Comment

International outlook: Time to rethink the English language test for overseas nurses

Changes to what evidence English-speaking nurses from outside the UK need to provide are welcome, but the real problem remains lack of investment.

Changes to what evidence English-speaking nurses from outside the UK need to provide are welcome, but the real problem remains lack of investment.

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The Nursing and Midwifery Council (NMC) recently announced it was broadening the evidence it will accept from nurses trained outside the UK to demonstrate their English language ability.

The RCN welcomes the decision because it fits with the results of our research into approaches taken in other countries (RCN 2017).

It also means that nurses seeking to join the register from other European countries can present evidence that they have, for example, undertaken training in English or practised over a minimum period of time in a country where English is the first language.

Several such English-speaking countries recruit nurses internationally and recognise at least one comparable test in addition to the International English Language Testing System (IELTS), currently adopted by the NMC.

Australia and New Zealand, for example, recognise the Occupational English Test, which was designed in Australia for healthcare professionals but is available in more than 40 locations worldwide. 

In Canada, the Canadian English Language Benchmark Assessment for Nurses (CELBAN) has been developed with nursing regulators. Importantly, those taking this test receive individual feedback on their strengths and weaknesses.

Nursing shortages

The NMC has been under pressure to broaden the evidence it accepts from overseas nurses because of the perception that IELTS is a stumbling block to recruiting nurses from the European Union and internationally. 

There is no systematic evidence for this perception, however, and the RCN does not recommend the NMC stops using IELTS or lowers the scores required.

The cause of the UK’s nursing shortages is a lack of investment in education, recruitment and retention of domestic nurses over many years.

The British Council, which runs IELTS, must do better at monitoring test scores to see whether there are challenges with particular modules, such as writing.

As with CELBAN, test takers should also receive relevant individual feedback on their performance. Tests are not cheap, and it is unfair to expect applicants to keep retaking them without understanding how they can improve.

For the long term, the NMC should consider a bespoke English language test for nurses coming to practise in the UK.


About the author

Susan_Williams

Susan Williams is head of international affairs at the RCN

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