly with the NMC at nmc.org.uk and your chosen OSCE test centre before booking. Critical fail points and marking principles described here reflect publicly available NMC guidance and may differ in specific station applications. Information current as of May 14, 2026.
