Blog: We’re making changes to our English

language requirements
18.10.22
By Matthew McClelland Executive Director of Strategy and Insight

This blog was published on 18 October 2022. To get our most up to date advice please
visit our English language consultation hub (/registration/joining-the-register/english-
language-consultation/).

Clear and effective communication is key to achieving high-quality care and maintaining public
trust in the nursing and midwifery professions. As our register continues to grow, our role is to
make sure nurses, midwives, and nursing associates are equipped to deal with a wide range of
complex issues. It’s therefore essential that everyone joining our register can demonstrate good
English language skills. This means the public can have confidence those looking after them can
provide the safe, effective and kind care they have the right to expect.

We’re making some changes from 2023 so that we maintain our high standards and make sure
our processes are as fair and proportionate as possible. Firstly, we’ll be standardising the
minimum scores we accept when combining test scores and extending the period for this from
six to 12 months. Secondly, there are certain circumstances where applicants will be able to
provide supporting information from their employers as additional evidence of their English
language proficiency.

Why are we making these changes?

Last year, we heard from some people with concerns that there were skilled professionals
working in UK health and care who were demonstrating English language competence in
practice, but who were narrowly missing out on passing the tests we accept and therefore
couldn’t join our register.

We sought initial views from a wide range of partners and started building an evidence base for
change. This included hosting a roundtable event in November 2021 with employers, trade
unions, test providers, and people who had experiences with our English language processes.
We gathered a wide range of opinions and used these to develop proposals for change.

We consulted on our proposed changes and received more than 34,000 responses from the
public, professionals, employers, and our key partners. This was a record for any NMC
consultation in the last decade and showed just how important it is to people that we get this
piece of work right.

The consultation showed good levels of support for our proposals overall. Internationally
educated professionals, employers, other health and care professionals, and students tended to
be most supportive of the changes. UK educated professionals, educators, and the public were
more cautious, which reflects how important English language skills are to good communication
between colleagues and to safe, effective and kind care.

We considered all the feedback very carefully in the final proposals which were approved by the
Council in September 2022. We’ll be bringing these changes into effect from January 2023.
What do these changes mean for applicants?
Some internationally educated applicants have asked us what these changes mean for them. We
hope the explanations below will provide some clarity about what the changes will mean when
they come into effect next year. We’re finalising the implementation timetable at the moment
and will provide more detail on exactly when the changes will be in place as soon as we can.

Combining your test scores

English language testing is one of the main ways you can demonstrate your ability to
communicate well in English if you’re applying to join the NMC register. We currently accept two
language tests: the academic International English Language Test System (IELTS) and the
Occupational English Test (OET). There are four domains we test for and the required scores
have not changed.

Table 1: Current required scores for English language tests

If you don’t pass first time, you can resit and combine scores from two test certificates.
Currently, you can’t combine test scores if you achieve less than 6.5 (IELTS) or C+ / 300 or
above (OET) in any part of the test. As this is already the required score for writing, it means
there’s no flexibility for this part of the test.

From early 2023, this will change. You must still achieve the required test scores for each
domain. But to combine test scores, you’ll need to get no less than 0.5 (IELTS) or half a grade
(OET) below the required score for every domain. This means you'll be able to combine your
scores as long as you achieve 6 (IELTS) or C / 250 or above (OET) in writing, and 6.5 (IELTS) or
C+ / 300 or above (OET) in the other three domains. We call this the minimum score - it makes
sure you don’t score too far below the required mark in any test sitting.

This table sets out the new minimum scores accepted for each domain to combine your results.

Table 2: New minimum scores for each part of the test

To combine your scores, you must currently retake your test within six months of sitting the first
test. We’ll be extending this period to 12 months to allow for greater flexibility and more time to
prepare before retaking the test.

While you have the option to resit if you need to, we encourage you to prepare as much as
possible so you can pass your test first time around. There’s lots of guidance and support
available on the IELTS (https://www.ielts.org/for-test-takers/how-to-prepare) and OET
(https://www.occupationalenglishtest.org/preparation-portal/) websites.

These changes will provide greater flexibility if you don’t pass the test first time, without
compromising the high standard of English that is needed for safe, effective and kind care.
Until these changes come into effect, you’ll need to continue with English language testing
following our current requirements.

Supporting information from your employer

From 2023, we’ll accept supplementary supporting information from your employer that
demonstrates your ability to communicate effectively in English in a practice environment, if:

you narrowly miss out on a score in one of the four domains by 0.5 in the IELTS (6 for
writing and 6.5 in the other domains) or half a grade in the OET (C / 250 or above in
writing and C+ / 300 or above in the other domains); or

you were trained and assessed in English in a country where English is not a majority
spoken language.

You’ll need to have worked for your employer for a minimum of 12 months within the last two
years, in practice in a health and social care setting in the UK. To ensure consistency and avoid
bias, we’ll also be producing a standard NMC form for employers to complete. Your manager will
need to be an NMC registered professional and use this form to provide evidence of your
English language competence. A more senior NMC registered professional who’s working for
the same employer will also need to counter-sign it.

It’s important to note that while we’ll consider carefully supporting information from your
employer, we cannot guarantee that we’ll accept you onto the register.

When will these changes happen and what should you do in

the meantime?
We know many professionals want us to implement them as soon as possible. We’re working as
quickly as we can, but we can’t rush this process. It’s important that we bring in any changes in
a careful and considered way that maintains public safety and supports safe, effective and kind
care. This will happen from January 2023 at the earliest.

Until our new proposals come into effect, professionals looking to join our register will need to
continue their applications following our current requirements.

Thank you
It's taken a lot of hard work and collaboration to reach this point. We’d like to thank everyone
who’s contributed to this work so far, whether it be through our consultation, Public Voice
Forum, our engagement events, or as part of our external advisory group. Your views have been
invaluable, and we’ll continue to keep everyone updated with our next steps. We also look
forward to working with our partners and stakeholders over the coming months to finalise our
plans and make sure these changes are fair and proportionate.

Other recent news…

11.11.22
Joint letter from the NMC, Chief Nursing Officers and the CQC (/news/news-and-updates/joint-
letter-supporting-nurses/)

Read our joint letter with the UK’s Chief Nursing Officers and the CQC on how we’re supporting
professionals during the busy winter period.

03.11.22
New anti-racism resource for NHS nursing and midwifery professionals (/news/news-and-
updates/new-anti-racism-resource-for-nhs-nursing-and-midwifery-professionals/)

NHS England, in partnership with NHS Confederation and the NMC, has produced a new
resource that supports nursing and midwifery professionals working in the NHS

27.10.22
NMC seeks new Council Associates (/news/news-and-updates/nmc-seeks-new-council-associates/)

Our Council is looking for two new Associates to join us in early 2023

Regulate
Support
Influence
© The Nursing and Midwifery Council 2022