A letter sent by NMC to NHS trusts also lays out further details about the options being looked at by the Nursing and Midwifery Council, following concerns about the difficulty of the International English Language Testing System (IELTS). The NMC has still not decided whether it should modify or switch the IELTS for another exam. Earlier this month, it committed to exploring the issue further. In addition to other options, the letter reveals the regulator is considering whether to allow non-European nurses and midwives to provide evidence of their language skills, such as having studied in English or practised in an English-speaking country, as an alternative to taking the IELTS exam. This would bring the rules into line with those for European staff, who are able to either provide evidence or take the test. The letter, sent last week following a meeting between the regulator and the NHS Employers organisation, also reiterates other potential changes. This includes lowering the score of just the writing element of the IELTS, or introducing an alternative test that focusses on clinical aspects of communication. It also highlights that the NMC has in the past been opposed to reducing the overall pass for the IELTS – currently set at 7.0 out of 9.0 – due to public protection issues. NHS Employers chief executive Danny Mortimer said in the letter to HR directors that he had been in contact with the head of the regulator since earlier this year about concerns relating to the high number of nurses failing the IELTS. He suggested to the NMC that the use of an alternative test that included clinical content would “increase its credibility to both employers and the NMC”. NHS Employers subsequently convened a meeting in the spring with NMC chief executive Jackie Smith, senior nurses from NHS England, regulator NHS Improvement and Health Education England, and representatives from the Department of Health and Royal College of Nursing, said the letter. Mr Mortimer said the group would continue to meet to discuss the issue, following an NMC council meeting earlier this month where the regulator committed to carry out further work on the possible changes. “It is likely that any changes would begin towards the end of this calendar year or early in 2018,” he said in the letter. “Although there is still a substantial amount of work to do, I trust you will agree there is potential for real progress and you will join me in welcoming the NMC’s response to our concerns. ‘’I see a real willingness from the NMC to critically review language testing, and to implement improvements as quickly as possible, without compromising patient safety,” said Mr Mortimer in the letter. “I will continue to work on this area on your behalf, ensuring the commitments and actions do progress, and will keep networks and employers updated,” he added. A spokesman for the NMC said patient safety was its priority and noted that the code of conduct for nurses and midwives required them to ”have the necessary command of English in order to practise safely”. “Nurses and midwives are responsible for delivering around 80% of patient care and we do not believe it is in the interests of public safety to lower the standard of English competence required without clear evidence,” he said. “While we are aware of some concerns about our English language policy, we do not currently have any hard evidence on which to base a change. (Credit: Nursing Times)