English language requirements

There are three types of evidence that will satisfy us that you have the necessary knowledge of English to practise in the UK. If we are not satisfied with what you send us, we will ask you to provide an alternative type of evidence.

Evidence type 1: You have recently achieved the required score in the academic version of International English Language Testing System (IELTS) or the Occupational English Test (OET). You must achieve the required score in reading, writing, listening and speaking.

If you have taken the test at least twice and missed the required scores in any one of the domains by no more than half a grade, you may be able to use supporting information from your employer in health and care setting in the UK as supplementary evidence of clinical competence in English in that area. This is not a standalone evidence

Evidence type 2: You have completed a pre-registration nurse, midwife or nursing associate programme that was taught and examined in English.

If your pre registration programme was completed in a country that is currently not on NMC’s majority English speaking countries list, you can provide supporting information from your  employer in health and care setting in UK (SIFE) as supplementary evidence of clinical interaction in English with people who use services, their families, carers, and other healthcare professionals.

To use SIFE, you must have worked in an unregulated role in a health or care setting in the UK for at least 12 months full time or full time equivalent if working part time, at the point of submitting your registration application. This is not a standalone evidence

If you did not train in a country where English is a majority spoken language and  is not eligible to use SIFE, we’ll consider evidence that meets the criteria set out in our English Language guidance, but please be aware that it’s likely that you'll need to provide an alternative type of evidence such as a language test.

Evidence Type 3: Employer reference that you have recently practised for one year as a registered nurse, registered midwife or nursing associate in a country where country where English is a majority spoken language.

Please click here for more information

All applicants trained outside the UK will need to meet our English language requirements using one of the types of evidences as stated in our guidance irrespective of their nationality.

Please refer to the information available on our website for guidance on meeting our English language requirements

We accept Academic version of IELTS including UKVI and OET.

We will accept an IELTS Academic test result that confirms you achieved at least 7 for reading, listening, and speaking, and at least 6.5 for writing. If combining two tests, no scores in either of the two test sittings are below 6.5 for listening, reading, and speaking, or below 6 for writing.

If you have taken IELTS atleast twice and missed the required scores in any one of the domains by no more than half a grade, you may be able to use supporting information from your employer in health and care setting in the UK as supplementary evidence of clinical competence in English in that area. This is not a standalone evidence

To use SIFE, you must have worked in an unregulated role in a health or care setting in the UK for at least 12 months full time or full time equivalent if working part time, at the point of submitting your registration application. This is not a standalone evidence

Please see more information here. Our website also provides a handy online Test Combining Calculator which can be accessed here.

Please use the online test combining calculator available on our website

We will accept an OET test result that confirms you achieved at least grade B (350 or above) for reading, listening, and speaking, and at least grade C+ (300 or above) for writing. If combining two tests, no scores in either of the two test sittings are below grade C+ (300-340) for listening, reading, and speaking, or below grade C (250-290) for writing.

If you have taken OET at least twice and missed the required scores in any one of the domains by no more than half a grade, you may be able to use supporting information from your employer in health and care setting in UK as supplementary evidence of clinical competence in English in that area. This is not a standalone evidence

To use SIFE, you must have worked in an unregulated role in a health or care setting in the UK for at least 12 months full time or full time equivalent if working part time, at the point of submitting your registration application. This is not a standalone evidence

Please see more information about accepted tests here. Our website also provides a handy online Test Combining Calculator which can be accessed here.

Please refer to the table below:

Please use the online test combining calculator available on our website.

Both IELTS and OET are valid for two years from the test date.

Your test result needs to be valid when your application joins our assessment queue after you have successfully completed both parts of test of competence, submitted your registration application/ fee and we have received all documents including third party verifications.

If you are relying on two tests to meet our English language requirements, both tests need to be within the 2 year validity period when it reaches our assessment queue.

If you are retaking an IELTS or OET, we can only accept tests where you have retaken all modules.

Yes, we accept the Academic version of IELTS including UKVI.

As stated on British Council website, IELTS for UKVI tests are designed to meet specific administrative requirements outlined by the UK Home Office and are taken at a UKVI approved test centre. The actual test taken is the same as IELTS tests for all other purposes and includes the same: content, format, scoring and level of difficulty. Test Report Forms will be slightly different in order to show that you have taken the test at an UKVI approved test centre.

No, after careful consideration we have decided that we are not able to accept the IELTS indicator test at this time.

This is because the security measures for the indicator test are not comparable to those in place for the face-to-face test and do not meet the standards we require for registration.

Yes, we accept OET@home and OET on computer at a test venue in addition to OET on paper at a test venue.

Yes, you can combine these as OET has confirmed they are the same tests, with the same test tasks, difficulty, format, and timings. All tests will be marked according to the same assessment criteria.

From  27 May 2023, we will be accepting Supporting Information from Employers (SIFE) from the UK for those who have narrowly missed the required scores for IELTS and OET.

If you have taken the test at least twice and missed the required scores in any one of the domains by no more than half a grade, you may be able to use supporting information from your employer in health and care setting in the UK as supplementary evidence of clinical competence in English in that area. This is not a standalone evidence

To use SIFE, you must have worked in the UK with the same employer for least 12 months (or full time equivalent) at the point of application in a non-registered role in a health and care setting, at the point of submitting your registration application. This is not a standalone evidence

Please click here for more information on how you can meet our current English language requirements. Our website also provides a handy online Test Combining Calculator which can be accessed here

This test is currently not included in in our English Language policy.

NARIC/ECCTIS certificates are currently not included in our English Language policy.

Applicants who fall in the following two categories are eligible to use SIFE

• Those who completed their pre-registration nursing or midwifery programme in English but in a country where English is not a majority spoken language. Such applicants must provide evidence that their course was taught and examined in English.
• Those who missed the required score by 0.5 (IELTS) or half a grade (OET) in any one of the four language domains, as long as they had exhausted all test combining options.

To do this, you must have:

• worked in the UK, in a non-registered role in a health and care setting, with the same employer for the last 12 months or more (or full time equivalent if working part time) at the point you submit your application in a non-registered role in a health and care setting
• had the same line manager for at least 6 months (we will accept supporting information from up to two line managers to cover 12 months or full time equivalent)

Your line manager should be an NHS Band 6 (or non-NHS equivalent) or above to complete the form. This form also needs be countersigned by an NMC registrant who is an NHS Band 8a (or non-NHS equivalent) or above, to confirm the process has been fair and consistent.

Applicants who have not yet submitted their registration application will be able to nominate their employer to provide Supporting Information from Employers (SIFE) form via their NMC online account.

Applicants who have already submitted their application but are eligible to use SIFE will be contacted directly to offer this route after their submitted application has been assessed.

We will also continue to manually process the SIFE form from employers who have already been sent PDF version.

Applicants who submit their registration application after 27th May 2023, will be able to nominate their employer via their NMC online account. Employers will receive a link via their NMC online account to complete the reference.

For applicants who have already submitted their registration application, we will contact you directly if you meet our eligibility criteria for using SIFE after their submitted application has been assessed by an officer.

We will also continue to manually process the SIFE form from employers who have already been sent PDF version.

Your line manager will be asked to provide information via a link to NMC online to confirm direct experience of your English language competence in speaking and listening. Your line manager should be an NHS Band 6 (or non-NHS equivalent) or above. This information also needs be countersigned by an NMC registrant who is an NHS Band 8a (or non-NHS equivalent) or above, to confirm the process has been fair and consistent.     

If you submitted your registration application before 27 May 2023 you will not be able to nominate your manager via NMC Online for SIFE. The International Registration Team will contact such applicants directly if they meet our eligibility criteria for using SIFE after their submitted application has been assessed by an officer. We will also continue to manually process the SIFE form from employers who have already been sent the PDF version. 

Please log in to your NMC online portal and use the ‘click here’ option next to language RFI to resubmit your application. Please use the text box to add any additional information.

Please log in to your NMC online portal and use the ‘click here’ option next to language RFI to resubmit your application. Please use the text box to add any additional information.

NMC’s list of countries accepted as majority English speaking is available to view on our website . This is broadly based on a list defined by the UK Border Agency.

Applicants can choose ‘Practice in English/ Recent Practice’ if they have practiced in a majority English speaking country as a registered nurse or midwife.

SIFE is not a standalone route for providing English language evidence. This can be used as supplementary evidence by applicants who are taught and examined in English, but from a country that is not on our list of majority English language speaking countries.

We have several measures in place to ensure that SIFE is not used fraudulently. In addition to the line manager providing SIFE, we also require a counter-signatory at the same employer to oversee the process. Both of these people must be NMC registrants. We only accept the manual version of the SIFE form from named applicants and the move to using NMC Online gives us even more assurance over the process. 

Our colleagues will continue to monitor all SIFE applications that we receive, both individually and for trends. If we identify anything suspicious, we will investigate thoroughly and, if necessary, act in line with our regulatory role. If we identify fraudulent activity, we can take steps to promote learning, prevent issues arising again and use our fitness to practise processes if we identify that a registrant may have been involved. We are also able to take action if we identify that a non-registrant is involved and holding themselves out to be a registered professional when this is not the case. 

Applicants to our register should not be asked for payment or any other additional conditions linked to their SIFE form. If this happens, please contact overseas.enquiries@nmc-uk.org so we can investigate this further. 

If you have already paid someone or undertaken any other conditions to obtain SIFE, please notify us, using the email address above.  

If you don’t currently have 12 months employment in a health and care setting in UK, you are not eligible to use SIFE as supplementary option.

Please click here for more information on how you can meet our current English language requirements

Most applicants provide us with straightforward evidence that they meet the requirements via their NMC Online application. However, if we need to make a decision about whether an applicant has met our English language requirements we’ll look at our Decision making guidance.