While the establishment of an English language level for nurses working in high stakes environments makes complete sense, from the very start we have had concerns about the choice of test and level set by the NMC. These concerns have increased firstly with the research we conducted for the White Paper released earlier this year, secondly, our participation in a recent round table consisting of NHS Trusts and recruitment companies, and thirdly our experience of training 100s of nurses both in exam preparation and in nursing English.

The test, Academic IELTS, and the level set – 7.0 from a maximum of 9.0 in the four papers (writing, speaking, listening and reading) is the same as Oxford University require overseas applicants to achieve in order to study on their undergraduate programmes and higher than that required for overseas candidates attending Nursing degree programmes offered in the UK.

Moreover, Academic IELTS is designed specifically to test the academic English skills of students wanting to study in English-speaking universities. It does not test those vital clinical language skills required by nurses when discussing symptoms and treatments, giving accurate ward handovers, talking to distressed relatives, etc.

SLC works extensively with NHS Trusts, private healthcare organisations, and international healthcare recruitment companies preparing their candidates for the test. We see how nurses are having to spend 100s of hours in many cases learning how to write academic essays, understand seminars, and read articles on subjects ranging from history to the environment to the arts.

Many nurses – as well as their potential employers – cannot understand the relevancy of this and, understandably, motivation levels are low. The required score being so high only exacerbates this, as without the 100s of hours of tuition, achievement rates at this level remain depressed. Individuals and hospitals have to invest months of training and considerable amounts of money to learn language that they may never use in practice.

We believe that an English language test makes good sense and will reassure patients that nurses can deliver safe and effective care. We understand that IELTS has a global reach and nurses from all over the world can take a test in a local centre. However, given the content of the test and the level set, we recommend the NMC consider the following:

1. requiring an average of 7.0 with a minimum of 6.5 in the 4 papers,
2. switching to the General IELTS test, designed for vocational purposes more explicitly than the Academic test designed for Higher Education, or
3. having an optional alternative test focusing on clinical English – the language nurses use in practice – such as the Occupational English Test, already recognised and used in Australia, New Zealand and Singapore.