Foreign nurses who fail the English test can still be hired by NHS

Nurses and midwives trained abroad will be able to practice in the NHS even if they fail the English language tests under controversial new rules.

Campaigners warn that patients are at increased risk of harm after the Nursing and Midwifery Council (NMC) watered down its requirements.

The supervisor will currently only register employees trained abroad if they achieve a certain score on independently assessed reading, writing, listening and speaking exams. But they have agreed to admit those who marginally fail the grade if they receive a letter from an employer vouching for their English skills.

The NMC announced on social media that its committee approved the change last week, with the new rules taking effect from January.

This chart shows the country of education of all newly registered nurses and midwives in the UK over the past five years. Unsurprisingly, British-trained nurses make up the majority with around 120,000 carpenters. India (around 21,000), the Philippines (nearly 18,000) and Nigeria (nearly 5,000) are the largest providers of overseas-trained nurses and midwives registered to work in the UK

These graphs, based on NHS staffing data, show the proportion of doctors and nurses joining the NHS in England based on where they were originally trained. In both professions, the number of UK trained carpenters has decreased over time (red lines), while the number of non-EU trained professionals has increased (yellow lines)

It’s because the NHS has a critical shortage of more than 50,000 nurses and midwives, with one in ten nurse posts vacant. Health bosses are increasingly dependent on foreign recruitment to close dangerous roster gaps.

Peter Walsh, chief executive of Action Against Medical Accidents, said: ‘Good communication between health professionals is absolutely essential for patient safety.’

He added: ‘There is a risk that employers who are desperate for staff will be tempted to vouch for someone’s English in a less honest way, so that needs to be taken into account.’

The NMC is adjusting its policy after an eight-week consultation, which received more than 34,000 responses.

It says the new approach provides an “honest and trustworthy” system that ensures staff can communicate “safely and effectively.”

The regulator now accepts ‘supporting evidence’ when candidates have ‘barely missed the English language test’.

They must have worked in an unregulated health or care position, such as a health assistant, in the UK for at least one year in the past two years.

And their employer has to prove that they have the necessary level of English proficiency.

A spokesperson for the NMC said: ‘This proposal will allow employers to provide objective information… about a person’s use of English in a health and social care setting in the UK, including evidence from interactions with people using services. This proposal will provide greater flexibility for people already contributing to health and social care in the UK without compromising the high standard of English proficiency required to provide safe, friendly and effective care.”

The supervisor will currently only register employees trained abroad if they achieve a certain score on independently assessed reading, writing, listening and speaking exams. But they have agreed to admit those who marginally fail the grade if they receive a letter from an employer vouching for their English skills (stock image)

Some 23,444 nurses and midwives trained abroad joined the NMC registry last year, two-thirds of them from India and the Philippines.

Foreign-trained employees accounted for nearly half of all new entrants, and the number increased by 135 percent compared to the previous 12 months.

Of the top 20 countries recruited by the UK, four – Nigeria, Ghana, Nepal and Pakistan – were on the World Health Organization’s ‘red list’, indicating significant own deficits.

This means that trusts could not ‘actively recruit’ from these countries in accordance with the Ministry of Health’s code of conduct.

However, the code does not prevent individual professionals from seeking work independently.

Dennis Reed, director of Silver Voices, which campaigns for older Britons, said he would not feel “quite comfortable” being treated by a nurse who had failed the language exams.

He added: ‘We would like all our nurses to speak perfect English, but when there is such a shortage, some patients may rather see a nurse with poor English than no nurse at all.

“Some nursing jobs may not require such a command of English…it may be safer if they are only allowed to perform those with lower risks.”

NMC’s Matthew McClelland said: ‘Internationally trained professionals make a vital contribution to safe, effective and friendly nursing and obstetrics in the UK.

‘It is essential for public safety that nurses and midwives have good English language skills and can communicate safely.’

The Royal College of Nursing said it supported the change. The Royal College of Midwives did not respond to a request for comment.