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Health select committee: Language testing must be ‘closely monitored’ by NHS England

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Language testing of nurses from outside the UK must be “closely monitored” by NHS England to ensure checks are set at an appropriate level while not hindering recruitment, according to a major report on nursing shortfalls by an influential group of MPs.

The recommendation by the Commons’ health select committee was one of 17 published in a report today following a wide-ranging inquiry into the current and future shortage of nursing staff, which was compiled with the help of Nursing Times.

“NHS England must closely monitor… language testing to ensure it is at an appropriate level”

Health select committee report

The group of MPs was told that language testing for those wanting to join the UK register, both of which are overseen by the Nursing and Midwifery Council, was a “significant barrier” to nurses coming to work in the country.

Language testing for nurses outside of the European Union has been in place since 2001, while the rules have only applied to EU nurses since 2016.

However, as reported by Nursing Times, questions were raised about the suitability and the difficulty of the test initially chosen by the NMC, sparking a review by the regulator.

Following continued criticism of the International English Language Testing System (IELTS) and problems with recruitment, in November 2017 the NMC opted to change its rules and began accepting an alternative test called the Occupational English Test (OET).

But the group of MPs received evidence from some parts of the profession stating the change was still “insufficient,” according to today’s report – titled The nursing workforce.

While there have been some indications that the alternative language test is proving popular, it is “too early to draw firm conclusions” said the MPs in their report.

The group recommended that NHS England monitor the effect of language testing on recruitment, including the impact of the NMC’s changes.

“NHS England must closely monitor the situation regarding language testing to ensure it is at an appropriate level whilst not proving an unnecessary barrier to recruiting trained international nurses,” it said.

“We recommend… NHS England provide us with a report setting out how they are monitoring the situation, what the data shows following the NMC’s changes, and what action they are taking as a consequence,” the report stated. “We will then expect an update on that report on 1 November 2018.”

“It is essential that overseas recruitment is undertaken responsibly and ethically, and nurses from overseas need to be welcomed”

Health select committee report

Professor Martin Green, chief executive of Care England, which represents independent providers of adult social care, said: “The English language tests are a vital safeguard but must be proportionately and realistically applied to ensure that good nurses from overseas can work in our sector.

“We hope the government and others will see this as a priority for review going forward,” he added in his response to the report.

Meanwhile, the committee also called for NHS England and workforce planning body Health Education England to develop an ethical overseas recruitment programme “as an immediate priority”.

The scale of nursing shortages and the length of time it takes to train new nurses meant the UK would continue to depend on nurses from overseas for a “considerable time”, it said.

“It is essential that overseas recruitment is undertaken responsibly and ethically, and nurses from overseas need to be welcomed and recognised for their skills and valued contribution,” it added.

Following a period of NHS recruitment efforts focusing on EU countries and in the wake of the Brexit vote, trusts have begun to turn their attention to countries such as India and the Philippines.

Responding to the report, Jon Skewes, director of employment relations, policy and communications at the Royal College of Midwives, said: “The implications of Brexit on the midwifery workforce are also most concerning given the current shortage of midwives.

“The latest data clearly shows the number of EU nationals coming to the UK and registering as midwives has dramatically decreased since the vote last year,” he said.

“The RCM is again calling on the government to give assurances to midwives and to all healthcare professionals working in the NHS that they can remain working in our health service regardless of the outcome of Brexit negotiations,” he added.

The committee’s report, which covers a range of issues affecting the nursing workforce was compiled with the help of the Nursing Times. The MPs held two focus groups where they met with frontline nurses from across the country, from a wide range of specialities and at different stages of their careers.

The chair of the committee, Sarah Wollaston, visited our Team Leaders’ Conference in Birmingham in November and found out what life was like for sisters and other managers who are charged with trying to fill their rosters.

She and her team also visited a group of nurses in London, with representatives present from hospitals and the community working in a range of specialties, including theatre and mental health. The evidence heard from nurses at these events is recorded in the report’s two annexes:


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