GUEST COLUMN: Will English language relaxation help ease nursing crisis?

Anne Morris

Immigration solicitor Anne Morris updates on recently-announced concessions to the NMC pre-registration process for foreign nurses, and asks if the changes go far enough to help care providers access overseas nursing talent.

With the UK health and social care sector facing nursing shortages to the tune of 40,000, and Brexit impacting the UK’s attractiveness to EU nurses, care home providers are increasingly looking overseas to meet their nursing staff needs.

To do this, the care home must first apply to the Home Office for a sponsor licence, and nurses from outside the European Economic Area must first pass the three-stage NMC pre-registration process.

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In basic terms, the pre-registration process can be summarised as follows:

  1. English Language Requirement
  2. Competence (CBT) Assessment
  3. Objective Structured Clinical Examination (OSCE) Test

NMC pre-registration process: unfit for practice?

While the focus of the pre-registration process should sit squarely on maintaining patient care standards, it is the arbitrary nature of parts of the format that have attracted criticism from care provider employers, foreign nurse applicants, unions and recruiters as being unfit for purpose.

The language requirement in particular has drawn much of the critique. All non-EEA national applicants prior to November 2017 had to sit ‘IELTS’ – including those from English speaking countries (think for example, Australia).

However, IELTS is notoriously difficult to pass, too difficult many say, deeming it overly ‘academic’.

The result is care providers have not been able to access sufficient numbers of foreign nurses who are willing and able to work in the UK at a time when their contribution is critical to solving shortages in qualified nursing staff.

NMC’s welcome concession
Following years of campaigning by care sector employers, chief nurses and unions, the NMC conceded by announcing the Occupational English Test (OET) is being introduced as an alternative choice to IELTS with effect from 1 November 2017.

OET is already used in Australia, New Zealand and Singapore to assess English language ability specifically in a nursing and healthcare context.

The downside is that OET is more expensive than IELTS, potentially out-pricing applicants.

In addition, the new rules also allow non-EEA nurses from English speaking countries to submit evidence of their language ability from relevant qualifications or previous successful applications, removing the need for further assessment.

Good, but must try harder!
After the language requirement, the next hurdle is completion of the OSCE within a strict eight-month period. By this stage, care homes will have spent thousands of pounds only to have to cease the sponsorship at eight months if the nurse fails the OSCE.

Applicants should be supported through the process. A new environment, settling family into schools, supporting spouses into new employment – all are considerations the Home Office must realise can impact applicant performance.

While lobbying may lead to process improvements, care homes in the meantime have to make the most of the status quo. Which means playing their part, investing more time after these Tier 2 nurses arrive in the UK to ensure they are geared up to the task.

We will continue our dialogue with the NMC and Home Office, voicing the concerns of our care provider clients to achieve the balance between maintaining standards in patient safety without the need for arbitrary, out of touch requirements in assessing much-needed skilled talent.

Anne Morris is Managing Director of immigration solicitors, DavidsonMorris. Anne can be contacted on, 020 7494 0118

Tags : Legal AdviceNMCNursingRecruitmentTraining

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