English Language Requirements for Nurses Working in the UK

Why is English language assessment of nurses important when you are recruiting?


September 2020 - New funding to help recruit NHS Nurses - Article from the Nursing Times

CNO announces £28m to restart international nurse recruitment 22 SEPTEMBER, 2020 BY GEMMA MITCHELL

Funding worth £28m is being made available in England to quickly “accelerate” the recruitment of nurses from overseas, following a period of inactivity due to the coronavirus pandemic. Half of the money is dedicated to supporting the arrival to the country of nurses who have already been appointed from abroad. The other half is to fund a “significant expansion” of future overseas nurse recruitment for the remainder of 2020-21.

The plans were outlined in a letter seen by Nursing Times from chief nursing officer for England, Ruth May, to regional directors of nursing across the country. The outbreak of Covid-19 had led to the majority of international nurse recruitment activity being paused. In the letter, Ms May said these “markets” were now beginning to reopen, with some nurses having travelled from abroad to the UK to join the NHS in recent weeks. “There is, therefore, a real opportunity to accelerate the recruitment and arrival of international nurses,” she said. There are currently more than 6,500 international nurses recruited waiting to come to England.

Ms May said a £14m financial package was being made available to help get these nurses into the NHS. Examples given for what the money could be spent on included flights, quarantine periods, accommodation and training to prepare nurses to join the Nursing and Midwifery Council register. A further £14m is being offered to help trusts recruit additional international nurses in 2020-21. Trusts are being encouraged to take a collaborative approach by partnering up with neighbour organisations and working “at scale to recruit, induct and provide pastoral support”.

The money is also intended to help trusts “develop a new pipeline of overseas nurses and diversify the intake of nurses from a range of countries”. “The NHS People Plan has underlined our ongoing commitment to international nurse recruitment,” said Ms May in the letter. “I, therefore, ask that you, directors of nursing, review and ramp up your international recruitment plans and activity in the next few weeks and also ensure you have an effective plan to get those overseas nurses that you have already appointed to the UK in the coming weeks and months.”

New English Language 'Offer' for HCAs?

In addition, as part of the wider international recruitment programme, Ms May said a new English language “offer” would be put in place this year to help overseas nurses working in healthcare support worker (HSCW) roles in the UK achieve NMC nurse registration. While Ms May flagged the need to follow ethical recruitment practices, concerns have still be raised about the implications of raiding other countries for nurses at the time of a global pandemic.

OET News - NMC to accept OET Writing C+

DECEMBER 2019 : In case you haven't heard already, I am delighted to inform you that the UK’s Nursing and Midwifery Council (NMC) has announced that it will amend its OET Writing requirement to a grade C+, alongside a minimum B grade in the Listening, Reading and Speaking sub-tests.

As you may be aware, many nurses have struggled to achieve a grade B in Writing, despite showing themselves to be capable of providing safe and effective care in an English-speaking environment. The change will come into effect from 28 January 2020.

OET results achieved during the previous two years that meet the new requirements will also be accepted.

Latest news on NMC decision to possibly lower the OET writing score to C+ to bring it into line with the IELTS writing grade requirement

NOVEMBER 2019 : The NMC announced they are considering lowering the OET writing grade required to bring it in line with the change to the IELTS writing in November 2018. Here is the article you can see on the NMC website at this URL :

We will wait to see if this is approved, but if it is it will have a significant impact on nurses who have taken the OET exam and achieved B grades in listening, reading and speaking but only a C+ in writing. Presumably there will be a retrospective application of the new writing score so many people who have taken the OET test in the past can apply for their PIN.

NMC's Statement on proposed changes to readmission and English language requirements - November 2019

Released Wednesday 20 November 2019 for approval by the NMC governing council on Wednesday 27 November 2019, are a number of proposed changes to our readmission process and English language requirements.

These proposed evidence-based changes will help to streamline the process both for those wanting to return to practice and for those seeking to join our register for the first time.

Changes to English language requirements

One of the changes we’re asking Council to approve is to our English language requirements. We’re proposing to remove the five year limit on using nursing and midwifery qualifications taught in English, as evidence of a person’s English language skills.

We’re also requesting that Council amend the required score for the written section of the Occupational English Test (OET) so that it aligns with the change we made at the end of 2018 to the score of the written section of the International English Language Testing System (IELTS).

Emma Broadbent, Director for Registration and Revalidation for the NMC, said: “These common sense changes are in line with the NMC’s commitment to better, safer care and will continue to ensure that only those nurses, midwives and nursing associates with the right skills, knowledge and command of English are able to join and re-join our register.”

These changes will go to the NMC Council for approval on 27 November 2019.

Background information

More information on the proposed changes can be found in the Council papers.

Following an extensive evidence gathering and analysis exercise with OET, we have agreed that the OET writing domain score requirement will change from a B (350-440) to a C+ (300-340). This will bring it in line with our requirement for IELTS test takers, which is an overall score of 7, but with a minimum 6.5 in the writing domain as of this year. 

NMC lowering IELTS grade for writing - November 2018

From November 2018 the NMC is accepting a lower score in writing for IELTS. Here's what they say on their website : Changes to our English language requirements: From Wednesday 5 December, we’ll accept an IELTS certificate that confirms you scored a minimum of 6.5 in writing alongside a minimum of 7.0 in reading, listening and speaking, so long as you achieved the minimum overall score of 7.0. Our Council agreed this change at their meeting on Wednesday 28 November.

Currently the OET requirement is still four "B"s however we think there must be pressure to reduce the writing element to "C+" which is the equivalent of IELTS 6.5

The OET Occupational English Test is changing from the September exam

With effect from the September exam the format of the OET exam is changing to keep pace with the changing medical world. Known as "OET2.0" the new exan makes changes to the reading and listening sub-tests, whilst the marking regime for the speaking test will be extended to include extra skills in communication. The writing test will not change. If you have traine dot do the 'old' OET exam and would like to take the new OET2.0 we can help you.

At Kingsway Medical we are running OET2.0 Conversion Courses. These are 1 week intensive courses to get you familiar with all the changes. We can alos provide accommodation if you live far away. See here for more information.

NMC to amend English language requirements for applicants trained outside the UK

This announcement came from the NMC today 18th October 2017 ... the OET Occupational English Test will be accepted as well as IELTS.

To see the original article please click here :

The Nursing and Midwifery Council (NMC) has today announced that it is making alternative options available for nurses and midwives, trained outside the UK, to demonstrate their English language capability.

From 1 November 2017, the NMC will accept the Occupational English Test (OET) in addition to the International English Language Test System (IELTS), as proof of a nurse or midwife’s English language competence. While this provides an alternative way for nurses and midwives to demonstrate their English language capability, applicants will still be required to meet the NMC’s existing English language standards.

Nurses and midwives who have qualified outside EU/EEA will now also be able to demonstrate their English language capability by providing evidence that they have:

  • undertaken a pre-registration nursing or midwifery qualification taught and examined in English.
  • registered and practised for a minimum of one year in a country where English is the first and native language, and a successful pass in an English language test was required for registration.

These alternative forms of evidence will bring the options available for nurses and midwives trained outside the EU/EEA more closely in line with evidence that we accept for those trained in the EU/EEA.

Update on IELTS requirements for Nurses, and other things! - October 2017

Anyone hoping for a change in the IELTS requirements for nurses coming to work in the UK don't hold your breath. At the last meeting of the NMC board at the end of September it was announced that they are still gathering data and reviewing the situation and any decision appears not to be on the horizon yet. So for the moment keep working toward a score of 7.0 in all four skill areas with a minimum overall score of 7.0.

They are also exploring the possibility of introducing another test that may be more relevant to the medical professions. At the moment favourite seems to be the OET or Occupational English Test.

Here's the information taken from the publicly available minutes of the NMC meeting:

English Language Stocktake: Update

Exploring flexibility in our approach and policies IELTS domain score requirements

Stakeholder feedback shows that there is general support for the overall level being set at 7.0, but with flexibility in individual domain scores. We could undertake further research to explore why the Writing domain consistently scores lower and what the impact of lowering it to 6.5 would be. The data we have gathered so far does not allow us to firmly conclude whether a move to 6.5 in Writing would raise public protection risks. Conversely, there is little evidence to say that it would not.

Some stakeholders have suggested that a language test which incorporates the clinical and social skills needed by nurses and midwives would be more appropriate than IELTS. English language academics, challenge whether IELTS currently tests English ‘preparedness’ appropriately, as it is divorced from context (for us that would be the nursing/healthcare context).

Two options to consider are
i) developing a new test or,
ii) using or adapting an existing healthcare-focused test.

Two such tests which assess the clinical and social aspects of language skills are the Occupational English Test (OET), recognised by over 20 regulatory bodies in Australia, New Zealand and Singapore and the Canadian English Language Assessment for Nurses (CELBAN). OET assesses the language proficiency of a range of healthcare professionals, including nurses and midwives, doctors and pharmacists. CELBAN was developed solely for nurses, although midwives are interested its use. We are currently gathering evidence related to OET and are exploring practical issues such as how OET domains and scores might map onto existing IELTS requirements. The OET has test centres in Asia and South East Asia, Africa, Europe, Australia and North American and additional test venues could be opened. Developments would need to be aligned with the other key professional regulators.

• Having considered the evidence in this initial stocktake our recommendation to the Council is to:
• Develop improved signposting and support from the NMC in relation to preparation for the IELTS test, including gathering and sharing best practice from employers.
• Explore a new strategic solution, considering in particular the OET.
• Further explore the Writing element of IELTS and the evidence base for any change.
• Conduct work with patient and public groups to understand 134 Page 5 of 5 their views and perspectives on this debate.


The following article is taken from the EL Gazette dated June 2017

You can read the article here :

Three quarters of nurses fail to reach UK Ielts demands

Around three quarters of all nurses worldwide who sit academic Ielts fail to reach the grades they would require if they wanted to practise in the UK, an EL Gazette analysis suggests. The findings, based on 2015 academic Ielts results, emerged as the UK’s Nursing and Midwifery Council (NMC) said it was ‘looking at’ the current requirements for all overseas nurses to have a level 7 in all four skills.

Ielts own statistics suggest that of all native speakers of English taking the test worldwide- regardless of their profession or status- only around 41 per cent would achieve this. Of nurse candidates worldwide only 24 per cent would pass. The NMC said it was ‘gathering further evidence’ that a change to the standards may be necessary. This follows complaints from recruiters and employers that they are set too high and are a barrier to employing much-needed foreign nurses.

One key issue is that nurses are expected to score at least 7 in each of the four skills including writing. Individual skills scores for nurses are not included in the statistics, but the results for all candidates from the top 40 language groups show that, on average, none reach level 7 in writing, with native speakers averaging just 6.3.

An NMC spokesperson said they were ‘aware of some concerns’ around the language policy, but did not yet have any ‘hard evidence’ on which to base a change. ‘It is important to state that this decision does not indicate that we feel the current standard we require is wrong or that we are committing to a change’, they said. Stephanie Aiken, deputy director of nursing at the Royal College of Nursing, said she welcomed the review but warned against ‘quick fixes’ designed to make up for the shortage of nurses in the UK.

*Our analysis follows a rule-of-thumb that writing skills are usually around half a band score lower than the mean score of the other 3 skills. Candidates achieving a score of 7 in writing would typically achieve 7.5 overall.

The following is taken from the Nursing Times dated 19th May 2017

You can read the article on the Nursing Times website here :

Regulator to carry out 'stocktake' of English language testing for overseas nurses

The Nursing and Midwifery Council is to carry out a “stocktake” of the test it uses to assess the English language skills of overseas nurses and midwives, following discussions with the Department of Health. In NMC council papers due to be discussed next week, the regulator said it would be “gathering data and evidence” to help it decide whether the standards for English language testing needed to change.

It noted that the International English Language Testing System (IELTS) exam it uses had been in place since 2007 for nurses and midwives from outside the European Union. Since the start of 2016, the IELTS has also been used to asses EU nursing staff who apply to work in the UK. The NMC’s decision comes after some trust chief nurses and recruitment agencies have warned that the test is set at too high a level and is delaying vital overseas recruitment needed to help fill staffing gaps in the UK.

As recently reported by Nursing Times, staff from abroad are taking between eight months and a year on average to pass the IELTS following several attempts and only around 50% of potential candidates are ultimately successful. Directors of nursing have been lobbying the NMC for a change to the test, with suggestions including reducing the pass rate – currently set as a minimum score of 7.0 across all elements of reading, writing, listening and speaking.

Prior to 2007, the NMC required overseas nurses to achieve a score of 6.5 across all four elements of the IELTS, but increased the level following a consultation. The number of EU nurses applying to register with the NMC surged at the start of 2016, ahead of the language test being brought in for European staff.

In 2015, an average of 700 EU staff applied to work in the UK every month, but in January 2016 this jumped to 1,977. Meanwhile, the number of EU nurses being admitted onto the NMC ‘s register has been falling significantly since summer 2016, when all applications under the old system had been processed. Just 100 EU nurses joined the NMC register in December 2016, compared with a high of 1,304 in July.

There has also been widespread speculation on whether the result of the EU referendum last summer had largely caused the drop-off in joiners. But an agency that recruits staff for NHS trusts previously told Nursing Times that it had not seen a decline in applications and warned it was the IELTS test that was stopping people from being able to take up job offers.

The NMC papers, to be discussed on Wednesday, state: “The chief executive [Jackie Smith] has had regular catch up discussions with Department of Health colleagues. “Issues discussed included plans for a stocktake of the current IELTS language test for nurses and midwives trained overseas seeking to join the NMC register, given that these have been in place since 2007, said the papers.

“Our foremost consideration must always be protection of patients and the public, and we will be gathering data and evidence to inform our consideration of whether any variation in either direction is needed to the current standards,” it added. Prior to 2005, the NMC’s policy on the language skills of non-EEA trained nurses and midwives was that applicants whose “primary mode of expression” was English or who had undertaken their nursing or midwifery training in English did not have to take a language test as part of the application process. But, in 2005, the NMC council agreed a new policy that stipulated all applicants would be required to undertake and successfully pass an IELTS test. The required score level required was set at 6.5 across the four modules, but was raised to 7.0 in all categories in 2007, following a public consultation.

The following is taken from the NHS Improvement website - dated 12th December 2016 and outlines concerns raised by providers in regards to obtaining registration for overseas nurses and the Nursing and Midwifery Council (NMC) response given in November 2016.

Here is the link to the full article :

Supporting nurses from overseas to achieve their registration: update to the Nursing and Midwifery Council requirements

This update outlines concerns raised by providers in regards to obtaining registration for overseas nurses and the Nursing and Midwifery Council (NMC) response given in November 2016.

International English Language Testing System (IELTS)

Provider issues:

  • no significant impact from the Introduction of combining scores from two IELTS tests
  • how relevant the English Language test is to the healthcare setting
  • it takes between 12 and 18 months for a candidate to move from 6.5 to 7.0

NMC response:

Following public consultations and evidence from the British Council, NMC has determined that a score of 7 was the appropriate level for overseas trained nurses and midwives to achieve as part of their application for registration. The British Council considers those achieving a level 7 score to be a good user of the English language, with operational command over it. This is the level NMC would expect from those working in a regulated healthcare role.

Our Comment:

We agree wholeheartedly with the British Council in saying "those achieving a level 7 score to be a good user of the English language" and we believe it should stop there! The extra requirement to achieve a minimum of 7 in each of the 4 components is unrealistic because each one of us has different skills and abilities that may mean we can be an excellent communicator (speaking and listening) and not so hot on reading and writing ... BUT (and it's an important but) there is quite a strong element of 'checks and balances' going on here. In order to score a 7.0 overall you can't afford to drop much less than a 7 in any one area. For example your 8.0 in speaking could be offset by a 6.0 in writing - so for every point you drop somewhere you have to pick up somewhere else. The chances of someone being a near-native speaker and near-beginner writing just aint going to happen. My point is that requiring an overall level 7.0 is in itself a reasonable assumption of overall level in all 4 skill areas.

We believe the NMC should change the rules so that nurses have to achieve an overall score of 7.0 with no other requirement. RJ.


Our Comment on the IELTS English exam requirements for nurses coming to work in the UK - December 2016

The 'relaxed' (if they can be called that) regulations in force since June 2016 which means that nurses get two shots in a six month period to pass the IELTS exam at level 7.0 in all four skill areas have not in our opinion significantly changed the landscape in the field of recruiting nurses to work in the NHS.

The fact remains that achieving a level 7.0 in all areas (and the Academic IELTS at that) is incredibly hard. I doubt most native English speakers would be able to pass the IELTS exam at this level, and indeed when we have given practice IELTS papers to native English speakers many of them look blankly at them wondering where quite to start.

Given that the entry requirements for UK universities varies from 6.0 to 7.5 (and that's the overall grade), it is in my view quite sufficient to have nurses achieve a level 6.0 in each area to undertake their roles in UK hospitals. One questions whether the academic variety of the IELTS exam is the right one for them to take anyway.

It may be far more appropriate for nurses to follow a general English programme with specific content for the medical profession, whereby they can achieve some academic depth of knowledge but perhaps more importantly, develop their 'bedside manner' - or the English they need to communicate with native English speaking colleagues and patients. It does seem the major problem encountered by the general public is that they simply can't understand their nurse or doctor or dentist, and when there have been communication problems reported in the press over the years, hasn't it just been a case of this kind of communication breakdown rather than the more formal ability to summarise academic passages of text or pick out the meaning of something from a lengthy audio file.

We are where we are ...

If you are a nurse or doctor wanting to come and work in the UK for the NHS we have to accept that (for the moment at least) we are where we are. This means 'go with the flow' and do your best within the current constraints.

Having provided in-hospital and residential IELTS courses for nurses throughout 2016 there is one course of action that can make your chances of a relatively smooth entry into the NHS a reality ... and that is study English like mad in your own country. Many of the nurses we have met over the last year have been under the impression that you can learn English once you are here. Not so, well not easily. Once you are here you will be working all hours of the day and night, so take advantage of the comfort of being in your home country and really ramp up your study of English for the IELTS exam. Do the hard work while you can, so that when you come to move to the UK you can undertake a short sharp IELTS English course and pass the exam with the required grades.

Many of the recruitment agencies in the UK (and hospital trusts themselves) are looking at entry to the UK at an IELTS level 6.5 so that a level 7.0 pass is achievable in a short time frame. Make sure you are there!

If you would like any particular advice or guidance please do get in touch. We are happy to help out with free advice. Just email This email address is being protected from spambots. You need JavaScript enabled to view it. and one of the team will get back to you.

Good luck in your future careers.

Rick Johns
Worcester Medical


Update on requirements from the NMC - 28th June 2016

This news item is reproduced from the NMC website page : 

New English language test requirements

NMC to amend English language test requirements for applicants trained outside the UK

The Nursing and Midwifery Council (NMC) is amending the International English Language Testing System (IELTS) requirements for nurses and midwives coming on to the register from overseas and within the European Economic Area. These changes will increase flexibility for applicants and ensure the appropriate standard of English language is still achieved.     

Under the previous system, applicants had to achieve the IELTS Academic Test Level 7 in reading, writing, speaking and listening in a single sitting. A Level 7 in all areas will still be required, but this can now be achieved over two sittings of the tests. Both tests must be within six months of each other and no single score must be below 6.5 in any of the areas across both tests.

"IELTS Level 7 provides us and the public with assurance that nurses and midwives applying to join the register from outside the UK meet the appropriate standard of English language required to work in the UK," NMC Chief Executive and Registrar Jackie Smith said.


The Nursing and Midwifery Council is the professional regulatory body for nurses and midwives in the UK. The article below is reproduced from their website :

International English Language Testing

The IELTS scores we require from nurses and midwives trained outside EU/EEA

All non-EU trained applicants to the nurses or midwives part of the register must complete the International English Language Test (IELTS) before sending their application to us.

You must complete the academic version of the IELTS test and achieve:

  • at least 7.0 in the listening and reading sections
  • at least 7.0 in the writing and speaking sections, and
  • at least 7.0 (out of a possible 9) overall.

Applicants may provide two IELTS test certificates to meet the above requirements, but must not have scored below 6.5 in any categories, in either of the test sittings.

The two test sittings must be taken within six months of each other to be considered.

We will not accept applicants who score lower than this standard.

As a result of public consultations for both nursing (November 2003) and midwifery (October 2005) and evidence from the British Council, the NMC decided that a score of seven was the lowest level acceptable for language skills. This applies equally to nurses and midwives who apply for registration from 1 February 2007.

We will not accept applicants who score lower than this standard.

IELTS test scores from more than two years ago

IELTS partners state they cannot verify an IELTS test score that is older than two years. Where the test score is more than two years old when submitting your application, you are required to resit your IELTS test.

IELTS test centres

Globally IELTS is available in 140 countries at over 1,000 test centres.. A full list of test centres is available on the IELTS website. If there is no IELTS test centre in your country, please visit the IELTS website for more information. Without exception, all overseas applicants who apply for NMC registration must meet the standard for English language.

The NMC uses IELTS because it has international use and recognition within nursing and midwifery. Most other healthcare regulators in the UK also use it.

Language testing applicants from Australia, New Zealand, South Africa, Canada and the USA

All overseas applicants are required to meet the NMC standard for English language regardless of where they come from. This makes sure that all applicants meet the same standard in a system that is equitable, fair and non-discriminatory. There are no current plans by the NMC to waive the IELTS requirements for these countries.

Language testing those trained outside the EU

All applicants who were trained outside the EU are required by the NMC Education Registration and Registration Appeals Rules 2004 to provide evidence that they have sufficient knowledge of English to practice safely and competently as a nurse or midwife in the UK.

The English language score of 7.0 is considered to be the standard of English that is required in order to function competently and expertly in a degree-holding profession and as a registrant. For applicants outside the EU, it is regarded to be a principle competency to make sure the required standard can be met through the overseas nursing programme or the midwifery adaptation course.

(End of NMC article from 28th June 2016)

Our Comment on Your Study Options - May 2016

If you are already working in the medical profession and are coming (or are planning to come) to work in the NHS in the UK then we suggest two ways of going about improving your English.

1) Study English while you are working : This means in addition to your current job in the medical industry you can study outside your work time to improve your English, you can take the IELTS exam at one of many centres around the world, and if you achieve the required grade you can apply to one of the many medical recruitment agencies to work in the UK. If you like this option then our Online IELTS training programme would work well.

2) Study English intensively : This means taking a break from your job for say 2 or 3 months and studying on a full-time course in IELTS, taking the exam and if you get the required grade then applying to come and work in the UK. Our in-school IELTS programme would provide this training for you.

Which is better?

There is no right or wrong. Studying for IELTS while you are still putting in your shifts in hospital is hard work. It will mean you have very little free time on top of an already hard schedule. Studying full-time means you cna devote more attention to getting your IELTS English score up but you have the period of 2 - 3 months not earning money. It depends on your personal circumstances really.


Doctors working in the UK

The General Medical Council requires doctors working in the UK to have a minimum score of 7.0 in each of the IELTS areas of speaking, listening, reading and writing. In addition the overall average score should be at least 7.5.  In theoretical terms this means that if you score a 7.0 in speaking and listening for example, then you will need an 8.0 in reading and writing. In practical terms this means you should be a "very good user" of English!

Nurses working in the UK

For nurses and midwives the Nursing and Midwifery Council (NMC) have similar rules. Prior to 18th January 2016 nurses and midwives from the Economic European Area (EEA) did not have to take the IELTS exam but this has changed.

Changes implemented from 18th January 2016

From 18 January 2016, new language requirements for EEA trained nurses and midwives joining the Nursing and Midwifery Council (NMC) register came into effect. Designed to strengthen public protection, the new controls mean that nurses and midwives will be asked to demonstrate that they have the necessary knowledge of English to practice safely in the UK.

EEA nurses and midwives will be asked to prove that they have sufficient evidence of English language skills, for example having worked or trained in an English-speaking country. If a nurse or a midwife is unable to demonstrate these requirements, he or she will be asked to complete an English language assessment. This means take the IELTS Academic exam and pass with a minimum score of 7.0 in all 4 skill areas.

Language Competency Guidelines

The NHS Employers Organisation has produced a set of guidelines for language competency. Click here for the Language Compency Guide Oct 2015.

Further Reading on the Changes

An article from the BBC website explains all

This article from the BBC website on 19th January explains the new setup. Here is a direct link to the BBC article : and the text is shown below for convenience purposes : 

BBC Article from 19th January 2016

Nurses and midwives coming to Britain from the EU will now need to prove they are fluent in English, under new rules. Until now, checks have only been applied to nurses outside the EU. It means any nurse who is unable to show they have sufficient language skills will need to have an English language assessment.

The move by the Nursing and Midwifery Council brings the profession in line with doctors, who are already vetted in this way for patient safety. The risk of a doctor not being fluent in English was highlighted by a lethal mistake made by Dr Daniel Ubani, a German doctor doing an out-of-hours shift who gave a lethal dose of a painkiller to patient David Gray in 2008. As a German citizen he was able to register to work in the UK without passing a language test.

Language checks NMC Chief Executive Jackie Smith said: "From now on all nurses and midwives applying to join the register from outside the UK, including the EU, will have to demonstrate they can communicate effectively to a high standard of English. "The ability to communicate effectively with patients is fundamental to patient safety and a principle that is central to our code." Tests will check listening, reading, writing and speaking fluency. And if an allegation is made that a nurse or midwife already working in the UK does not meet the necessary English language skills, they could be investigated under fitness to practise rules.

The NMC has more than 690,000 nurses and midwives on its register. Around 66,000 of these come from non-EU countries and 33,000 from the EU. The UK is looking to recruit more foreign nurses. In October, the government temporarily lifted restrictions on recruiting nurses from overseas by adding the profession to its Shortage Occupation List. This means nurses from outside the European Economic Area now have their applications prioritised. The Department of Health said the move was designed to ease pressure on the NHS without having to rely on expensive agency staff.

Katherine Murphy of The Patients Association said: "Nurses from other countries make an extremely important contribution to healthcare in the UK. However, we hear from patients on our National Helpline that there can be real issues with some overseas health professionals; including problems with communication and a lack of understanding of processes and procedures. "The Patients Association calls on all Trusts to ensure that their staff meet these new requirements, and that all overseas nurses have the necessary support and training to be able to offer patients safe and effective care."


Thousands of NHS nursing and doctor posts lie vacant

This article from the BBC website on 29th February 2016 explains the problems in the NHS. Here is a direct link to the BBC article : and the text is shown below for convenience purposes : 

BBC Article from 29th February 2016

More than two-thirds of trusts and health boards in the UK are actively trying to recruit from abroad as they struggle to cope with a shortage of qualified staff, figures reveal. Tens of thousands of NHS nursing and doctor posts are vacant. The statistics, obtained by the BBC, show the scale of the NHS recruitment crisis. Health unions blame poor workforce planning, but officials say the NHS has more staff than ever before. Data from a BBC Freedom of Information request shows that on 1 December 2015, the NHS in England, Wales and Northern Ireland had more than 23,443 nursing vacancies - equivalent to 9% of the workforce.

Agency workers

In comparison, the average vacancy rate across the UK economy from November to January 2016 was 2.7%, according to the Office for National Statistics. The figures - which include 106 out of 166 trusts in England, Wales and Northern Ireland - also revealed:
◾Between 2013 and 2015, there has been a 50% increase in nursing vacancies, from 12,513 to 18,714.
◾For doctors, the number of vacancies went from 2,907 to 4,669 - an increase of roughly 60%.
◾In England and Wales, there were 1,265 vacancies for registered nurses in emergency departments - about 11% of the total.
◾For consultants in emergency medicine there were 243 vacancies - again 11% of the total.
◾Paediatric consultants - specialists in the care of babies, children and young people - were also hard to recruit, with 221 vacancies - about 7% of the total.

Vacancy rates in Scotland are published quarterly and so comparable figures are not yet available. In England, many hospitals are having to rely on expensive agency workers to make up the shortfall in staff. That has been identified as a key factor driving a growing financial crisis within the health service.

NHS recruitment crisis

69% of UK trusts are actively recruiting abroad for doctors or nurses
23,443 nursing vacancies in England, Wales & Northern Ireland
9% vacancy rate for nurses
6,207 doctor vacancies
7% vacancy rate for doctors

One solution to the staff shortage adopted by many trusts is employing doctors and nurses from overseas. The BBC also asked trusts and health boards across the UK whether they were actively recruiting staff from abroad, and in this case Scottish hospitals were also able to answer. The figures show more than two-thirds - 69% - of all NHS trusts and health boards are seeking staff overseas. And in just England and Wales, the figure is nearly three-quarters of all trusts - 74%. Some are travelling from as far afield as India and the Philippines.

Maca Fernandez Carro is a nurse who is originally from Bilbao in Spain but has worked at Royal Bolton Hospital since 2014. Maca Fernandez Carro Image caption Maca Fernandez Carro said she liked working for the NHS She told BBC Radio 5 live: "There was no opportunities for us back home. The options were having a three-month contract back home, or coming here with a permanent position." "Even though we are really under pressure, and really, really stressed I like working for the NHS."

Hard to recruit Nursing staff

More than two-thirds of trusts are looking to recruit nurses from overseas The health unions, the Royal College of Nursing and the British Medical Association blame poor workforce planning for the problems hospitals are having in finding qualified staff. Janet Davies, chief executive of the Royal College of Nursing, said: "Nursing posts are often the first target when savings need to be made, leading the NHS to find itself dangerously short and having to spend more on agency staff and recruitment from other countries. "The modest increases made in training places are not nearly enough to tackle current problems or the significant challenges facing the NHS over the coming decade." A spokesman for the doctor's union the BMA - which is currently locked in a dispute with the government in England over a new contract for junior doctors - said the crisis in recruitment was down to a number of factors. "Poor workforce planning means we aren't producing enough doctors and sending them to the right areas," he said.

More staff than ever

But in a statement, the Department of Health in England said: "Staffing is a priority — that's why there are already over 29,600 extra clinical staff, including more than 10,600 additional doctors and more than 10,600 additional nurses on our wards since May 2010." But the statement also acknowledged that "much more needs to be done", and said the government was "changing student nursing, midwifery and allied health professionals funding to create up to 10,000 more training places by the end of this Parliament." Danny Mortimer, the chief executive of NHS Employers, which covers NHS trusts in England and Wales, added that he was "deeply concerned" about the shortages, and said action to address nurse vacancies must be a priority. "Whilst measures such as increasing nursing training have been introduced, they take time to come to fruition," he added.

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