English Language Requirements

International flags

Employers are responsible for ensuring all staff have the required level of English language skills to undertake their role effectively and deliver safe care to patients.

Regulated healthcare professionals who are recruited from overseas need to pass a level of language competency as part of the requirements for professional regulation before they can practice in the UK. This then allows them to communicate effectively with their colleagues and patients.

There are two main language tests available which are taken by overseas candidates who wish to work in the NHS and attain their professional registration. These are the Occupational English Testing (OET) and the International English Language Testing System (IELTS).

You can find a useful cross-mapping reference tool for IELTS and OET in Appendix 4 of our language competency guidance. This includes a list of the language levels required for the different regulatory bodies.

Please be aware of the current challenges around face-to-face support and test centres due to COVID-19 For the latest guidance on IELTS and test centres, please see on the IELTS website

IELTS has introduced an IELTS Indicator, which is an online test aimed to help students progress their language skills during this time of uncertainty. Although, professional regulators are not accepting the test as evidence of an applicant’s English language, we encourage you to explore whether this might support your candidates develop their language skills if your recruits are eligible for this. 

Administration of the Occupational English Test (OET) meanwhile, is resuming throughout the UK. Please go to the OET website for the most up-to-date information on test venues which are open.

If you are an NHS trust or health board and have candidates who would like to sit OET on your premises please follow the link to register your interest.

How much preparation is required

The length of preparation an individual will require for OET or IELTS will depend on the following:

  • their current level of English
  • their commitment to regular study
  • any previous English language test-taking experiences.

International English Language Testing System (IELTS)

IELTS is a universally recognised and long-standing international test of English language proficiency. IELTS measures language ability of people who wish to study and/or work where English is the main language of communication.

 Who is the test for? Everyone wishing to study or work where English language is required  
 What does it test? Reading, writing, listening and speaking
Can it be used for UK Visas and Immigration? Yes
Can it be used for professional registration? Yes, a full list of professional regulatory bodies can be found on the IELTS website
Cost per test Between £160 - £200 dependent on the test centre
Where can the test be taken? IELTS is widely available in more than 1200 locations worldwide with 65 test centres in the UK. Details of these test centres and dates can be found on the IELTS website

Supporting candidates to pass IELTS

There are different ways employers can support candidates to prepare for IELTS, by signposting to resources and materials or creating a tailored support plan for individual or organisational requirements. Support materials available include:

  • Sample test questions to help candidates familiarise themselves with the test and experience the different types of questions they will be asked.
  • Preparation courses which can be purchased and delivered by local IELTS test centres to assist students.
  • An IELTS progress check consisting of an online official IELTS practice test, marked by IELTS trained and qualified markers, including a full feedback report.
  • A detailed explanation of the test, highlighting its format and a breakdown of marking criteria and sub-score categories.

Occupational English Test (OET)

The Occupational English Test is an international English language test designed specifically for the healthcare sector. It assesses the language communication skills of healthcare professionals who wish to register and practise in an English-speaking environment. From 1 October 2019, OET will also be accepted by the Home Office for individuals entering the UK on a Tier 2 visa. 

Who is the test for?    It is specifically designed for healthcare professionals
What does it test?  Reading, writing, listening and speaking using real healthcare communication scenarios
Can it be used for UK Visas and Immigration?  Yes, from 1 October 2019.
Can it be used for professional registration?  Yes, a full list of professional regulatory bodies who accept the test can be found on the OET website
Cost per test 587 AUD (approximately £336.55 depending on exchange rates)
Where can the test be taken? OET is available at more than 140 venues in 40+ countries. Details of these and available test dates can be found on the OET website

Supporting candidates to pass OET

There are several ways you can help your overseas candidates prepare to pass OET which includes signposting individuals to lots of free and paid-for resources.

  • A preparation portal, which includes sample tests to help candidates familiarise themselves with the different types of questions they will be asked to take under test conditions.
  • A free Start for Success package of videos, lessons, sample answers, guides and more.
  • Daily preparation resources and test tips plus live Q&A sessions twice each month on OET’s official Facebook page.
  • Online OET Masterclasses for expert advice on all four sub-tests.
  • Two-hour taster online preparation course.
  • Practice books in print or digital versions which are sub-categorised based on the field of practice, available from Amazon. Follow the links from the OET shop to be sure you are buying the official OET resources.
  • 'Living the Language - a nurses' guide to English usage in British life and work' was also launched by OET in September 2020. This includes guidance for patient communication and common challenges such as local accents and dialects, person-centred care and active listening. It also includes tips on every day use of British English and help with settling into professional cultures. 

Why Register?

Great reasons to register with NHS Employers

  • A personalised website
    Manage your profile and select topics of interest to you
  • Access your dashboard
    Bookmark useful content to help you quickly find what you're looking for
  • Get involved
    Contribute to our Talking Points discussions, comment on and rate our webpages
  • Keep up to date
    Receive the latest newsletters and media summaries

Log In