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Extra options for overseas nurses to show English capability to start next month

  • 5 Comments

From next month, the Nursing and Midwifery Council is to expand the range of options that overseas nurses can use to prove their English language credentials are sufficient to join the UK register.

As recently reported by Nursing Times, the changes were trailed at the regulator’s last council meeting in early October but have now been confirmed.

Under the move, overseas nurses whose first language is not English will now be able to take one of two recognised language tests to prove their competence, instead of the current single option.

“We are increasing the options available for nurses and midwives to demonstrate the necessary command of English”

Jackie Smith

Meanwhile, those from outside the European Union will no longer have to take a test if they can prove they studied nursing in English or worked previously in a country where it was the “native” language.

The International English Language Testing System (IELTS) exam that the NMC uses has been in place since 2007 for applicants from countries outside the EU and European Economic Area, even if they come from countries such as Australia or New Zealand where English is the first language.

In addition, since January 2016, overseas nurses and midwives from Europe have also had to be able to demonstrate the necessary command of English to practise safely and effectively in the UK, either by passing IELTS or having trained or previously practised in English.

However, the requirements, especially the controversial IELTS test have been blamed by some for holding up trust’s ability to get overseas recruits onto wards and even for deterring applicants.

Trust chief nurses and recruitment agencies have previously warned that the test was set at too high a level and was delaying vital overseas recruitment needed to help fill staffing gaps in the UK.

Staff from abroad were said to be taking between eight months and a year on average to pass IELTS following several attempts, and only around 50% of potential candidates were ultimately successful.

As a result, in May this year, the NMC agreed to hold a “stocktake” of the IELTS test to decide whether any changes were necessary. Employers, agencies, unions and senior nurses among others were then consulted about a number of proposals – the results of which have just been published in a report.

Following this, the NMC announced today it was “making alternative options available” for nurses and midwives, who trained outside the UK, to “demonstrate their English language capability”, but has maintained its view that the bar should not be lowered for passing IELTS.

As a result, from 1 November, the NMC will accept the Occupational English Test (OET) as proof of English language competence, as well as 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. It is, however, more expensive to take than IELTS and is available in fewer testing centres around the world.

The regulator highlighted that, while the move provided an alternative way to demonstrate language capability, applicants to the register would still be required to meet the NMC’s existing standards.

In addition, nurses and midwives who have qualified outside EU or EEA – which comprises parts of Scandinavia – will now also be able to demonstrate English language capability in two other ways.

For example, it said they could provide evidence that they have undertaken a pre-registration nursing or midwifery qualification taught and examined in English.

In addition, they could have registered and practised for a minimum of one year in a country where English was the first and native language, and where a successful pass in an English language test was required for registration.

The new alternative forms of evidence would bring the options available for nurses and midwives who trained outside the EU “more closely in line” with evidence of language capability that the NMC accepted for those trained within in, said the regulator. It has also published guidance on all the changes.

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Jackie Smith

Jackie Smith, the NMC’s chief executive and registrar, said: “Nurses and midwives trained outside the UK make up around 15% of our register. They are vital to the delivery of health and care services across the UK.

“By accepting alternative forms of evidence, we are increasing the options available for nurses and midwives to demonstrate they have the necessary command of English to practise safely and effectively, without compromising patient safety,” she said.

The move represents the first stage of the NMC’s review of its English language requirements. The regulator said it would continue to evaluate other potential types of evidence, develop additional support for applicants and explore the evidence base for the IELTS test.

For example, it has previously said it is looking at whether to lower the pass score for just the writing element of the IELTS, but has largely rejected suggestions that the exam overall is too hard.

OET is run jointly by Cambridge Assessment English, part of Cambridge University, and Australia’s Box Hill Institute.

OET chief executive Sujata Stead said: “What sets OET apart from other tests is that it is designed for healthcare. We use real communication scenarios, similar to the ones healthcare professionals encounter every day.

“For example, a nurse’s speaking skills will be assessed via a face-to-face role play using a typical nursing scenario, with a trained interlocutor who plays the part of a patient or carer,” she said.

“In addition, the speaking and writing tests are different for each of the 12 healthcare professions we test, so the scenarios for nurses and midwives will be different to the scenarios for physiotherapists,” she added.

  • 5 Comments

Readers' comments (5)

  • And when are they going to review the ridiculous revalidation requirements that take up so much time....unpaid.

    I have lost count of the excellent nurses I know who are not revalidating,

    such a loss of experienced dedicated staff.

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  • This English test is ridiculous. The most to be expected from the floor nurses are bringing commodes, urine bottles, bed pans,tea and feeding. This is easily understood and does not need a high level of dry English test which has no relevancy to nursing. However, I have noticed that even the White English are incapable of writing good English, but their promotion is fast track!!!!One of a Band 6 white British wrote an incident report" the nurse shud not have called the doctor to make a decision. She does not any good knolege." He could have used the spelling check more often to appear less stupid. Who should then go for English test?

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  • I am in agreement for those that have had their Nursing qualification taught in English to be exempt from taking the English test and those that have their 0 level and A level English qualification at grade C and above. This should also apply to British nationals as some have good spoken English but when it comes to writing you find that some have problems in spellings and constructing good understandable sentences especially for those that have been fast trucked to do Nursing, having been carers without having full academic qualifications.




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  • These changes are a little too late, especially for those nurses who have paid exorbitant prices to pass ielts, what should have been done first is being done last... which proves my point, that the nmc has not examined there vetting process with a fine tooth comb.. ielts is a waste of time and money...

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  • Some british nurses should do ielts as well, because they are a poor representation of the queens language.

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