Specialist Language Courses report examines NHS nurse recruitment

A report based on research conducted by Sussex Innovation has highlighted several issues with the English language standard that has been required of nurses joining the NHS from overseas over the past year. Research published by Specialist Language Courses (SLC), a leading technical, academic and business language training provider, suggests that the new measures may already be leading to increased nursing shortages.

Since 19th January 2016, all new registrants trained in the European Economic Area (EEA) now need to score 7.0 in the international IELTS Academic English language test. SLC’s researchers conducted in-depth interviews with senior professionals working across 9 NHS Trusts and 1 Welsh Health Board to discuss the impact of the changes. The findings have been published in a white paper available to download from the SLC website.

The IELTS test is an academic English test originally designed for students who wish to study in English speaking universities at either degree or postgraduate level. The score of 7.0 currently being asked of EEA-trained nurses is the same level of English required by overseas students to study at Oxford or Harvard University. In addition, the content of the test is often of little or no relevance to nursing, featuring subjects such as the rainforest and invader ants, or character creation in theatre productions.

The measures were brought in following a consultation by the Nursing and Midwifery Council (NMC) in summer 2015. The research report highlights that there was very little participation in the NMC consultation from NHS Trusts, and that at the time of this consultation, there was very little understanding of what IELTS consists of.

"Our researchers found little doubt that the IELTS standard is reducing numbers of both EEA-trained and non-EEA-trained nurses significantly and causing delays," said Chris Moore, SLC's Managing Director and author of the report. "This comes at a time when overseas recruitment remains vital to the future of the NHS, given the challenges Trusts face recruiting and retaining UK-trained nurses."

SLC outlined four key recommendations for NHS Trusts and the NMC as a result of the research:

1. Trusts should build their awareness of the test, what it consists of, what level is required to achieve 7.0, what skills candidates need to develop to score 7.0, and how they can acquire those skills. 

2. Due to its difficulty, there are very few nurses who can score 7.0 without considerable work on language awareness, test strategies and techniques. Trusts should therefore systematically adopt IELTS training programmes for nurses under offer, to be delivered by experienced IELTS teachers and examiners (not General English teachers) and under the direction of an organisation aware of the time and budget constraints experienced by NHS Trusts.

3. If ‘safe and effective’ practice is the key outcome of language testing, then the IELTS test should be either supplemented or replaced by a test that focuses explicitly on the language used by nurses at work. Rather than writing an academic essay, for example, nurses should be required to write a handover or case notes. 

4. The NMC should therefore review the language assessment regime as promised in the original consultation report of October 2015, with fresh input from Trusts affected as well as English Language training organisations with experience of working with overseas nurses. Such a review would work towards providing an assessment that enables international nurses to focus on learning the language they need to truly provide the excellent levels of care expected of them by patients, colleagues and employers.