Information for employers affected by the OET issue

OET is one of two English test providers which the NMC accepts as evidence for English language competency of internationally educated professionals.

OET recently informed us about malpractice concerns at one of its test sites in India.

From the initial analysis of data, OET informed us that this issue affects 45 professionals on our register and 59 applicants to the register.

Upon completion of their investigation at the end of March 2024, OET found an additional 25 registrants are affected by this issue, and an additional 9 applicants are affected.

This means a total of 70 registrants, and 68 applicants, are affected by this issue. 

OET’s investigation into the malpractice is still ongoing. We will be working with them to understand what happened at their test site in India.

OET has conducted a global investigation across all test centre to identity whether this malpractice has taken place anywhere else.

At the end of their investigation, OET reported that no cases of malpractice of this type have been identified at any test centre beyond the test centre in India.

OET will close the test site in India once all remaining booked tests have been taken.

While we're taking these concerns very seriously, we're also clear that the vast majority of internationally educated professionals on our register make a welcome and vital contribution to people's health and wellbeing in the UK.

The 70 professionals and 68 applicants impacted by these concerns represent a tiny fraction of the 55,429 nurses, midwives and nursing associates on our register who were educated in India.

OET have removed all the previous test centre staff, replaced them with new staff and will have auditors on site for all remaining tests. Once all tests booked have been taken, they will close the centre.

In line with our usual Fraudulent/Incorrect Entry process the NMC will contact employers directly if you employ someone on the register where there are concerns about OET malpractice.

Yes, we have contacted the registrants affected by this issue explaining our concerns, the regulatory approach we plan to take and the implications for them.

Registrants will be required to take another test or provide another form of evidence to reassure us as to their language competence. OET have offered to pay for any new tests.

Affected registrants are being asked to provide alternative language evidence to provide reassurance of language competence and to support our decision on whether to refer their case to an independence panel.

We have opened Fraudulent/Incorrect Entry cases for the affected professionals on our register. This means that we’ll now investigate the concerns raised about the individuals and then decide whether to refer the case to an independent panel.

Since OET have withdrawn these registrants’ test results, we will be requiring them to take another test or provide another form of evidence to reassure us as to their language competence. OET have offered to pay for any new tests.

We will keep employers informed about our regulatory processes that registrants or applicants go through and what the outcome of those processes are. We aim for an outcome to these processes within the next six months.

A registrant successfully passing one of our accepted English language tests will have demonstrated the necessary knowledge of English for registration. However, this does not mitigate against their alleged fraud.

Because there is suspected fraud, the matter would still require investigation and if appropriate, referral to an independent panel called an Investigating Committee. The Registrant will have the opportunity to provide evidence to the Investigating Committee who will consider the charge and make a decision about whether to allow the individual to remain on the register or to remove them from the register if they find concerns about an individual’s honesty and integrity.

We have written to all employers requesting relevant information about the registrants affected by this issue – this is to support our investigation and risk assessment process.

Where there are previous documented concerns about affected registrants' ability to communicate in English with people in the workplace (i.e., with patients, services users, family members and/or healthcare professionals), you should notify us.

When notifying us about English language concerns, please confirm the following information:

• the details of any incidents involving their ability to communicate in English, including but not limited to:
  • the date of the incident
  • what happened or didn’t happen
  • whether any harm was caused or if there was a risk of harm
• the details of any action the employer has taken to address concerns about their ability to communicate in English, e.g.:
  • if you’ve restricted their practice
  • supervision
  • further learning / training

You can contact us by email:

FtP-IEFETeam@nmc-uk.org

Local action will be a matter for employers following their own policies.

Employers may also want to consider what support they can offer registrants who are awaiting the outcome of the investigation.

If an employer has concerns about an individual’s competency that does not relate to OET’s notification of malpractice, please raise those concerns through our fitness to practice process as soon as possible if appropriate. Visit this webpage to find out more: Raise a concern as an employer - The Nursing and Midwifery Council (nmc.org.uk)

Employers can also speak with our Employer Link Service for advice about a potential referral. Visit this webpage to find out more: Working with us when managing concerns - The Nursing and Midwifery Council (nmc.org.uk)

We also offer a suite of referral guidance material, which can be found here: www.nmc.org.uk/employer-resource/

Our concerns relate to fraudulent or incorrect entry to our register. Fraudulent/Incorrect Entry cases look at how someone got onto the register, rather than a concern about a professional’s fitness to practise (FtP).

At present, no clinical concerns have been raised with us about the affected individuals on our register.

We apply multiple assurance checks to individuals applying to join our register, of which English language competency is one. All of those on our register will have subject to the following additional checks:

·       Sitting the computer-based test

·       Sitting the practical OSCE exam

·       In-person identity and documentation verification

Interim orders protect the public from risk by restricting or suspending a nurse, midwife or nursing associate’s practice while we investigate concerns about them.

As these individuals are already on the register and likely to be practising, we have conducted initial risk assessments of each registrant to determine whether we need to apply for an interim order or not. Any decision to apply for an interim order is based on the available evidence at the time, taking into account the our guidance on interim orders.

At present, the information does not support an application for interim orders for any of the registrants and no clinical concerns have been raised with us about the affected individuals on our register. However, further information is being sought from employers and OET and we will continue to proactively assess risk on receipt of any new information.

If through the process of investigating this issue, the Fraudulent/Incorrect Entry team consider there are  grounds to apply for an interim order, we will  do so at the earliest opportunity.

We have undertaken a regulatory risk assessment and will keep this under review.

Registrants will be asked to take an approved language test which we will use to help inform our risk assessment and any action required. A registrant successfully passing one of our approved tests does not however change the fact that they may have entered the register either incorrectly or fraudulently.  Because there is suspected fraud, the matter would still require investigation and if appropriate, referral to an independent panel, called an Investigating Committee. The Registrant will have the opportunity to provide evidence to the Investigating Committee who will consider the charge and make a decision about whether to allow the individual to remain on the register or remove them from the register.

If the Investigating Committee decides, having listened all of the evidence, that an entry was fraudulently obtained, they’re likely to direct the individual be removed from the register. The individual would have a right of appeal against this decision.

Alternatively, the if the Investigating Committee, having listened to all the evidence, considers that there’s no evidence of fraud, then providing the registrant has taken a new test or provided alternative language evidence, they will remain on the register.

Where we suspect that an individual in the application process has obtained their OET entry fraudulently, we will write to them explaining our concerns, the regulatory approach we plan to take and the implications for them once we have received a complete application.

We have told individuals that they must share this letter with their employer or sponsor.

You can ask applicants whether they have received that letter from the NMC and to share it with you. If you are unsure whether an individual has received this letter, you can contact a dedicated team at the NMC who will be able to confirm whether an individual has received a letter from us.

The email for that team is: FtP-IEFETeam@nmc-uk.org

We do not currently hold complete information on who is employing or sponsoring all applicants.

If you contact us with the names of individual(s) you have concerns about, we will be able to review this against our list of applicants affected and confirm this with you.

To do this, please email: FtP-IEFETeam@nmc-uk.org

You can then ask the individual to share a copy of the letter they have received from us which will contain all the information relevant to their case.

There are a number of affected people who are still in the process of applying to join our register.

Applicants will be required to take another test or provide new evidence of English language to reassure us as to their language competence before they can submit and progress their application. OET have offered to pay for any new tests.

Once complete, these applications will then be considered by our Assistant Registrars to provide an extra level of scrutiny to ensure the individual also meets our other requirements for registration.

The Assistant Registrar will need to consider whether an individual meets the character requirements of registration.  

Where we have concerns that somebody does not meet our health and character guidance, we can refuse entry to the register as part of our role in protecting the public.

We require applicants to take another test or provide another form of language evidence to meet the requirements for registration and complete their application. We will then consider any concerns about their character as part of a completed application.

An applicant successfully passing one of our approved English language tests allows them to meet the English language requirements for registration. However, this does not mitigate against their alleged fraud.

Because there is alleged fraud, once complete, the application will be referred to an Assistant Registrar to decide whether to allow the applicant onto the register.

The Assistant Registrar may refuse the application if they have concerns that someone has acted fraudulently or dishonestly and do not meet the character requirements for registration or the Assistant Registrar will accept the application if they feel the applicant meets our character requirements.

If applicants do not have a valid language certificate, then they do not have a complete application for us to consider. 

The Assistant Registrar will consider the completed application, evidence from OET, and any other information the applicant has provided to support their case to demonstrate that they meet the character requirements for registration. This may include an account from the applicant about what happened, any supporting statements from employers or other third parties, and any evidence to support their account of what occurred.

We have not yet made any decisions about whether someone will be able to join our register, so we do not expect you to take any direct action against individuals at this stage.  

However, you may wish to carry out your own local risk assessment.

OET have committed to paying for any new re-tests.

We accept the OET on Paper, OET on Computer, and OET@Home test. Anyone taking the OET should choose the Nursing examination from the list of OET Professions versions. 

OET recommend that the individuals affected by this issue take the OET on Computer for the fastest turnaround on test results.

Candidates must contact OET to book the free re-sit by 1 December 2024.  

For applicants and registrants to request an OET re-sit at no cost, they should email applications@oet.com.au. They must contact this email by 1 December 2024 to get a free re-sit of the OET.  

There are a range of resources on the NMC’s website about our English language requirements.

English language requirements - The Nursing and Midwifery Council (nmc.org.uk)

Fraudulent and incorrect entry cases look at how someone got onto the register, rather than a concern about a professional’s fitness to practise (FtP).

However fraudulent or incorrect entry cases are considered by an independent panel called the Investigating Committee. This is similar to how FtP concerns are sometimes heard by a panel.

If an independent panel finds, based on the evidence available, that someone on the register entered it fraudulently and removes them from the register, this decision will be published on our website in line with our publication guidance.

If an Assistant Registrar refuses an application to the NMC register, based on the evidence available, this will not be made public.

In both cases, the individual would be able to appeal the decision and seek to reapply to the register at a later date.

All affected registrants and applicants to the register have been notified of our regulatory approach and any implications for them.

In line with our usual Fraudulent/Incorrect Entry process the NMC has contacted employers directly if they employ someone on the register who is affected by this issue.

Employers or sponsors of applicants to the register can ask us to confirm whether someone they are currently employing or sponsoring is suspected of obtaining their OET results through malpractice. They can do this by contacting our team: FtP-IEFETeam@nmc-uk.org.

This will depend on the individual facts of each case.

Our concerns relate to fraudulent or incorrect entry to our register. Fraudulent and incorrect entry cases look at how someone got onto the register, rather than a concern about a professional’s fitness to practise (FtP).

However, we are considering all the details provided by OET and will carry out a full risk assessment once we have analysed this and any relevant information from employers.

If you would like to seek a review of our decision to not proceed with the case, please contact our Employer Link Service at employerlinkservice@nmc-uk.org.

If you have concerns about an individual’s competency that does not relate to the concerns of OET malpractice, please raise those concerns through our fitness to practice process as soon as possible if appropriate.

Visit this webpage to find out more: Raise a concern as an employer - The Nursing and Midwifery Council (nmc.org.uk)

Yes, we are following our regulatory processes as set out in out in the Nursing and Midwifery Council (Education, Registration and Registration Appeals) Rules 2004 and The Nursing and Midwifery Council (Fitness to Practise) Rules 2004.

We have provided guidance on the Fraudulent and Incorrect Entry process and for internationally educated registrants joining the register which can be found on our website.

The NMC is governed by legislation which sets out how our processes work and what approach we take to different scenarios, including the approach we take to Fraudulent/Incorrect Entry cases.

The legislation that governs the Fraudulent/Incorrect Entry process is the Nursing and Midwifery Order 2001 and the Nursing and Midwifery Council Fitness to Practise Rules 2004.