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Update on our English language requirements

12 Jun 2024

Tom Miller

Policy Manager

Between October 2023 and January 2024, we consulted on four proposals to update our English language requirements for international applicants, and we engaged with a range of stakeholders throughout this process.


The changes we proposed would apply to new applicants using our international registration route to join the register and would not change the level of English language proficiency we require. Instead, the changes would revise the types of evidence we will accept as proof of an applicant’s English language proficiency.

Why we are reviewing the requirements

The ability to communicate effectively in English is crucial to work as a health professional in the UK. Our role is to protect the public, and we are always looking to adapt or improve our regulatory systems and processes to ensure that remains the case. We are also committed to making sure that the way we do this is fair and proportionate to registrants and applicants who wish to join our register.

One recent area of this improvement work has been on our assessment of English language proficiency for international applicants who apply to join our register.

The consultation and our proposed changes

Our consultation included four proposals, and we also asked respondents to give us their view on our Equalities Impact Assessment (EIA) to make sure the impacts of any change on protected characteristics were fully thought through and mitigated where possible.

The proposals we consulted on were:

  1. That we no longer accept self-declaration of English as a first language as evidence of proficiency
  2. That we create a list of “qualifying” countries which are majority English speaking (with 75% of the population speaking English as the baseline). If an applicant had gained their primary qualification in one of these countries, we would accept this as evidence of their proficiency.
  3. That we accept evidence of registered work experience in one of the listed countries, or evidence of UK work experience that had been supervised by a registrant.
  4. That we expand our list of approved test providers (but make this list exhaustive).

While the consultation was underway, we carried out a programme of promotion and engagement in order to raise awareness of our consultation, especially with people and organisations who might be affected by the proposals.

Consultation outcome

We received over 500 responses, with more than 40 of these coming from our stakeholder organisations. We also commissioned the Patients Association to speak directly to service users and carers in focus groups, and we considered their report alongside responses to the consultation.

Overall, there was a broad agreement with the proposals when taken as a whole, and positivity about the direction they were taking.

Those responding the consultation supported each of our proposals in principle. Some areas require further work, for example on the 75% English speaking requirement for a country to be included on our list of “qualifying countries”, and the technical and process requirements for the proposal focussed on previous overseas registration or supervised UK work experience.

Next steps

In May 2024, the proposals were discussed at a meeting of our Council, where Council decided that we should take forward proposals 1, 2 and 4 as outlined in our consultation. Proposal 3 will be paused whilst we carry out some further research on the technical challenges to putting the proposal in place.

We now begin the work to implement proposals 1, 2 and 4. This work will require research and analysis to develop our qualifying countries list (proposal 2) and the development of criteria and a final list for approved tests (proposal 4).

We will also need to update our systems and processes to reflect these changes and ensure we provide a good service to applicants. This will include putting in place guidance and training for our teams and providing information for applicants about our new requirements.

We expect to begin bringing the proposals into force in either late 2024 or early 2025 and will make sure we provide information to applicants and other stakeholders as early as we can.

Thank you for your feedback

Thank you to everyone who responded to the consultation and gave us their thoughts, ideas, questions and support. We believe that, following the implementation of this work, the system in place will be fairer, clearer and more robust, and will ensure the public retains full confidence in all of the professionals on our register.

Visit the page below to view the consultation outcome document, EIA and the commissioned report from the Patients Association.

If you would like any further information about the current English language proficiency requirements, see our Certificate of English language proficiency page.

Please note that if you have queries about your individual circumstances or application, you should contact our International Registration team as usual. Information about how to get in contact with them can be found here

Page updated on: 12/06/2024
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