UK (NMC), Reduce IELTS Score for EU/EEA/Overseas Nurses Registration in the UK

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Overseas and EU/EEA  qualified nurses need to achieve an Individual score of 7/9 in Academic International Language Testing system(IELTS) to gain registration with the Nursing Midwifery Council UK (NMC). International nurses started migrating into the UK  in 2001 when no language requirements were in place. At a later stage, the NMC implemented the academic IELTS requirements. The requirements are based on 4 modules:  Listening, Reading, Writing and Speaking. Individual scores of 7 needs to be achieved in each module (with no category being under 6.5)  in a single or double sitting. This is considered really difficult to achieve and unnecessary for the needs of the profession.  

As from January 2016, EU and EEA nurses, as non-EU (overseas) nurses, also need to go through the same IELTS scoring criteria. Coincidentally, during this time, the number of EU/EEA staff registering to the NMC has gone down by 96%(from 1304 to 46 applications)  by June  2017 from its peak in July 2016.  We believe, and from feedback on the ground from nurses who want to work in the UK, or are already practising in the UK - the language requirement remains a significant barrier to registering with the NMC.

Sir Bruce Keogh’s  report identified that the shortage of nurses and understaffing levels were the reason for high death rates in 14 NHS hospitals. Also, the Royal College of Nursing (RCN) report says the NHS faces a shortage of  20000, nurses leaving patients to suffer (this original figure has now been superseded and is now 24000, as quoted by the RCN and predicted to reach up to 42000, within 6 years). The Health Foundation report published in May 2017 highlights the combined issues of the current problems: recruitment, retention and morale which the issue of IELTS is aggravating and could lead to unsafe staffing levels. 

A recent consultation conducted by the NMC stated that the majority of the public believed the  IELTS  score threshold for registration with the NMC  should be reduced and this to still be satisfying patient safety. Also, the report says the IELTS does not reflect mastery of language and other approaches should be considered. 'Academic IELTS' requirement is not a good reflection of the English needed to practise as a nurse. A high level of Oxford grammar is not necessarily what will best equip nurses working with elderly residents in a private nursing home in rural Northern Ireland or Scotland. Accents, colloquialisms, phone situations will be more relevant than a university lecturer’s standard of English. Steve Brent, CEO of International House and IELTS expert, who facilitated 46,000 tests last year, says that General Training would be ‘a better fit for recruiting nurses than the Academic Module’. 

A recent study conducted by HCL Workforce confirms currently 1 in 10 nursing posts are unfilled and current nursing vacancies stand at a massive 24,000. But UK recruitment isn’t picking up the slack. Bursaries being replaced by student loans is making nursing a less attractive career for candidates in the UK, and early indications suggest applications for nursing degrees in 2017 are down by 20%. In short, the NHS badly needs overseas nurses in large numbers. Currently, 13% of our nurses come from overseas, but this percentage, it’s widely agreed, needs to increase – not only because of demand but because recruiting overseas nurses to UK posts is more cost-efficient than recruiting a UK based locum nurse. In fact, HCL Workforce research illustrates that an overseas nurse would be a minimum of £33,000 cheaper over a 3-year period than a locum nurse. However, as we will see, numbers are actually going down – and there is a clear and undeniable link to IELTS test failures.

Overseas qualified nurses of which a majority have gained bachelor or masters degree from the  UK, and are competent working in the healthcare sector, are being downgraded to healthcare assistants and support workers for a decreased wage.  This opens up worker's right issues. A similar scenario occurs for EU/EEA citizens, overseas nurses of which qualifications and nursing/midwifery competencies are recognised are also being downgraded to a lesser grade due to the failing of the IETLS exam.

Furthermore, it is also worthwhile emphasising that the cost of the exam is  £150.00 a time. Anecdotal evidence shows some nurses takes the exams more than 9 times or over (cost not including potential extra costs if attending language courses.).It is also evidenced that many native English speakers will struggle to score 7/9 in the IELTS. The concern is that the test is becoming a money making exercise.

In light of these facts, we hereby petition for consideration of the following suggestions;

  1. Reducing the academic IELTS score for NMC registration (ideally to 6.5 with no categories under 6.0)
  2. Provision of exclusion for nurses who have completed a degree or masters from  UK Universities.
  3. Reduce the IELTS requirements for overseas and EU/EEA nurses who have 3 or more years of work experience in the healthcare sector in the UK.
  4.  Change the Academic IELTS to General IELTS for NMC Registration. 

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