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Foreign nurses excluded from the profession because of a “discriminatory” language test | Feeding with milk

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Thousands of qualified nurses recruited by the NHS from overseas are stuck in unskilled jobs due to unnecessarily difficult language tests, researchers say.

British national nurses who have lived in the UK for years are among those who find themselves in “regulatory limbo” because they cannot pass the language exams needed to register with the Nursing and Midwifery Council.

Nurses have already taken English proficiency exams and often have years of experience working with patients in the UK. Of 857 surveyed by the University of Salford, more than 600 had British nationality, which includes English tests, 79% had lived in the UK for over a decade and 17 had master’s degrees in nursing. But they cannot practice as nurses because they cannot take the OET or IELTS language exams, although in some cases they have an NHS employer to vouch for their language skills.

Jini Joy, 43, who arrived in the UK from India in 2007, said she spent £3,500 in 10 attempts on the OET exam, which is designed to assess the language skills of healthcare professionals . She passed the speaking and writing elements but struggled with the comprehension section, which requires candidates to read a text before answering 20 questions in 15 minutes.

She now works as an assistant practitioner in an NHS trust, dealing directly with patients. “We do almost exactly the same job as nurses, but for less pay. It’s not fair,” she said.

Critics say the exams demand an academic level of reading and writing that many native English speakers – who usually only need a C at GCSE – would be unable to achieve. They are calling for an overhaul of the NMC’s testing requirements, which they say are ‘discriminatory’ and exacerbating the UK’s nursing shortage by ignoring an ‘untapped doorway resource’. The NHS is currently short of around 40,000 nurses and is investing heavily in overseas recruitment.

Accept other proof of language skills – such as three years of work in a healthcare facility, an employer reference, and completion of a UK citizenship exams – could allow an additional 3,000 qualified nurses from India who are already in the UK to be added to the register, the researchers say, along with hundreds more from other countries, including Nigeria and the Philippines.

Dr Dilla Davis, senior lecturer in nursing at Salford, said the aim was not to ‘water down’ standards and that safety was paramount: ‘The question is, is it fair? When you look at a native speaker, what is their literacy level and reading age? For the average person, it’s not at the professorial level. But that’s what we ask of foreign nurses. She added that the tests did not take into account “cultural nuances of speech”, unlike practical assessments.

Currently, nurses recruited from abroad must pass the OSCE proficiency exam in English as well as the IELTS language exam, which can include questions on any subject, or the OET.

Nurse and researcher Dr Agimol Pradeep, liver transplant coordinator at King’s College Hospital, said many applicants were surprised by the reading section. In the OET, they can be asked questions about everything from cancer treatments to cannabis use or genomics. “These are not everyday topics,” she said.

Calls for reform are backed by high-profile figures including Andrew Foster, chairman of Manx Care in the Isle of Man, and Peter Mount, former chairman of the NHS Trust in Manchester, who jointly wrote to the Health Secretary , Sajid Javid, calling for urgent intervention.

They claim there are ‘elements of racism, discrimination and exploitation’ in the case, with nurses being wrongly ‘trapped in lower level roles’. “These are nurses who are considered good enough to provide safe care to patients in nursing homes, but who are barred from accessing registered nursing jobs and proper pay for very bad reasons. “, they wrote.

Mount told the Observer it was wrong that qualified nurses who had proven they spoke proficient English were barred from registration amid a critical shortage of nurses. “We don’t say for a moment, ‘Don’t take a language test. We say, “Give credit to the experience,” he said. “We have cases of nurses who have taken this 15, 16 times. Some gave up and went to work for Tesco.

The Nursing and Midwifery Council said it was reviewing its English requirements to ensure the approach was fair. It has set up an advisory group and scheduled a public consultation for the summer.

Matthew McClelland, Executive Director of Strategy, said: “It is essential that everyone who joins our registry can communicate well in English, regardless of where they trained.

“Nurses and midwives spend the most time with patients and service users, and effective communication is fundamental to high-quality, person-centred care.

“Over 17,500 professionals trained outside the UK joined our register in the 12 months to the end of September 2021 alone, and the vast majority of them passed one of the English tests.”