interviews

Prompting competency

Nyla Cooper, programme lead on professional standards at NHS Employers, discusses the new guidance issued on language competency.

NHS Employers has been in negotiation with the European Commission (EC) unit responsible for the Department of Health for some time regarding language competency, with guidance developed in a variety of drafts over the last four years.

Issues around the new European Directive on the Recognition of Professional Qualifications has delayed earlier publication, but programme lead on professional standards Nyla Cooper stated that this guidance is based on existing legislation and is “not anything new”.

For political reasons, there is now a risk that the new directive will not come into force until 2014. Until this time, NHS Employers is seeking to ensure that all organisations across England are compliant with the current 2005/36/EC directive and has now published ‘Language competency: good practice guidance for employers’.

The new directive is far wider than just language testing, and covers the whole recognition of qualification, including restricting free movement throughout the member states and regulation issues.

Cooper said: “Language competency forms a very small but nevertheless very important part of the directive with regards to recognising other people’s qualifications as they move around from country to country. Because there isn’t firm legislation out there at the moment, this is good practice guidance rather than issuing any mandate to the NHS.”

Because the structure of the health service across countries is so different, there hasn’t been a consistency of language competency applications, making this difficult to measure. Cooper explained: “We wanted to ensure that there was consistency in England at least so that we could help organisations who weren’t quite meeting the requirements. The majority of them will do their own assessments, but this isn’t applied consistently.”

Protecting trusts

The guidance highlights the main frameworks for organisations to assess their language competency practices against, and seeks to reduce the inconsistency of medical professionals moving around England and finding different checks, giving the process “more validation”. This guidance is particularly key at a time when there’s been a “tightening of the whole process around patient safety with lots of media attention”, Cooper said.

She explained: “It was to make sure that we’re not leaving organisations vulnerable and they have the support from us that they need. We have a member section survey that we do every year which monitors what trusts need from us and this was one of the issues that they really wanted some steer on.”

In terms of feedback to the guidance, it is still early days, but Cooper stated: “It’s been very positively received; we’ve liaised with the professional regulators and had endorsement from them, and seen support from the key regulators.”

The document was published on February 27, and NHS Employers is allowing a period of time for the trusts to embed their recommendations. Online FAQs will manage any day-to-day operational issues that might arise from the guidance and this will be built upon depending on the types of enquiries that trusts raise.

For those who have not yet established firm protocols or for newly merged organisations in the NHS, there is an issue that trusts will need to pick this up “very quickly as part of safeguarding remits”, Cooper said, and acknowledged that there will probably be questions.

Prompt to action

However, language competency has been an issue for NHS bodies for a very long time, meaning that most organisations should only have to tighten up their processes rather than start from scratch. Newly formed organisations would have such checks embedded in their governance process.

Cooper said: “Certainly this is a prompt to revamp existing policies and practices that are in place or embed new ones to help them work more with the regulators with regards to raising issues.

“The risk is that there are organisations out there that are systematically checking language competency, which goes against the directive around free movement for EEA nationals.

“It’s less around bringing new policies in line to make sure that trusts are doing the checks, but to make sure that they’re assessing appropriately. This isn’t about testing; this is about measuring somebody’s competency to speak to their colleagues and patients alike. It’s about applying proportionate measures.

“The issue where the regulators test individuals for their language competency at the point of registration doesn’t give you any guarantee that that person can communicate in a work situation, such as on a ward, where there might be regional dialect issues, slang or terms that a foreign national wouldn’t understand.

“It’s about encompassing all of those things and rather than applying a systematic test, assessing the whole thing; whether they can speak, write and communicate and whether they understand the terms used in medical dialects, which can differ from country to country. It’s about measuring the competency around whether they can understand and work in normal environments within their member state country.”

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