Recommendation F172: Proficiency in the English language
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
The Government should consider urgently the introduction of a common requirement of proficiency in communication in the English language with patients and other persons providing healthcare to the standard required for a registered medical practitioner to assume professional responsibility for medical treatment of an English-speaking patient.
In brief (written by this site)
In September 2024 commentary published in February 2026, the Department of Health and Social Care and NHS England recorded the recommendation as implemented, stating that professional regulators, including the NMC and HCPC, have requirements in place to ensure English proficiency (DHSC and NHS England, Feb 2026). Earlier, in May 2024, the Thirlwall Inquiry legal team found that 2014 legal amendments had introduced language checks for European doctors where concerns arose, but noted that it was unclear what action had been taken in respect of other healthcare workers (The Thirlwall Inquiry legal team, May 2024).
AI-generated summary of the record on this page, checked by a second model and automatic checks, 26 Sep 2026. The record below is the sources' own words.
Government response
Accepted.
The Department of Health has been working with the General Medical Council to ensure that all doctors working in the UK have the necessary knowledge of English to treat patients safely.
Overseas doctors (non-EU) are currently required to demonstrate that they have the necessary language skills before they are registered with the General Medical Council. The Government wishes to ensure that all doctors (including EU nationals) working in the UK has the necessary knowledge of English to treat patients in a safe and competent manner and the Department of Health has been working with the General Medical Council to achieve this policy.
The Department of Health launched its consultation paper Language Controls for Doctors: Proposed Changes to the Medical Act 1983 on 7 September, seeking amendments to the Medical Act 1983. The proposals will give the General Medical Council the power to require evidence of English language capability as part of the licensing process where concerns about language have been identified during the registration process; and create a new category of impairment relating to the necessary knowledge of English, strengthening the General Medical Council’s ability to take fitness to practise action where concerns about language competence are identified.
Also, the new National Health Service (Performers List) (England) Regulations have been streamlined and will allow NHS England to nationally refuse to include a GP on its list where it is not satisfied that they have sufficient knowledge of the English language necessary to perform their work.
The initial focus has been on arrangements for doctors however, we are committed to ensuring all healthcare professionals coming to work in the UK can speak English well enough to communicate with patients. The revision of the Mutual Recognition of Professional Qualifications (MRPQ) Directive, which impacts on registrations from within the European Economic Area, clarifies that healthcare regulators, can undertake proportionate language controls on professionals following registration.
How this response relates to the recommendation
Site note: This is volume two of "Hard Truths: The Journey to Putting Patients First" (Cm 8777-II), the government's response to the Inquiry's 290 recommendations, published by the Department of Health on GOV.UK on 19 November 2013 and dated to that day here. The PDF the row links to is the accessible edition, whose title page reads "January 2014". The Department of Health has been the Department of Health and Social Care since January 2018. The volume says it includes accounts from each of the national organisations the recommendations name, but it does not mark which passage each organisation wrote, so every row is filed under the Department that published it.
Blanket government agreement does not establish acceptance or delivery by each addressee. Some response passages cover groups of recommendations.
Scope of the government response
Government responded via "Hard Truths: The Journey to Putting Patients First" (2014), a single document covering all 290 recommendations with a blanket acceptance. Individual recommendation responses were not broken out.
Delivery
DHSC and NHS England say completed (27 February 2026)
The Thirlwall Inquiry has noted action taken following the conclusion of the Inquiry.
Professional regulators have requirements in place to ensure English proficiency, including the NMC and HCPC.
Site note: DHSC and NHS England's own account of progress, supplied to the Thirlwall Inquiry in September 2024 and printed in the Inquiry legal team's Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025, published 27 February 2026). It is not a finding of the Inquiry. Their reviewed extent of implementation reads “Implemented – Closed”. Table row: section 18.2 No. 172, PDF page 508.
Department of Health and Social Care says in progress (11 February 2015)
In 2013 the General Medical Council consulted on the principle of ensuring that all licensed doctors have the necessary knowledge of English to practise safely in the UK. Following the consultation, which received strong support, new checks came into force on 25 June 2014. The changes will require doctors from other European countries to provide evidence of their English skills or undergo a language assessment, if the General Medical Council has concerns about his or her ability to communicate effectively with their patients.
The General Medical Council also announced in February 2014 that they are raising the scores for overseas doctors who take the International English Language Testing System test to demonstrate their English language skills, in light of the results of some research they commissioned. From June 2014, doctors will need to achieve an overall score of 7.5 out of 9 rather than the current score of 7. This change will help to ensure that patients are treated by doctors who can speak and communicate in English to a sufficiently high standard. They will continue to keep the score they require under review.
Site note: This is the supporting annex published on 11 February 2015 with "Culture change in the NHS: applying the lessons of the Francis Inquiries" (Cm 9009), attached to the GOV.UK page as "Culture change in the NHS supporting annex". The annex has no title page; that title is GOV.UK's and the PDF's own. Its table has four columns (No., Recommendation, Hard Truths Government response, Progress update), and the row carries the Progress update cell. No column says which organisation wrote an update, so the row is filed under the Department of Health (now the Department of Health and Social Care), which published it.
What other bodies have found
In their own words. These do not change the delivery statement above.
Thirlwall Inquiry legal team (15 May 2024)
This recommendation was accepted by the Government.
The Medical Act 1983 (Amendment) (Knowledge of English) Order 2014 introduced requirement to provide evidence of English language proficiency in relation to doctors from other European countries where concerns about language had been identified during the registration process (this was already a requirement in respect of other overseas doctors).
It is unclear what action, if any, was taken in respect of other healthcare workers.
Site note: The Thirlwall Inquiry legal team's own notes on implementation, from its Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024). The review does not colour its Extent of Implementation cell for this recommendation green; it leaves the cell uncoloured where a recommendation was rejected, where evidence of implementation was insufficient, or where steps had been taken but implementation was not yet complete. Table row: section 16.2 No. 172, PDF page 474-475.
Source
Responsible bodies
Themes and tags
Who has spoken
- Department of Health and Social Care
Response, delivery statement - DHSC and NHS England
Delivery statement - Thirlwall Inquiry legal team
Finding