English language skills for EU and overseas midwives and nurses working in the UK: your views wanted

[RowanMumsnet]

Hello

We've been talking to the Nursing and Midwifery Council - the body that regulates nursing and midwifery in England and Wales - about our Postnatal Care Campaign. They are going to be writing a guest post soon for us outlining how Mumsnet users can feed in to a training curriculum review they're currently undertaking, but in the meantime they're seeking the views of service users on another developing issue.

The NMC currently requires all midwives and nurses recruited from overseas and the EU to be able to show they are competent in English. They can prove this language competence by taking an International English Language Testing System (IELTS) test. Currently, the NMC asks for a standard of 7.0 in each area – listening, reading, writing and speaking. Other medical regulators tend to have similar requirements, while the General Medical Council, which regulates doctors, requires overseas recruits to have a score of 7.5.

Because of a shortage of nursing and midwifery staff, there have been calls among some employers and agencies for the NMC to drop the required standard to 6.5. The NMC would like to find out what service users think.

So do please add any comments to this thread and we will pass them on to the NMC. If you have any queries, let us know and we will pass those on too.

More information on the IELTS test is available here, and more information about the process for registering midwives and nurses from outside the UK is here.

Thanks
MNHQ

NO absolutely not. I would actually want the nurses language test to be on a par with Doctors as theyre more likely to spend time with patients and need to understand everything a patient is saying not just the odd word here and there.

I think the NHS should spend more money recruiting students who may just miss out on gaining a place at University due to gaining grade D's rather than C's from the UK and offering them extra support. There's millions of reasons students don't quite get those grades on the day and discounting them all because they didn't quite make it is madness with such shortages.

Absolutely not. How can a midwife advocate for a woman if she can't communicate effectively?

How about instead of dropping language requirements in order to boost midwife and nursing numbers the government reinstate bursaries so people who want to train as midwives and nurses don't have to worry about student finance? Or some other incentive maybe? Just a thought!

I know a few people who scored 6.5 on the IELTS and they speak quite fluently.
Plenty of native English speakers couldn't get a 6.5 on the written part of that test. It's difficult.

Difficult to say without knowing what a 6.5 score looks like on that test, if as previous poster points out it's very challenging then that calls the validity of that test into question. My feeling (as a pregnant first-time mum-to-be) is that pregnancy and labour can feel like an intimidating and scary process at times so to me I want to feel reassured that my midwife/nurse understands me and that I can understand them so I won't have to worry about being understood and explaining things at a time when I feel vulnerable. Surely this standard should be in place for all NHS employees? And I say that as an NHS employee myself!

In fact the NMC regulates those professions in the whole U.K., Scotland and NI too. I wonder though if 6.5 might be adequate, as Girl says above.

And of course the test covers standard language, not local accents, dialects and vernacular, which can be a problem in pressured settings like health care.

Been to hospital over the past few years as a patient and visitor and the language abilities at times have been poor, so lowering the level of English would be a bad move.

I just watched the video of someone called Xin speaking at level 6 on the website. here
He was fluent and I could understand him totally. I also listened to the level 7.

Based on those, a level 6.5 would be absolutely fine for a nurse or midwife in my opinion.

6.5 is totally adequate. Many first language English speaking midwifes would not get level 7

I also had a look at the videos. If these people are speaking spontaneously and not in a prepared and rehearsed (controlled assessment style) exam, then a 6.5 sounds reasonable.

On the other hand, will somebody at this level be able to understand a woman in distress in a life threatening situation? I'm not so sure.

I don't think there should be a difference in level of language ability between midwives and doctors in this case. In less pressured environments the language requirements might be less crucial.

I found the level 6 and 7 fine to understand, the level 5 harder. But my hearing is OK and I'm used to different accents. I'm not sure my 70 year old mother would find it so easy. I know she has trouble with some health workers as it is. (I appreciate she isn't going to give birth anytime soon, but she does have contact with nurses )

I used to be a nurse and remember being horrified at the poor level of English spoken by some overseas entrants who had apparently passed the language element.
I'd much rather see nursing and midwifery afforded sufficient levels of respect and remuneration to attract the required numbers of native speakers into the profession.
I don't think the standard should be dropped.
(Realises she sounds like some pro Brexit, UKIP-voting bigot but really isn't!)

There is a significant difference between polished polite conversation, as shown in the video, and the degree of fluency needed to carry out a professional role reliably. I've seen nothing in the videos linked above that indicate the candidates could cope with the technical or colloquial language needed in health care.

Reducing the expected standards is not going to make a dent in the 95% drop in over seas applications and will only lower moral on wards when your colleague has poor verbal communication and you have to do all the talking.

If someone is serving me in a shop then this would be fine but I was in pain or needed complicated medical advice/treatment I'd want to speak to someone who was a native speaker.
Having to even ask this question explains all that is wrong in the NHS and many employers in U.K. these days who just don't want the expense of training the indigenous population so we have to recruit from abroad, give them a 1% pay rise which doesn't even keep pace with inflation and you wonder why retention of indigenous staff is difficult.
We need to train more nurses and midwives and not make them pay for this then we need to pay them a fair wage so they stay in U.K. then you won't have to ask this question

The standard of English required should not be dropped. I have been in NHS hospitals many times, both as an inpatient and as an out patient including to give birth, although not for some years. As I am a native English speaker I can usually understand what someone from another country is saying as I can differentiate between accents but I find that staff from different countries often don't understand eachother. I have also found that, although someone may understand what I say, they don't understand what I mean. This can all be very dispiriting when you are sick and vulnerable

No the standard of English should absolutely not be dropped.

Level 7 (or 6.5) is fine in an environment where the interaction is fairly calm and measured.

Less than that though in an environment where the people you are talking to are often in great pain, frightened and stressed is just not good enough. People tend to not speak as clearly under these circumstances and lowering the standard of English required is just asking for miscommunication. An accident waiting to happen.

That being said, I do think that there are other areas in the NHS where a level 6.5 would probably be acceptable. Midwifery (and A&E, for similar reasons) are most certainly not those areas.

I also wholly agree with pp about actually training and adequately paying our own medical staff so we don't have to import them. (and stop increasing the registration fee, it's bloody extortionate enough as it is!)

I'm a nurse on a busy surgical ward and I don't think they should go with the lower score. I can't understand what some nurses say and the patients definitely can't. This makes patients feel unsafe, communication is paramount.
Instead of shipping nurses in from other countries, GIVE UK NURSES PAY RISES and you will retain them and spend less on agency nurses and nurses from abroad!!

There is also the factor that many patients do not speak English well which complicates communication even more

I'm a nurse. I've worked with staff who have achieved the required level 7. However passing a test doesn't actually always translate into being able to manage to work in a medical field. I had one lovely colleague who passed but unfortunately the problem was he wasn't confident in his skills. He wouldn't even answer the phone because he couldn't understand the person on the other end! He was a liability rather than a help and eventually he left. Don't get me wrong, I have worked with many nurses who have moved to the UK who are excellent. My trust have recruited many nurses from abroad but hardly any of them stay past one year. I believe in the last recruitment we employed 50 new nurses, only one stayed beyond a year!

In my opinion, we won't improve recruitment by lowering the standards of who gets in but by offering a better wage, security and better working conditions. Unfortunately I don't this will happen until the conditions of Brexit are established and I dread to think what the nursing and midwifery professions will be like by then.

Definitely not.
I'm a nurse and on a Trust induction last year was in a group with the majority of nurses who had come over from another country. While their general English skills were relatively good, they knew almost NO medical terms!! We had to do a fake emergency situation and they didn't know enough to put a fake emergency call out which is quite frankly, dangerous and extremely worrying.

I am an IELTS teacher and examiner.

6.5 is very similar to 7 and both are more than adequate for virtually anything.

IELTS is an academic exam- mainly targetted at students who aim to study at university in an Anglophone country.

I would love many native speakers to achieve a 6.5 or a 7 in, for example, the listening or writing element of IELTS. It wouldn't happen.

I am actually quite shocked that nurses are expected to do IELTS, given what IELTS is actually for.

They would be far better doing an English Skills for Life type of qualification.

A 6.5/7 IELTS qualified person can write a bloody good analysis of 2 bar charts comparing crime rates in New Zealand over a period of 20 yrs- and can identify 4 different kinds of nutshell bite marks from various rodents from a listening comprehension.....

Understand a frightened patient in the throes of a cardiac arrest? Who knows...

I think confusion and confusing conversations plus misunderstandings occur at level 6.
Spoken is ok but the listening can reallly be not up to scratch and can cause terrible issues.
I work for a multi eu company and from my experience I would be pushing for a min level 7.
So many 'oh I thought you meant this' discussions. In medically intense situations there will be lots of chances for errors.
Perhaps in a low risk area then 6.5 is adequate.

There is so little difference between a 6.5 and a 7 the risk would be minimal. 6.5 is very upper intermediate, 7 is lower advanced.

The point that needs making is that IELTS is by and large completely irrelevant to what these people are doing.

Also worth pointing out that IELTS is only valid for 2 years.