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January 2018

Will a vocational English test prove the solution to overseas nurses’ woes?

Ielts teacher Warren Turner asks whether the Occupational English Test will answer the prayers of overseas nurses hoping to work in the UK.

 A recent decision to accept the Occupational English Test (OET) as proof of competence in English may come as welcome news for many overseas healthcare professionals hoping to work in the United Kingdom.

However, there are doubts over whether the new certification will be accessible or affordable for all would-be test-takers. Prior to the decision by the Nursing and Midwifery Council (NMC), nurses and midwives from outside the EU had the sole option of taking the Ielts Academic exam, with a requirement of an overall band 7.

The obligation on overseas health workers to take Ielts was in itself a relatively new development.

It came after former minister Matthew Hancock introduced new regulations that required ‘foreign nationals employed in customer-facing public sector roles … to speak a high standard of English’.

The difficulty involved in getting that crucial level 7 has come at a price for UK recruiters. Many promised jobs to workers from Europe, the Philippines and elsewhere on the understanding that they would attain the Ielts grade – only to find the actual uptake of jobs to be far lower.

To give a flavour of the problem, in July of this year Walsall Healthcare NHS Trust revealed that, of 100 Filipino nurses taken on the previous year following interviews in their home country, only three had arrived.

Rachel Overfield, director of nursing at the health authority, was unequivocal in her assessment. ‘The reason is we just can’t get them through the International English Language Test,’ she told a local newspaper.

Following a recent review by the NMC, native speakers, many of whom failed to reach level 7 in writing, are no longer required to take Ielts. Nurses who have worked for a period in English-speaking countries are also exempt.

However, Ielts continues to take its toll on those who arrived in the UK to work as hospital healthcare assistants with a view to joining the nursing staff once the test had been passed.

Ielts teachers report meeting experienced and qualified nurses who have endured months – in some cases even years – of frustration in narrowly missing out on level 7 time and time again, despite a high level of competence in communicative English.

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For frustrated healthcare assistants and hospitals facing staff shortages, the new pathway to language certification offered by the OET, effective from November, looks to be a huge lift. The exam body offers tests based on a dozen healthcare specialisms, including nursing, and it is widely expected that those put off by Ielts will find the new subject matter to be more engaging and motivating.

Nursing recruiters who responded to the NMC’s language consultation were almost unanimous in their support for the new exam, with one NHS trust director of nursing commenting, ‘It is more role-specific, and I feel would result in a higher pass rate.’

That said, the test is unlikely to provide a panacea for the health sector. The cost of taking the test – $587, or about £335 at current conversion rates – has been cited as a significant turn-off for some students. And despite the expected higher pass rate, there is no certainty, even for Ielts students who are tantalisingly close to achieving level 7.

As Janeen Gardiner of Cambridge Boxhill Language Assessment – owners and administrators of the OET – said, ‘It is not easier than Ielts, it’s different.’

Cambridge Boxhill Language Assessment is partially owned by Cambridge English Language Assessment, which is part of the Ielts syndicate.

Respondents to the NMC report also highlighted the fact that there are currently fewer test centres for the new exam than for Ielts. There are a large number of test centres in countries that supply nurses to Australia, for example the Philippines, which has nine. But there are few in Europe. Spain has only one test centre in the far-flung city of Santiago de Compostela. In the United Kingdom, just eight test centres across six towns and cities in England and Scotland were ready to receive test-takers in November. That left out the entirety of Northern Ireland and Wales, while the East and West Midlands were covered by just one test venue in somewhat out-of-the-way Melton Mowbray.

In defence of the OET, four new test centres are expected to open their doors in December and, as Ms Gardiner points out, ‘There are no waiting lists to take the test in any test locations.’ But would it be fair to say that, currently, there may not be enough accredited training centres and teachers to meet demand?
She pointed to the wealth of readily available online preparation materials, some free of charge, which are suitable for self-study. That is not to say that language teachers will find themselves missing out on work if nurses favour the new test over Ielts.

‘We believe that teachers will in fact have a greater role for preparation than with non-profession specific tests,’ Ms Gardiner said.

‘OET has introduced a training course for providers, the Preparation Provider Programme. It focuses on teachers moving away from test preparation courses that are aimed at test cramming or coaching in favour of courses which encourage the building of language skills and learning outcomes.’

That preparation course is, however, strictly limited to teachers affiliated to schools with OET accreditation, and requires fifty hours of online study.

Unfortunately, there may never be enough specialist teachers on hand to ensure that it delivers the expected higher pass rates.

Point of View

The acceptance of the Occupational English Test (OET) in the UK is clearly a very welcome move. Many nurses and midwives will surely find the content of the exam more engaging than that of Ielts Academic, although whether that results in higher pass rates in the long term remains to be seen.

There seems to be good news too for EFL teachers, who could find new opportunities for employment once they have gained accreditation status through the Preparation Provider Programme. One language school, Worcester-based Kingsway, is enthusiastically getting behind the new test as it prepares to become an authorised training and test centre. ‘We have seen so many nurses work so incredibly hard to achieve their Ielts results over the last eighteen months but still can’t quite reach that high academic level that the exam requires,’ said Kingsway’s marketing head Jane Carley.

‘OET will equip nurses with a much more appropriate language foundation and skill set to give them confidence in the workplace.’ Kingsway is cautiously optimistic of a high demand for courses in the coming months. ‘Initially we feel that there will be a big rush to get nurses enrolled onto a course,’ said Jane.

‘However, there will be others who may sit back and wait to see what results these initial courses achieve.’

A student of mine who has struggled with Ielts for some months wondered why the Nursing and Midwifery Council had not opted to accept the OET sooner.

This is arguably the biggest question to arise from the council’s change in language assessment policy.

And what of language teachers like myself? If overseas nurses favour the new exam in great numbers, will there be less demand for EFL and EAP teachers working in the health industry? Janeen Gardiner argues that the opposite is true. ‘We believe that teachers will in fact have a greater role for OET preparation than for non-profession-specific tests,’ she says.

Warren Turner works as a freelance EFL teacher and Ielts trainer.

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