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'The answer is not to keep lowering the bar'


After months of pressure, it seems that the Nursing and Midwifery Council has listened to the feedback given in its consultation around the IELTS test for overseas nurses.

Now, international nurses wishing to practise in the UK look likely to have the option of taking an alternative test – the Occupational English Test. Many nursing professionals and employer organisations have said that this seems a more appropriate way to assess a nurse or midwife’s ability to communicate.

In addition, if the regulator decides to go ahead with the plans, nurses who have practised for two years in an English-speaking country won’t have to take an English language test at all.

On the face of it, these seem pretty sensible suggestions. One particular part of the test – the section that was a little like an English Language ‘O’ level comprehension test – caused the most problems, and the most controversy.

As for the relaxing of the rules over those applying to be on the register from English-speaking countries, again this seems prudent. After all, why should someone who has been working in Dublin suddenly have to pass the IELTS to work in Belfast or Bristol? And ditto nurses coming from Australia.

However, we must be careful this is not the start of the slippery slope. Overseas nurses may not be joining the register, and Brexit and our weak pound may be encouraging international nurses to leave the UK, but the answer is not to keep lowering the bar so anyone can practise.

I am sympathetic to employers struggling to get nurses they’ve recruited from other countries onto their register. I can understand their frustration at them being prevented from doing so because of their inability to understand a wholly unrelated topic such as jam-making, which is one of the topics pulled out in the IELTS.

But we must make the gates to enter the professional register suitably high to maintain the standard of communication, knowledge and skill – and therefore the standard of nursing. If this is the start of a slippery slope where we just make it easier to become a nurse, then we are all in very deep trouble.


Readers' comments (6)

  • It is definitely not good to lower the bar but I feel the bar is already lowered. How does one explain the nurses that can not even understand their colleagues, what more their patients. Nurses with English that bad are on the register and IELTs has nit been their pre requisite.
    At the same time nurses from e.g Zimbabwe /Zambia former British colonies attend school from primary to secondary in English. English is their main language and yet they are expected to sit for IELTS.
    Something is very wrong there.
    I doubt it is to do with one's ability to speak and write English

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  • The bar has already been lowered in terms of education, skill and safety. The approach is all hands on deck. Why should language be any different? Poor workforce planning caused this and nothing is being done to plan for the future, except lowering the bar.

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  • With respect to all nurses from Zimbabwe, I have worked with a number of nurses from that country and despite their written English being excellent, I could barely understand them; neither could the elderly patients they cared for. If nurses have a good grasp of English, then taking the test should not be a problem for them. I worked extensively in the Middle East, where interpreters were on hand 24/7. I still made it my business to learn the language and spoke it at every opportunity, in and out of work. What is wrong with expecting nurses and doctors to be fluent in the language of the country they have elected to work in?

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  • The ability to care, does not require English Language I dare say. What the NHS need are more caring nurses, people who would be true to the call to care. If Language is a barrier, give them time to blend in. with adequate training more would be achieved. As a football fan, have seen many new coaches come to the Premier league to manage without English Language as first language, some can't even speak it. But now, they are more fluent than when they first arrived. The Language barrier has not hindered them in their jobs that require great level of communication. So why are we stigmatising those who have decided to come and be a part of the team we desperately need.

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  • Believe me, even British or Americans can fail IELTS especially to pass the 7 in each section. I'd encourage you to sit once for this exam then be able to comment.

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  • I don't see how this is a slippery slope. You're simply facilitating a process that allows primary English speaking nurses to pursue registration in the UK. If I come from an English speaking country (America in my case) and completed my nursing education from a US university, then that alone should be proof enough I can read, write and speak the language. I did take the IELTS test. The oral examiner even asked me why I was taking it. Given the nursing shortage, the NMC is doing the right thing for overseas trained nurses like myself.

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