Hundreds of international nurses are unable to take up job offers in the NHS, which is stalling overseas recruitment, because the level to which their English language is being tested is too high, a new report has warned.
The report, compiled by healthcare staffing agency HCL Workforce Solutions and shared exclusively with Nursing Times, said that while it was important to check communication skills, the level required to pass the International English Language Testing System (IELTS) exam was “unjustified”.
“The average time needed to obtain the mandated level currently stands at a minimum of eight months, resulting in an average 12 month turnaround”
HCL Workforce Solutions report
It claimed the score of 7.0 across all elements of the test – reading, writing, speaking and listening – was higher than the average result a native English speaker would be able to achieve.
In addition, some universities – such as the University of Gloucester – accept international students onto pre-registration nursing courses with an IELTS score at the lower level of 6.0, said the report.
Across a sample of 14 NHS trusts that HCL works with around 50% of the 1,972 nurses it has recruited have either dropped out of the process or been removed since November 2014 due to failed attempts of the IELTS.
Just 117 are now working as a nurse in the UK and 887 are still going through the process.
“The average time needed to obtain the mandated level currently stands at a minimum of eight months, resulting in an average 12 month turnaround time from hire to deployment,” said the report.
“There is a huge financial implication for the NHS, as well as the morale issue for the nurses”
The delays to recruitment have been worsened since the start of 2016, when the Nursing and Midwifery Council introduced language checks for the first time for European Union staff, to match the system it already had in place for those coming from the rest of the world.
Prior to this, EU nurses had, on average, been able to start practising in the UK as a nurse within two months of being recruited, which meant they were being increasingly relied upon to fill vacancies, those behind the report told Nursing Times.
But with language testing now affecting all overseas staff, the impact on recruitment had become “severe” and some trusts were having to revise their plans about how far international nurses are able to fill vacancies, said the report.
It noted that the UK currently had a shortage of nurses and altering the IELTS score slightly could help to fill many empty posts.
“The bar is so high for candidates to achieve… the reduced morale is a cycle they have to continue to go through”
It estimated that if nurses only had to achieve an average of 7.0 overall – rather than in each of the four individual parts of the test – then around half of HCL’s 694 non-European nurses who have failed since 2014 would instead have passed.
The organisation also said that the areas where people fall down if they fail marginally are usually reading and writing – which are the more “academic” modules that involve, for example, writing an essay on an abstract subject rather than a clinical one.
It suggested that it would be more appropriate for nurses and aid recruitment if an alternative, general version of the IELTS were used instead.
The agency’s report chimes with a separate investigation by Nursing Times, also published today, in which trust nursing directors highlighted concerns that the test was hampering their ability to recruit overeas nurses from EU countries.
Charlotte Fisher, director of permanent recruitment at HCL, and Teresa Wilson, HCL’s operations manager for international recruitment, said the situation had not improved despite efforts to improve the support offered to candidates – for example, by bringing them to the UK and immersing them in the language while they trained to take the IELTS.
“The bar is so high for candidates to achieve that in addition to the cost implications, the reduced motivation and morale is a cycle they have to continue to go through,” said Ms Wilson.
“There are stories in the media that say registrations with the NMC have dropped due to Brexit, but that is not the case. Registrations have dropped because nurses can’t pass the IELTS exam,” added Ms Fisher.
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They said they had so far not been seeing a reduction in the number of applications from international recruits, but this was now beginning to change as morale worsened.
Around 70% of any cohort of overseas nurse recruits would typically not succeed at all, they added.
Exclusive: English exam stalling nurse recruitment, says agency
“That is not because their English language is low. Their English language is often deemed by the NHS interviewers as being of no risk. It is purely because this version of the IELTS is an academic one that is leading to failed attempts,” added Ms Wilson.
“Hospitals are not able to fill their staffing gaps, which are increasing, meaning they are having to use more agency staff which costs more money – not to mention the cost of training nurses for the IELTS,” said Ms Fisher.
“So there is a huge financial implication for the NHS, as well as the morale issue for the nurses,” she told Nursing Times.
“IELTS is an internationally recognised means of testing language proficiency which has been in place for over a decade”
A spokesman for the NMC said it was aware of some of the concerns relating to its language testing but that it did not “currently have any hard evidence on which to base a change”.
“IELTS is an internationally recognised means of testing language proficiency which has been in place for over a decade,” he said.
“However, as a responsible regulator that continually looks at the suitability of all the standards we set, we have committed to looking at this standard and gathering further evidence over the coming months,” he said.
“We are committed to working with organisations to better understand their concerns, but at this stage it is important to state that this decision does not indicate that we feel the current standard we require – IELTS level 7, is wrong or that we are committing to a change,” he added.
- Copies of the report will be available on request from HCL Workforce Solutions in the near future