Council to consider important English language proposals

Published on 21 September 2022

We’re asking our Council to approve two key changes to our requirements.

In September we announced that we will be taking forward changes to our English language requirements for applicants seeking to join the register from overseas.

We will start to implement these changes in the coming weeks. While changes are being embedded, we encourage applicants to continue with their applications.

Please register for our English Language requirement update emails to receive the latest information and be notified when the changes are made live.

Our Council will consider important changes to our English language requirements at its next meeting on 28 September. These aim to provide a fair and reliable approach to ensuring nursing and midwifery professionals can communicate safely and effectively in English. 

Our proposals follow an eight-week consultation that received more than 34,000 responses – a record for any NMC consultation in the last decade. We consulted on two areas. First, our approach to testing. Second, whether we should consider other evidence of English language competence.  

Our proposals 

Most people who responded to our consultation agreed with our proposals overall. There was strong agreement that a high level of English language proficiency is critical for effective communication between professionals, and the safety of those they care for. 

Currently most people from outside the UK who apply to join our register take one of our two English language tests: IELTS and OET. Testing will remain the main focus of our English language requirements in the future and we are also proposing to make some changes. 

After carefully considering the consultation responses, firstly we’re proposing to:  

  • standardise the minimum scores we accept when combining test scores across two test attempts, and extend the period for combining test scores from six to 12 months.  

Some people marginally miss the test score needed to join our register. This proposal will allow a bit more flexibility for people who need to resit a test, while maintaining the high standard of English language proficiency that the public has a right to expect.  

Secondly, we’re proposing to: 

  • enable employers to provide supporting evidence of English language proficiency. 

We plan to accept supporting evidence where an applicant has: 

  • trained in English in a country where English is not a majority spoken language; or 
  • narrowly missed passing the English language test. 

This proposal will allow employers to provide objective information and evidence to us about someone’s use of English in a health and social care setting in the UK, including evidence from interactions with people who use services. This proposal will provide greater flexibility for people who are already contributing to health and social care in the UK without affecting the high standard of English language skills needed to deliver safe, kind and effective care.   

We also consulted on whether to accept post-graduate qualifications taught and examined in English as supporting evidence. While there were similar levels of support for this proposal, the consultation raised some issues for us to consider further. Given the variety of post-graduate courses, these issues are more complex to address so we are not making a recommendation on this to Council at this point. We will do more work to decide whether it would be feasible and beneficial, and will return to Council with a recommendation at a later date. 

Next steps 

Subject to Council approval, we plan to prepare for implementation of the proposed changes from January 2023.  

Matthew McClelland, Executive Director of Strategy and Insight at the NMC, said: 

“I’m extremely grateful to everyone who took the time to respond to our consultation. 34,000 responses is an exceptional number and shows just how important it is to people that we get our English language requirements right. We’ve considered all responses thoroughly, and believe these proposals will ensure that our requirements are fair and reliable for everyone.  

“Internationally trained professionals make a vital contribution to safe, effective and kind nursing and midwifery across the UK. It is essential for public safety that nursing and midwifery professionals have effective English language skills and can communicate safely with each other and those they care for. 

“While we’ll look to bring in any approved proposals as quickly as possible, we can’t rush this process. It’s important that we bring in any changes in a kind, careful and considered way. We’ll continue to keep professionals, our stakeholders and partners updated moving forward.” 


Further information: 

  • Further details about the proposals for our English language requirements can be found in our latest Council papers.  
  • Information about why we reviewed our English language requirements can be found on our website. 
  • Our website also includes frequently asked questions about our English language requirements and why we decided to launch a consultation.  
  • Our English language consultation was run by Britain Thinks and lasted for eight weeks from 17 June until 12 August 2022. The survey received 34,064 responses. 
  • We developed our plans for the consultation using feedback from representatives of international applicants, employers, trade unions, test providers, educators, members of the public and professionals on our register who have direct experience of our processes.  
  • We worked with an external advisory group to develop plans for our consultation.  
  • The group includes representatives from international registrant and applicant groups, employers, trade unions, test providers, and registrants who have experience of our English language processes.  
  • The group’s membership reflects the UK’s four nations.  
  • We also talked to our Public Voice Forum to seek their views on our requirements.  
  • We developed this to understand the impact of our current requirements and potential policy changes on different groups with protected characteristics.  

About the NMC 

  • Our vision is safe, effective and kind nursing and midwifery that improves everyone’s health and wellbeing. As the independent regulator of more than 758,000 nursing and midwifery professionals, we have an important role to play in making this a reality. 
  • Our core role is to regulate. First, we promote high education and professional standards for nurses and midwives across the UK, and nursing associates in England. Second, we maintain the register of professionals eligible to practise. Third, we investigate concerns about nurses, midwives and nursing associates – something that affects less than one percent of professionals each year. We believe in giving professionals the chance to address concerns, but we’ll always take action when needed. 
  • To regulate well, we support our professions and the public. We create resources and guidance that are useful throughout people’s careers, helping them to deliver our standards in practice and address new challenges. We also support people involved in our investigations, and we’re increasing our visibility so people feel engaged and empowered to shape our work. 
  • Regulating and supporting our professions allows us to influence health and social care. We share intelligence from our regulatory activities and work with our partners to support workforce planning and sector-wide decision making. We use our voice to speak up for a healthy and inclusive working environment for our professions. 


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