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Nurses and midwives coming to Britain from the EU will now need to prove they are fluent in English, under new rules.

Until now, checks have only been applied to nurses outside the EU.

It means any nurse who is unable to show they have sufficient language skills will need to have an English language assessment.

The move by the Nursing and Midwifery Council brings the profession in line with doctors, who are already vetted in this way for patient safety.

The risk of a doctor not being fluent in English was highlighted by a lethal mistake made by Dr Daniel Ubani, a German doctor doing an out-of-hours shift who gave a lethal dose of a painkiller to patient David Gray in 2008.

As a German citizen he was able to register to work in the UK without passing a language test.

Language checks

NMC Chief Executive Jackie Smith said: "From now on all nurses and midwives applying to join the register from outside the UK, including the EU, will have to demonstrate they can communicate effectively to a high standard of English.

"The ability to communicate effectively with patients is fundamental to patient safety and a principle that is central to our code."

Tests will check listening, reading, writing and speaking fluency.

And if an allegation is made that a nurse or midwife already working in the UK does not meet the necessary English language skills, they could be investigated under fitness to practise rules.

The NMC has more than 690,000 nurses and midwives on its register. Around 66,000 of these come from non-EU countries and 33,000 from the EU.

The UK is looking to recruit more foreign nurses.

In October, the government temporarily lifted restrictions on recruiting nurses from overseas by adding the profession to its Shortage Occupation List.

This means nurses from outside the European Economic Area now have their applications prioritised.

The Department of Health said the move was designed to ease pressure on the NHS without having to rely on expensive agency staff.

Katherine Murphy of The Patients Association said: "Nurses from other countries make an extremely important contribution to healthcare in the UK. However, we hear from patients on our National Helpline that there can be real issues with some overseas health professionals; including problems with communication and a lack of understanding of processes and procedures.

"The Patients Association calls on all Trusts to ensure that their staff meet these new requirements, and that all overseas nurses have the necessary support and training to be able to offer patients safe and effective care."