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Regulator to carry out 'stocktake' of English language testing for overseas nurses


The Nursing and Midwifery Council is to carry out a “stocktake” of the test it uses to assess the English language skills of overseas nurses and midwives, following discussions with the Department of Health.

In NMC council papers due to be discussed next week, the regulator said it would be “gathering data and evidence” to help it decide whether the standards for English language testing needed to change.

“We will be gathering data and evidence to inform… whether any variation in either direction is needed to the current standards”

NMC board papers

It noted that the International English Language Testing System (IELTS) exam it uses had been in place since 2007 for nurses and midwives from outside the European Union. Since the start of 2016, the IELTS has also been used to asses EU nursing staff who apply to work in the UK.

The NMC’s decision comes after some trust chief nurses and recruitment agencies have warned that the test is set at too high a level and is delaying vital overseas recruitment needed to help fill staffing gaps in the UK.

As recently reported by Nursing Times, staff from abroad are taking between eight months and a year on average to pass the IELTS following several attempts and only around 50% of potential candidates are ultimately successful.

Directors of nursing have been lobbying the NMC for a change to the test, with suggestions including reducing the pass rate – currently set as a minimum score of 7.0 across all elements of reading, writing, listening and speaking.

Prior to 2007, the NMC required overseas nurses to achieve a score of 6.5 across all four elements of the IELTS, but increased the level following a consultation. 

The number of EU nurses applying to register with the NMC surged at the start of 2016, ahead of the language test being brought in for European staff.

In 2015, an average of 700 EU staff applied to work in the UK every month, but in January 2016 this jumped to 1,977.

Meanwhile, the number of EU nurses being admitted onto the NMC ‘s register has been falling significantly since summer 2016, when all applications under the old system had been processed. Just 100 EU nurses joined the NMC register in December 2016, compared with a high of 1,304 in July.

There has also been widespread speculation on whether the result of the EU referendum last summer had largely caused the drop-off in joiners.

But an agency that recruits staff for NHS trusts previously told Nursing Times that it had not seen a decline in applications and warned it was the IELTS test that was stopping people from being able to take up job offers.

The NMC papers, to be discussed on Wednesday, state: “The chief executive [Jackie Smith] has had regular catch up discussions with Department of Health colleagues.

“Issues discussed included plans for a stocktake of the current IELTS language test for nurses and midwives trained overseas seeking to join the NMC register, given that these have been in place since 2007, said the papers.

“Our foremost consideration must always be protection of patients and the public, and we will be gathering data and evidence to inform our consideration of whether any variation in either direction is needed to the current standards,” it added.

Prior to 2005, the NMC’s policy on the language skills of non-EEA trained nurses and midwives was that applicants whose “primary mode of expression” was English or who had undertaken their nursing or midwifery training in English did not have to take a language test as part of the application process.

But, in 2005, the NMC council agreed a new policy that stipulated all applicants would be required to undertake and successfully pass an IELTS test. The required score level required was set at 6.5 across the four modules, but was raised to 7.0 in all categories in 2007, following a public consultation.


Readers' comments (11)

  • The UK is right to make any nurse coming to work from any part of the world to understand that effective CARE can be given only through effective communication.This should apply to everybody whether from EU or outside the EU and the agencies recruting these nurses should focus on this.Thank you.

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  • I would infact invite the NMC to request prove of IELTS test from all nurses previously registered from outside the UK before the last legislation in 2016.Thank you

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  • My experience as a Director of Nursing, is that the test protects patients from those nurses with poor standards of verbal and written English and this is purely driven by those DoN who seek to resolve recruitment issues. If any nurse from outside of the UK seeks to work here, then they should strive to reach the standard. I am aware that nurses are given multiple opportunities to pass the test, is this right, we just reduce the standard to fit? A slippery road I feel.

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  • As a New Zealand trained registered nurse, I was made to complete the IELTS and I have to say that it was quite difficult (not to mention the 3 years it took to receive my PIN from the NMC, but we won't go there!) I don't speak any other language apart from English and I scored 8.0...not perfect. Yes it is hard/challenging but it NEEDS to be!
    Saying that the IELTS is too hard for some nurses to successfully achieve vexes me. is an idea! Lets move the goal posts so that we are able to solve our recruitment issues and have nurses that may not be able to communicate EFFECTIVELY. I whole heartedly agree with the comment above; " If any nurse from outside of the UK seeks to work here, then they should strive to reach the standard" (amen sister!).

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  • I agree with all the comments above. This is nursing we are talking about and one of the key component of this job is communication. Lets put it this way if I were to work as a nurse in Spain it would be the expectation of the Spanish health service that I was fluent in Spanish. I have read documentations and have witness communication by some nurses where English is not their first language and I must say I was worried.

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  • The IELT tests english proficiency but is irrelevant to care work. The 7.0 pass mark is equivalent to study at Masters level. I really dont feel the ability to discuss the wing span of an Albatross is relevant to nursing. Why not use a more appropriate test such as the Cambridge test? This is occupation relevant. Have those questioning a 7.0 pass mark actually seen the questions?

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  • The majority of international nurses sitting IELTs fail the written. Not speaking, reading or listening. An overall average of 7.0 across the 4 areas is achievable. Not 7.0 in each

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  • This is not purely about resolving recruitment issues. We dont have enough local nurses to deliver safe, quality patient care. The pipeline is simply not there. Even if we increased student numers, demand outweighs supply. This is causing retention issues. Who wants to work on a chronically understaffed ward? We stay late and miss breaks all in an effort to look after our patients. This is emotionally and mentally exhausting.

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  • Dammit I just cant seem to score a goal.
    Dont worry try these goals instead. No?
    Ok how about these goals? Still no luck?
    Well what about these goals over here? Yes!! Result.
    Ok so we'll see you next week with all your paperwork. If you make sure you are at least 15 minutes early so we can have an interpreter from language line in place in order to carry ou the interview. Ok? Is that clear? Mmmm. Hang on I'll just ring language line.

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  • My suggestion is that the General IELTS should suffice. Perhaps the Academic version is a bit unnecessary.

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  • In New Zealand the migrant nurses have to have minimum scores of 7 in IELTS (can be passed over several tests ) in order to undertake the competency assessment course to register as a RN. They can also use the minimum scores of B on the OED test. I have found that even with scores of 7 in IELTS, communication is still not easy for some. Those migrant nurses with less than a degree qualification in nursing from their mother country need scores of at least 6.5 on IELTS and still have to undertake the second 2 years of the BN course to register. I think the scores gained in IELTS are irrelevant and that there should be another method used, such as the OED testing that is at least focused on the occupation English required for the role of RN.

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