IELTS and Nursing Recruitment on the Beeb

Good to hear an article on yesterday evening’s ‘The World Tonight’ on Radio 4 covering the impact of the IELTS test on international recruitment. The article starts 16 minutes into the show.

Since last year, all nurses from overseas have needed to score 7.0 in all 4 papers of the Academic IELTS, the international English language exam used by universities to check whether overseas applicants can understand lectures, write essays, follow academic articles and make presentations. A very good exam, respected around the world for its reliability and integrity, but – at least to most we’ve spoken to in both English Language Teaching and Healthcare sectors – not the right test to see whether nurses can communicate with patients, colleagues and families in a clinical setting.

There were interviews with a nurse who had to write about making jam in her test, as well as an HR director at one Trust who took the exam and struggled with texts about light and shade in theatre. He made the point that while it’s important to check nurses’ English, the content of the Academic IELTS simply wasn’t relevant. He also said that the level was so high that his Trust alone had 140 nurses who were waiting to come and work, but were half a mark short. While this doesn’t seem like a lot, in practice, going from 6.5 to 7.0 in the 4 papers can take 150 hours or more of study.

Jackie Smith, head of the NMC, stated how important it was to ensure overseas nurses can communicate effectively and therefore there was no need to reduce the level of the test. However, given the Speaking component is only 11 to 14 minutes long and the Listening includes understanding lectures and seminar discussions on a wide range of subjects from wildlife to urbanisation to technology to climate change, we’re not sure that the IELTS test is the best test to do this.

Fortunately, the article did highlight that alternative tests focusing on clinical language are being considered. At SLC, we urge the NMC to look at the Occupational English Test (OET) as a first step here. The OET focuses entirely on the language used in healthcare settings, offer similar levels of linguistic challenge as the IELTS, and has been used successfully for many years in Australia, New Zealand and Singapore among others. The OET is 70%-owned by Cambridge, who also part own IELTS, and are well-known for the integrity of their tests.

In the long term, as one interviewee pointed out, the real solution has got to be better workforce planning and making sure British nurses are being trained in greater numbers and incentivised to stay in the NHS. However, in the short-term, given the nursing shortages across the country, it makes sense to continue to recruit internationally, and make sure those nurses are being tested with an appropriate English language test to safeguard patients and deliver effective care.