In view of the widespread nursing shortfall around the globe, nurses are packing up for foreign lands – particularly the UK – but many, though qualified, have been turned away because of their weak command of English.

Against a backdrop of depleting numbers of nursing staff entering UK from EU countries, senior managers and recruitment agencies warn that nursing shortage may exacerbate. Already, many are campaigning for regulators to lower the entry language score from 7 to 6.5. Around 3,000 nurses have signed a petition lobbying for the lowering of the rigorous test score.

A recent report by the healthcare staffing agency HCL Workforce Solutions felt the current language requirements were “unjustified”.

Across a sample of 14 NHS trusts, it is reported that failure to achieve the required score has led to as high as 50% of its approximate 2,000 nurses being either dropped out or been removed, since November 2014. Delays and repeat tests mean that these nurses need an average of one year between recruitment and deployment.

Recruitment managers call for a lower language entry bar

Recent statistics from the Institute of Employment Studies revealed that one in 10 NHS nursing positions are unfilled, with 13% of the workforce coming from overseas.

This dire state of nursing shortage has prompted the Nursing and Midwifery Council (NMC) to call for a board meeting to discuss this issue. The council is now gathering information concerning whether the tests should be made easier.

Initiating the campaign was Febin Cyriac, the managing partner of a UK healthcare recruitment firm. He said, “We’re turning away good candidates.”

According to Cyriac, many Indian, Filipino or Middle Eastern nurses come to the UK to do their masters in nursing.

“The nurse's language capacity is the same, but every test attempt produces a different score,” he said. “It doesn't mean they can't speak English.”

NHS trust senior managers have also called on the regulator to reduce the pass score. Following the rejection of 102 out of 104 NHS nurses based on their English skills – Jackie Daniel, chief executive of University Hospitals of Morecambe Bay NHS Foundation trust, has appealed to the NMC for a review of the system.

Daniel argued the NHS is too short-staffed to afford losing overseas nurses to countries such as the US and Canada, which accept a 6.5 pass rate.

“We need these applicants,” she said. “We are reaching a point in the road now where things are coming to a head in terms of workforce.”

Concerns over patient safety

While rallying for easier language requirements mounts on, there are some health professionals and administrators who are concerned that compromising standards could hinder patient safety.

“Communication is such an important part of healthcare, and it is already often where things go wrong,” said Joyce Robins from Patient Concern. “I don't think we can afford to take risks like this.”

Stephanie Aiken, deputy director of nursing at the Royal College of Nursing argued, “Whilst we welcome the review of the current requirements, clear communication is vital in nursing and so the NMC must make sure tests remain rigorous.”

Aiken expressed her view that lowering language requirements is not the answer, and that better pay and better working conditions are needed if the aim is to retain valuable staff and attract more people into the profession.

“As we leave the EU, the Government needs to focus on building a sustainable, home-grown workforce if it is to avoid the staffing crisis getting even worse.”

Andrea Jenkyns, a Conservative member of the Commons health select committee, is adamant that the existing language requirements for foreign nurses should stay.

“Sometimes life or death decisions need to be made and I would be concerned about the potential impact on patient safety,” she added.

No decision about any change in the rules, says NMC

An NMC spokesperson stressed on patient safety and said, “Our foremost consideration must always be the protection of patients and the public. And we will be gathering data and evidence to inform our consideration of whether any variation in either direction is needed to the current standards.”

“Patient safety is always our first priority and as such, the code requires all nurses and midwives to have the necessary command of English in order to practise safely and effectively.

“While we are aware of some concerns about our English language policy, we do not currently have any hard evidence on which to base a change,” he said. MIMS

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