Recently, hope has been shed on the issue regarding the understaffing in NHS (National Health Service). From a sudden drop application among nurses course to a high level of retirement since the eradication of student bursaries, a lot of nurses are leaving NHS rather than joining.

What’s more alarming here, according to the reports, is that there’s a sharp drop in the number of individuals applying to go and work under NHS from foreign countries. That is arguably associated with the difficult language tests that is exclusive for foreign nurses.

It has been documented that NHS has been suffering from staffing shortage of approximately 40,000 nurses and recruiters. With that, most NHS employers have been petitioning for looser language requirements to give thousands of nurses from different countries like Philippines, India, and Australia a chance to work in Britain.

Last June, The Observer revealed evidence stating that Australians along with other native-speaking nurses were being rejected for the reason they couldn’t pass the IELTS (International English Language Testing System) test. Because of that, the Nursing and Midwifery Council would consider a specific measure to enable other measures like Occupational English Test.

International English Language Testing System was a specially designed examination to assess the language ability of a non-native English speaker who needs to work or study in countries where English served as the medium used in communication. Employers and universities in countries including the USA, UK, New Zealand, Ireland, Canada, and Australia recognize it as a prerequisite for those who want to migrate, study, or work with them. It is a requirement every nurse must adhere to for the approval of the visa. In fact, almost 1.4 million individuals take this test each year.

This is administered by the joint effort of the IDP British Council: IELTS Australia, as well as Cambridge ESOL or ESOL Examinations University of Cambridge. IELTS follows the language assessment’s highest international standard.

What Does It Contain?

IELTS assesses four English macro skills: listening, speaking, reading, and writing. The examinee can take either the General Training or Academic version. General Training will be for individuals who wish to live or work in the said countries while the Academic version is taken by individuals who want to study or work for a specialized profession in the English-speaking communities.

The exam content will vary on the chosen version, but the speaking and listening section will be included in each and should be taken by each examiner.

The listening section contains 4 sections with 40 question that should be answered in 30 minutes. The sections might be a monologue or a dialogue, played only once and has increasing difficulty.

Speaking will be assessed through a one-on-one interview with a trained examiner for 15 minutes. It consists of three parts: an introduction and the interview, where it is the candidate's turn for speaking about a given topic within a minute or two, and the discussion in between that is thematically linked in the second part.

Reading questions contains 3 sections with 40 questions that should be answered within an hour. It consists of three sections that increase in difficulty. The writing’s allotted time will also be 60 minutes. Examinees must do a 2-part writing task. Each should be written with a different style.

The reading and writing questions will be different for the general training and academic versions. The exam will last for 2 hours and 45 minutes. Vocabulary and grammar tests that are IELTS relevant might also be included in the practice tests.

Scoring Procedure

IELTS scoring is band based which means none will be failed. But their performance will be rated in level 0 for the lowest and 9 for the highest. As an IELTS student, one should have a target level which will determine whether the student pass or fail the exam. Some countries such as Canada and New Zealand provide a standard level, which is usually between 6 and 7 for General Training to determine the passing rate of an examiner.

The case is, of course, different from the Academic category. A university or any higher educational institute usually set their own mandatory band, but each will be different depending on the given considerations. Some states such as the UK, United States, and Singapore currently set a required band scores for new students. Even though the tefl certification cost is not cheap, don't let that put you off. Typically, band scores for a bachelor’s degree will be 5.5-6 while for Master’s degree should be 6.5.

Last 2016, the government required that all public sector bodies would introduce strict exams for new employees. Cabinet Office minister Matthew Hancock declared that the tests are crucial to regulating immigration. He also emphasized that it is just for the benefits of those individuals who work hard. Due to that, NMC decided to bring in the IELTS exam; however, it resulted in a dramatic drop among foreign nurses applying in the UK. From 1,304 European nurses who registered last July 2016, this year it went down to 46 in April.

As such, recruitment firms like HCL told that most English-speaking nurses writhed with the written part of the IELTS exam, particularly the essay-based exam. The candidates need to obtain a minimum score of 7 out 9 in each of 4 sections.

Be that as it may, the NMS is still searching whether they should decrease the required minimum score or not.

The Campaign Against Rigorous Exams

Recruitment agencies and senior managers protested to regulators in reducing the pass rate. In fact, the NMC (otherwise known as Nursing and Midwifery Council), who is responsible for regulating over 680,000 midwives and nurses, is collecting information with regards to whether they need to alter the tests. These concerns were discussed at a certain board meeting. But still, some health executives are concerned that it might compromise standards which hinder patient’s safety.

As per the statistics from the Institute of Employment Studies last 2016, one out of ten NHS nursing position is vacant along with 13% of the workforce from the foreign countries. In connection with that, a petition to cut the pass rate from 7 to 6.5 out of a possible 9 were signed by not less than 3,599 nurses according to the report of Nursing Times.

For more information, the significance of fluency in the English language drew attention when David Gray died in 2008, right at the hands of Daniel Ubani, a German GP. The said physician had flown in to perform his first locum shift. He never encountered any examination, which evaluates his ability or competence to speak English fluently and provide the pensioner from the Cambridgeshire 10x the safe dosage of diamorphine.

Due to that incident, the laws have been stricter. However, repeated cases demonstrate mistakes still occur.

The Result of the Consultation on the Alterations

Due to the recruitment problem caused by difficult exams, NMC consulted several employers, unions, and chief nurses on whether they will use Occupational English Test instead of IELTS. OET is already utilized in Australia as well as examines the English language in a healthcare and nursing content rather than IELTS that has been critiqued for being too academic.

Additionally, the NMC has been considering modifying its rules to allow nurses who already have the training on pre-registration courses in English and those who already practiced for years in an English-native country don’t need to pass the IELTS anymore.

Good news, there’s a positive response in bringing OET as one of the options as per Emma Broadbent, the NMC director of registration. She said that because OET is still covered by health care setting, they are plenty of individual saying this would be helpful. These days, European Union nurses may not take IELTS if they practiced or trained in English; however, nurses from outside Euro need to pass the test.

Broadbent announced that both the aligning of the rules of EU, as well as non-EU nurses and introduction of OET, got a positive response during the consultation. They think that these are fair proposals, and they strongly believe that they are dealing with lack of harmonization problems. They have added these could be implemented with no public protection issues.