Blog: We’re making changes to our English language requirements

Clear and effective communication is key to achieving high-quality care and maintaining public trust in the nursing and midwifery professions. As our register continues to grow, our role is to make sure nurses, midwives, and nursing associates are equipped to deal with a wide range of complex issues. It’s therefore essential that everyone joining our register can demonstrate good English language skills. This means the public can have confidence those looking after them can provide the safe, effective and kind care they have the right to expect.

We’re making some changes from 2023 so that we maintain our high standards and make sure our processes are as fair and proportionate as possible. Firstly, we’ll be standardising the minimum scores we accept when combining test scores across two tests and extending the period for this from six to 12 months. Secondly, there are certain circumstances where applicants will be able to provide supporting information from their employers as additional evidence of their English language proficiency.

Why are we making these changes?

Last year, we heard from some people with concerns that there were skilled professionals working in UK health and care who were demonstrating English language competence in practice, but who were narrowly missing out on passing the tests we accept and therefore couldn’t join our register.

We sought initial views from a wide range of partners and started building an evidence base for change. This included hosting a roundtable event in November 2021 with employers, trade unions, test providers, and people who had experiences with our English language processes. We gathered a wide range of opinions and used these to develop proposals for change.

We consulted on our proposed changes and received more than 34,000 responses from the public, professionals, employers, and our key partners. This was a record for any NMC consultation in the last decade and showed just how important it is to people that we get this piece of work right.

The consultation showed good levels of support for our proposals overall. Internationally educated professionals, employers, other health and care professionals, and students tended to be most supportive of the changes. UK educated professionals, educators, and the public were more cautious, which reflects how important English language skills are to good communication between colleagues and to safe, effective and kind care.

We considered all the feedback very carefully in the final proposals which were approved by the Council in September 2022. We’ll be bringing these changes into effect from January 2023.

What do these changes mean for applicants?

Some internationally educated applicants have asked us what these changes mean for them. We hope the explanations below will provide some clarity about what the changes will mean when they come into effect next year. We’re finalising the implementation timetable at the moment and will provide more detail on exactly when the changes will be in place as soon as we can.

Combining your test scores

English language testing is one of the main ways you can demonstrate your ability to communicate well in English if you’re applying to join the NMC register. We currently accept two language tests: the academic International English Language Test System (IELTS) and the Occupational English Test (OET). There are four domains we test for and the required scores have not changed.

Table 1: Current required scores for English language tests

If you don’t pass first time, you can resit and combine scores from two test certificates. Currently, you can’t combine test scores if you achieve less than 6.5 (IELTS) or C+ / 300 or above (OET) in any part of the test. As this is already the required score for writing, it means there’s no flexibility for this part of the test.

From early 2023, this will change. You must still achieve the required test scores for each domain. But to combine test scores across two tests, you’ll need to get no less than 0.5 (IELTS) or half a grade (OET) below the required score for every domain. This means you'll be able to combine your scores as long as you achieve 6 (IELTS) or C / 250 or above (OET) in writing, and 6.5 (IELTS) or C+ / 300 or above (OET) in the other three domains. We call this the minimum score - it makes sure you don’t score too far below the required mark in any test sitting.

This table sets out the new minimum scores accepted for each domain to combine your results.

Table 2: New minimum scores for each part of the test

To combine your scores, you must currently take your second test within six months of sitting the first test. We’ll be extending this period to 12 months to allow for greater flexibility and more time to prepare before retaking the test.

While you have the option to resit if you need to, we encourage you to prepare as much as possible so you can pass your test first time around. There’s lots of guidance and support available on the IELTS and OET websites.

These changes will provide greater flexibility if you don’t pass the test first time, without compromising the high standard of English that is needed for safe, effective and kind care.

Until these changes come into effect, you’ll need to continue with English language testing following our current requirements.

Supporting information from your employer

From 2023, we’ll accept supplementary supporting information from your employer that demonstrates your ability to communicate effectively in English in a practice environment, if:

• you narrowly miss out on a score in one of the four domains by 0.5 in the IELTS (6 for writing and 6.5 in the other domains) or half a grade in the OET (C / 250 or above in writing and C+ / 300 or above in the other domains); or
• you were trained and assessed in English in a country where English is not a majority spoken language.

You’ll need to have worked for your employer for a minimum of 12 months within the last two years, in practice in a health and social care setting in the UK. To ensure consistency and avoid bias, we’ll also be producing a standard NMC form for employers to complete. Your manager will need to be an NMC registered professional and use this form to provide evidence of your English language competence. A more senior NMC registered professional who’s working for the same employer will also need to counter-sign it.

It’s important to note that while we’ll consider carefully supporting information from your employer, we cannot guarantee that we’ll accept you onto the register.

When will these changes happen and what should you do in the meantime?

We know many professionals want us to implement them as soon as possible. We’re working as quickly as we can, but we can’t rush this process. It’s important that we bring in any changes in a careful and considered way that maintains public safety and supports safe, effective and kind care. This will happen from January 2023 at the earliest.

Until our new proposals come into effect, professionals looking to join our register will need to continue their applications following our current requirements.

Thank you

It's taken a lot of hard work and collaboration to reach this point. We’d like to thank everyone who’s contributed to this work so far, whether it be through our consultation, Public Voice Forum, our engagement events, or as part of our external advisory group. Your views have been invaluable, and we’ll continue to keep everyone updated with our next steps. We also look forward to working with our partners and stakeholders over the coming months to finalise our plans and make sure these changes are fair and proportionate.

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