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Overseas nurses’ skills being squandered by tough language tests

NMC’s English language proficiency rules for foreign-trained nurses hold applicants to unfair standard, forcing many into unregistered roles while health services lose out, study finds
students sit a written exam

English language proficiency rules for foreign-trained nurses hold NMC applicants to a needlessly high standard, forcing many into unregistered roles – while UK health services lose out on their knowledge, study finds

Skilled nurses are being prevented from joining the Nursing and Midwifery Council (NMC) register by unnecessarily harsh English language requirements, say nurse researchers and union reps.

Researchers at the University of Salford suggest the NHS is missing out on thousands of qualified nurses who have made their home in the UK but struggle to pass language tests.

Unison has also raised concerns about the number of overseas-trained nurses with proven communication skills being rejected by the NMC.

System weighted against foreign nursing professionals

English language proficiency rules for foreign-trained nurses hold NMC applicants to a needlessly high standard, forcing many into unregistered roles – while UK health services lose out on their knowledge, study finds

students sit a written exam
Picture: iStock

Skilled nurses are being prevented from joining the Nursing and Midwifery Council (NMC) register by unnecessarily harsh English language requirements, say nurse researchers and union reps.

Researchers at the University of Salford suggest the NHS is missing out on thousands of qualified nurses who have made their home in the UK but struggle to pass language tests.

Unison has also raised concerns about the number of overseas-trained nurses with proven communication skills being rejected by the NMC.

System weighted against foreign nursing professionals

Researchers surveyed 857 nurses from India currently working in support worker or healthcare assistant roles in the NHS. They found 629 had British citizenship, 79% had lived in the UK for more than ten years and 17 had master’s degrees. But they are unable to practise as nurses because they could not meet the NMC’s English requirements.

Researcher and lecturer Dilla Davis said the system was unfair because overseas nurses must demonstrate language proficiency not expected of counterparts from the UK.

Rejecting their applications and expecting them to work as unregistered staff ‘risked exploiting their skills and competencies’, she added.

Dr Davis said more weight should be given to British citizenship, which requires people to pass English language tests, as well as time spent living and working in the UK, passing other NMC tests, and recommendations and references from employers.

How overseas-trained nurses must demonstrate proficiency in English

To join the UK register, overseas-qualified nurses must demonstrate they are competent in speaking, listening to, reading and writing English.

They can do this in one of three ways:

  • Passing the occupational English test or international English language testing system test
  • Completing pre-registration training taught and examined in English
  • Working in a mainly English-speaking country for at least a year where they passed an English language assessment to register

Source: NMC

UK health services are missing out on knowledge and skills

Unison said it is helping a number of overseas nurses whose NMC registrations applications have been declined, including those who had completed nursing qualifications in English and whose language skills had been endorsed by colleagues and managers.

The union’s national nursing officer Stuart Tuckwood said: ‘They often experience unnecessary stress and anxiety because of this, while their services miss out on the full range of knowledge and skills they have.’

The NMC is reviewing English language testing with the aim of introducing an updated approach by the end of this year. A public consultation is due this summer.

NMC executive director of strategy Matthew McClelland said: ‘It’s very important everyone joining our register, whether they trained in the UK or in another country, can communicate effectively in English.’

He pointed out that more than 17,500 professionals who trained outside the UK joined the register in the year up to September 2021.


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