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Alternative language test for overseas nurses set to be brought in 'within weeks'

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The introduction of an alternative language test to check foreign nurses’ communication skills could occur “within weeks” following an “overwhelmingly positive” response to a consultation on the changes, the Nursing and Midwifery Council has said.

Employers have expressed growing concerns that the International English Language Testing System exam – the only test currently used by the Nursing and Midwifery Council – is too difficult to pass, which is causing recruitment problems.

The NMC said at its council meeting in London last week that it had been consulting with employers, chief nurses and unions on whether to use the Occupational English Test as an alternative to the IELTS.

The OET is already used in Australia and assesses English language in a nursing and healthcare context – as opposed to the IELTS which has been criticised for being too academic.

So far there had been a “high degree of support” for bringing in the option of the OET, said NMC director of registration Emma Broadbent at the meeting last week.

“Because [the OET] in the context of a healthcare setting, we are getting a lot of people saying that would be helpful”

Emma Broadbent 

“Because it is in the context of a healthcare setting, we are getting a lot of people saying that would be helpful,” she said.

In addition, the NMC has been looking at changing its rules so that all nurses who have trained on pre-registration courses taught in English, as well as those who have practised for two years in an English-speaking country, are no longer required to pass the IELTS before they can work in the UK.

Currently European Union nurses are able to avoid the IELTS if they have trained or practised in English - but nurses from outside the EU are required to pass the exam.

Ms Broadbent said both the introduction of the OET and the aligning of the rules for EU and non-EU nurses had received an “overwhelmingly positive” response in the consultation, which was due to close at the end of last week.

“We think these are proportionate and fair proposals and we believe that they deal with some of the lack of harmonisation issues, and that they can be implemented without public protection issues – but that is what we are consulting on at the moment,” she said.

“We need to know there are a range of countries that employers are going to where [theses changes] would make a difference”

Jackie Smith

As long as there are no major concerns that arise in the analysis of the consultation, the NMC wants to “move sooner rather than later,” she added, due to the “high degree of consensus”.

At the meeting last week, the NMC council agreed to allow the body’s chair and chief executive to sign off the decision on the changes ahead of the next council meeting in November.

NMC chief executive and registrar Jackie Smith later told Nursing Times the changes could, as a result, be brought in within “weeks, rather than months”.

However, Ms Smith stressed that the NMC wanted first to be told by employers that it would make a difference to recruitment.

“We want to know if we make these changes it will have an effect on employers and where they go to recruit…. We need to know there are a range of countries that employers are going to where it would make a difference,” she said.

Meanwhile, the NMC is continuing to explore whether other tests, in addition to the IELTS and OET, could be used to assess English language. It is also looking at whether to lower the pass score for just the writing element of the IELTS.

“This proposal to align the rules is a small step in the right direction….[but] this will not solve huge nursing shortages on the whole”

Alex Melia

At last week’s council meeting the regulator also confirmed that it will carry out a wider review of all parts of its process for allowing overseas nurses into its register.

This work will look at language testing, competency checks, the cost and location of testing.

“Ideally we’d like to have a position where the testing regime – whether that’s language or competence or skills – is done in a location at a cost that is proportionate and fair,” Ms Smith told Nursing Times.

But recruiters have said that while the alignment of the rules for EU and non-EU nurses would be a positive step, nurses from countries that do not have English as their first language could still face problems.

In addition, they said the OET was a more expensive exam than the IELTS, which could mean nurses from abroad are unable to make use of it.

“The current pass rate for nurse’s undertaking the OET is marginally higher than the IELTS but it is much more expensive to take”

Teresa Wilson

“This proposal to align the rules is a small step in the right direction from the NMC and it will help many nurses from the likes of Australia, New Zealand and other English speaking countries to become nurses in the UK,” said Alex Melia, owner of Swoosh English, a UK-based tutoring company that helps nurses to pass the IELTS exam.

“However, with 40,000 nurse vacancies across the UK that so desperately need to be filled, this will only ease it slightly and will not solve huge nursing shortages on the whole,” he told Nursing Times.

Healthcare staff recruitment firm HCL Workforce Solutions, which has previously raised concerns about the use of the IELTS, said it was encouraged by the proposed changes but would like to see the NMC go further by also lowering the score required to pass the IELTS.

“The current pass rate for nurses undertaking the OET is marginally higher than the IELTS but it is much more expensive to take,” Teresa Wilson, HCL’s international operations manager, told Nursing Times.

“While we expect to eventually see an increase in the supply of foreign nurses using the alternative system it will take time to imbed the new process and build the recommended training, and serious questions should be asked about the financial burden this could place on those that continue not to pass,” she added.

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Readers' comments (4)

  • This is so unfair for people like me who sat and pass the exam! If nurses worked hard towards the IELTS they would certainly pass! Yes it’s a tough exam but it’s feasible!

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  • They move the goal posts as it suits.

    The nursing hierarchy should be fighting to have the bursary re introduced. Instead it seems they promote nursing associates as adequate to fill qualified RGN posts, all it will do is increase the stress on properly qualified nurses and add to the recruitment problem.

    Never mind just so long as they are cow towing to govenrment and pocketing their over inflated salaries.

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  • Patience is not unlimited, but Patients` Expectations are...

    The nurse recruitment crisis was forecast 10 plus years ago but the government did nothing. Now we see a difference in English speaking competency as a possible way to help. Nursing is increasingly a legally driven profession now, with every word pored over in the case of any error the human, tired, constantly interrupted, hungry nurse may make. Many is the time I have had report from a nurse for whom English is not the first language - whose kindness is touching, and respect for the elderly extremely impressive, but with whom on more than one occasion I have been told in report about a female patient, that "he" had a sore vagina, or that someone is "falling" on the floor - when in fact they FELL on the floor. Now, without being pedantic, this is perfect fodder for a legal team to dissect in the case of any investigation - when the said respectful, honest, well meaning nurse is unwittingly drawn into say another investigation as a witness or whatever, but cannot give grammatically, and thus contextually, accurate responses, especially under stress. We all lose our turn of phrase when stressed, sometimes - think job interviews - I think the government needs to look at nursing as a crisis as much as what constitutes their Cobra type meetings - if we have no nurses due to retirement, burnout, or disillusioned well meaning nurses who have fallen foul of the investigatory processes because their written records do not stand up....we have a serious crisis - not in the future, but now. We may have defence, counter terrorism and surveillance facets of the government for any crisis there, but who will look after the people who need it, for example post Arriane Grande victims, as there will always be patients...The government needs to stop passing the buck and look at ways to help the non English speaker nurses become more fluent, not place barriers or be complicit in those barriers....

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  • The Conservatives have for a very long time aimed at reducing taxes by reducing the Gross National Product. They do not want a real NHS only a token one.

    All nurses need to have sufficient language AND communication ability PLUS knowledge of the law in relation to health and social care.

    We just have a mess.

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