The action we’re taking following concerns about the Yunnik test centre

When internationally educated nursing and midwifery professionals wish to join the NMC register to practice in the UK, they must demonstrate to us that they have the skills, experience, and aptitude to meet our high standards of proficiency and conduct.  This includes passing a two-part test of competence (ToC): a computer-based test (CBT) that assesses their clinical and numeracy competency and is usually sat in their home country, and a practical test (OSCE) taken in the UK.

We notified all those who sat their CBT at the Yunnik site that we needed to look in more detail at this data and the concerns it raised. We also published a statement on our website. 

We have now completed our initial investigation. While the majority of the individuals who sat their CBT at the Yunnik centre are not considered to have joined our register fraudulently, we believe there is evidence of widespread fraud at the Yunnik site.

Steps we took to investigate

Firstly, we asked Pearson VUE to provide us with assurance that the data concerning tests taken at the Yunnik centre is accurate. Pearson VUE confirmed it is satisfied that there’s no evidence of system error, cyber-attack or other technical error, and that the data is indicative of one or more ‘proxy testers’ operating at Yunnik. 

We then asked an independent data analytics expert to provide an objective analysis of the data. They looked at the times CBT candidates at Yunnik took to achieve their pass, compared with times from other test centres in Nigeria and globally. This analysis clearly indicates that the overall pattern of test-taking at Yunnik is statistically significantly quicker.

What we’ve concluded

There is evidence of widespread fraudulent activity at the Yunnik centre, where we suspect some people fraudulently obtained their CBT, probably by use of a proxy tester, where someone takes the test on behalf of someone else. Overall, this means we cannot have confidence in any CBT result from this test centre and we’re treating all CBTs obtained at Yunnik as invalid.

It’s essential for the NMC to maintain the safety and integrity of the register, and the public’s trust and confidence in the professions we regulate. This means we need to assure ourselves that anyone on our register, or applying to join it, meets our proficiency standards. A valid CBT result is one way in which an internationally educated professional can demonstrate they meet these standards.

How does this affect professionals on the register?

Of the 515 professionals on the register, 48 achieved their score in a time we believe is more likely than not to indicate that they obtained their result fraudulently. We will refer each of these cases to an independent panel, called an Investigating Committee, to decide whether they gained fraudulent entry to the register.

In line with our existing policy, those individuals will be offered three opportunities to take a new CBT and will be able to give the Investigating Committee information about the circumstances in which they took the CBT at Yunnik, including any mitigating circumstances or character references. They’ll have the chance to attend a hearing to provide the Investigating Committee with evidence in person.

If the Investigating Committee decides that an individual’s entry to our register was fraudulently obtained, they’re likely to direct us to remove that individual from the register. An individual would have a right of appeal against this decision

What about others on the register?

Based on the evidence at this stage, we are not taking forward allegations of fraud for the remaining 467 professionals on the register who took their CBT at Yunnik.

However, because we are treating all CBTs from the Yunnik site as invalid, they will need to resit the test successfully to remain on our register. They will be offered three opportunities to do this, in line with our existing policy. This will enable them to evidence to any employer that they hold a CBT result about which there can be no doubt.

How are those still at the application stage impacted?

Of the 1440 people still at the application stage, there are 669 who passed in a time we believe is more likely than not to indicate that they obtained their result fraudulently. They will need to obtain a new CBT result to complete their application, which will then be passed to an Assistant Registrar to consider if they meet our character requirements for safe and effective practice. If an Assistant Registrar has concerns that someone has acted fraudulently or dishonestly, they may refuse the application.

Those individuals will have the opportunity to provide the Assistant Registrar with any written information about the circumstances in which they took their CBT at Yunnik, plus any other mitigating factors, character references or other information they wish to give.

And the remaining applicants?

Based on the evidence at this stage we are not considering fraud/dishonesty for the remaining 771 applicants. Providing that they resit the CBT successfully, and there are no concerns with other aspects of their application, their application can continue in the normal way towards registration.

What happens if someone doesn’t take or pass a retest?

Individuals have up to three retake attempts, which are free of charge with Pearson VUE covering the candidate exam fees. If somebody on the register declines to retake the CBT, or fails three retake attempts, we’d need to take further action on the basis that their entry to the register is incorrect. This would include referring their case to a panel of our Investigating Committee. If the Investigating Committee decide that without a valid CBT, the entry on the register is incorrect, they may direct us to remove the individual from our register.

If an applicant does not retake or fails three resits, then we’ll close their application and they will not be able to join the register.

We expect employers to support individuals to retake their retest.

Protecting against racism and discrimination

As an organisation committed to promoting diversity, equality and inclusion, we’re determined to work with our partners to eradicate all forms of discrimination in health and care. We know employers will be thinking of the potential for unfair and discriminatory behaviour towards individuals affected by the issues at Yunnik, as well as other internationally educated or ethnically diverse colleagues. That’s why we’re asking employers to be proactive and take any further steps they can to eradicate any unfair, racist or discriminatory behaviour from their workplaces. Each individual must continue to be treated with the dignity they have a right to expect at all times, by their employers, fellow professionals and people who use services.

We are now writing to all those professionals and applicants affected, explaining our findings and the specific nature of our concerns, and what this means for them. Within this we have provided information about booking a new CBT free of charge.

Andrea Sutcliffe, NMC Chief Executive and Registrar, said:

“We understand this continues to be a distressing time for people facing uncertainty about their application or place on our register. We're committed to managing these concerns in the safest and fairest way we can. It's been essential to look carefully at all the data and other information presented to us before deciding on the right and proportionate approach for everyone.

“Internationally educated nurses and midwives make an incredibly important contribution in our health and social care system. Our paramount concern remains to protect the public by maintaining the integrity of the register for nursing and midwifery professionals practising in the UK. That’s why we’ve responded to this situation with such painstaking care and consideration.

“We've kept employers and key partners, including trade unions and other support groups, updated while we've worked through this, encouraging them to support individuals affected and proactively tackle any incidents of racism or discrimination that may have arisen. We'll continue that dialogue while we move forward with this regulatory action, and I’m grateful for their collaboration and understanding.”

Matthew Poyiadgi, Vice President EMEA & Asia, Pearson VUE, said:

“Pearson VUE fully supports the NMC in the actions taken to uphold the integrity of the Test of Competency (ToC). It is of the utmost importance that high-stakes examinations such as the ToC ensure trust both in the outcome and in the candidate who has achieved the certification. For all testing companies, threats to test integrity are rapidly evolving and attempted proxy testing is an unfortunate, periodic occurrence. We conduct regular security checks at all our testing sites and employ cutting-edge technologies to detect any type of fraudulent activity.’’

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