Filipino nurses’ perspective of the clinical and language competency requirements for nursing registration in England: a qualitative exploration

Aim- To understand Filipino nurses’ experiences of the ‘Test of Competence’ process, alongside the additional competency requirements of their sponsor Trust. Background- The Philippines has been a significant and sustained source of foreign trained nurses to the UK over the past twenty years. Since October 2014, the Nursing and Midwifery Council has required that all non-UK nurses pass a ‘Test of Competence’ prior to acquiring registration. However, there is limited evidence exploring how overseas nurses experience this process and the tests which comprise it. Design- A qualitative study informed by pragmatism, using focus group discussions. Methods- Focus groups were held with pre-departure nurses in Manila, the Philippines and with post-arrival Filipino nurses in the Southeast of England. A total of 21 male and female Filipino nurses participated. Qualitative data were analysed using Reflexive Thematic Analysis. Results- Three themes were generated in relation to the competency process. Firstly, inappropriate preparation, Second, a competency/practice disparity and finally intergenerational and intra-professional support. Conclusion- Some aspects of the ‘Test of Competence’ process were seen as unnecessarily difficult, contradictory, repetitious and/or of little relevance to practice. Lack of support and insufficient information relating to how best prepare for the tests were mitigated to some extent by individual learning and informal support mechanisms. An evaluation of the impact that repeated changes to the Test of Competence process may have on the quality of support offered by NHS Trusts to overseas nurses is recommended.