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NMC finds 'no evidence' so far to lower English language test but considers change to writing


The Nursing and Midwifery Council has so far found “no compelling evidence” that the English language test it uses for nurses coming to work in the UK is set at too high a level.

However the regulator said that following its initial “stocktake” of the test it does have plans to further explore whether it should lower the pass score for just the writing element of the International English Language Testing System (IELTS) in the future, which is thought to be more difficult for candidates.

”Our stocktake, so far, has provided no compelling evidence that the IELTS is not fit for purpose or that the level is set too high”


It also intends to look at alternative assessments to the IELTS – such as those used in countries including Australia and Canada, which focus more on the clinical aspects of communication.

The plans were revealed in NMC council papers published yesterday, which are due to be discussed next week.

As previously reported by Nursing Times, there have been growing concerns in recent months that the difficulty of the IELTS test is causing delays to nurse recruitment and NHS trust chief nurses have been lobbying the regulator for a review.

Trusts told Nursing Times that staff were taking between eight months and a year on average to pass the IELTS following several attempts and only around 50% of potential candidates were ultimately successful.

It has been a requirement for nurses outside the European Union to pass the test with a minimum score of 7.0 out of 9.0 across all four elements of reading, writing, listening and speaking since 2007.

At the start of 2016 English language testing was also brought in for EU nurses, with the same pass score as for non EU nurses.

Since last summer, there has been a significant reduction in the number of EU nurses registering with the NMC, with many blaming the introduction of the IELTS for the drop.

The NMC council papers said: “Our stocktake, so far, has provided no compelling evidence that the IELTS is not fit for purpose or that the level is set too high. However, this is an initial stocktake and we suggest more work would be helpful.”

Feedback so far has indicated that while the overall pass score of 7.0 is supported, flexibility in the four different parts of the test would be welcomed, said the NMC papers.

The regulator also noted that its initial research had found nurses struggled most with the writing part of the IELTS.

“The data we have gathered so far does not allow us to firmly conclude whether a move to 6.5 in writing would raise public protection risks”


It was told by the British Council, which jointly owns the IELTS, that if only the score for the writing assessment were lowered to 6.5, then “many more candidates” from India and the Phillippines, two popular countries for recruitment, would be able to work in the UK.

The NMC said more analysis by the British Council was required to understand how many additional staff would have passed.

“The data we have gathered so far does not allow us to firmly conclude whether a move to 6.5 in writing would raise public protection risks. Conversely, there is little evidence to say that it would not,” said the papers.

Meanwhile, the regulator said it was gathering evidence about the Occupational English Test used in Australia, New Zealand and Singapore, which assesses language in a clinical context.

The NMC said it had been challenged by English language academics about whether the IELTS tests communication appropriately, because it is not set in a healthcare context.

In its conclusion the NMC said:

Having considered the evidence in this initial stocktake our recommendation to the council is to:

  • Develop improved signposting and support from the NMC in relation to preparation for the IELTS test, including gathering and sharing best practice from employers.
  • Explore a new strategic solution, considering in particular the OET.
  • Further explore the Writing element of IELTS and the evidence base for any change.
  • Conduct work with patient and public groups to understand their views and perspectives on this debate

The NMC council will meet next week on 5 July to discuss the recommendations.



Readers' comments (3)

  • 7 is achievable (especially if spread over the two tests) and this requirement should not be lowered. It is not easy, but if you put a little bit of an effort, you will score even more than that.

    The test should be cheaper, for sure.

    IMHO, patient safety is at risk if you go lower than 7. The IELTS grading is exponential and in order to get 5 or 6, it suffices if you know just basics of the basics.

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  • every nurse should sit a maths test
    that would have frightening results

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  • IELTS score of 7 is not an easy work, Listening to patients, Speaking which means communicating is an important part of the health system, It does not mean reading &writing is not needed. reading&writing part of the score needs to come down because we are not for looking
    for extraordinary English instead listing the gist of the patient needs, treatment in medical terminology is needed not a complicated literature of English is needed in health sector, if these elements of score comes down means we will get plenty of nurses or even if the overall band comes to 6.5&speaking 7 , itself will bring nurses to the UK.

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