Figures released last week by The Health Foundation painted a pretty bleak picture of the impact of Brexit on the NHS - they told us that EU nurses registering to work in the UK had fallen by 96% since June 2016. To the naked eye, you would think there was no way out of this dismal hole we have found ourselves in, at least in the short term.
To deliver an NHS that provides for patients and is financially sustainable, it is an unavoidable necessity that the system recruits staff from abroad, whether from the EU or further afield. There are staffing shortages right across the workforce but arguably nursing sits top of the pile.
This week's news is particularly concerning - we rely on nurses in all parts of the system to deliver the high quality and attentive care we need at the time of our greatest need. The idea that nurses from around the world, but in particular the EU given recent events, would be turned off from coming to the UK to fill vital workforce gaps is worrying. But is this really the true picture?
As the Chief Executive of a staffing provider to the NHS, of which nurses make up a sizable portion of our provision, we have evidence that suggests that this Brexit uncertainty view is misplaced. Whilst it is true that EU nursing registrations with the NMC have fallen to a worryingly low level, our data suggests that this is not through a lack of trying. In fact, HCL's registration data suggests more EU nurses have registered an interest in working in the UK in the year following the referendum than the year before.
So why is there a gap between registered interest and full NMC registrations for EU nurses?
The truth is that the introduction of IELTS, the prequalifying English language test, for EU nationals in 2016, has been the number one issue preventing suitably qualified nurses applying for NMC registration. HCL published a report in May that outlined this issue and was supported anonymously by 14 NHS trusts who provided data and testimony, who all share the same view: the Academic IELTS is not fit for the purpose of vetting international nurses to work in the NHS.
Trusts and bodies such as the British Council acknowledge this too. From our conversations with trusts it is clear that despite approving candidates for jobs through their interview process, these nurses are then failing the Academic IELTS, and therefore not being employed in the system. This has little to do with Brexit uncertainty. A UK-based nurse has to achieve a grade C in GCSE English in order to train and practice and although there is limited understanding of how this compares to the Academic IELTS level 7, anecdotally it seems to be a mismatch. Indeed, IELTS' own website confirms that the average overall score for native English speakers is 6.9 - lower than what is being demanded of overseas nurses.
From data that was featured in our latest report looking at the matter, if an average score of 7 was required rather than a minimum score of 7 across each individual testing criteria, 340 out of the 694 HCL candidates that have previously failed the IELTS would have passed and currently be working in our NHS.
We wholly support stringent vetting on staff to ensure they have the relevant skills and competencies to be working in the NHS, but we firmly believe the current Academic IELTS standard is not fit for this purpose and the NMC should look at switching to an average required score or from Academic to General IELTS testing.
The publicity conjured up as a result of The Health Foundation's Freedom of Information Request to the NMC serves an important purpose - it exposes the dramatic change that has taken place over the last year, but crucially it must play a role in encouraging the NMC to look in depth at the real reasons why this has happened and seek to implement changes that will relieve the pressure.