Language experts are being drafted in to the NHS to assess the linguistic skills of Spanish nurses coming to work in the UK.

There have been concerns that some of the 400 Spanish nurses who have started work in the NHS over the last 15 months have found that, despite believing they had good English, they had difficulty talking to patients on the wards.

But they cannot be given language tests, as nurses from outside the European Union can, because that would contravene European laws of freedom of movement.

To combat the problem without breaking the rules, NHS representatives who travelled to Spain this week to assess potential recruits were accompanied by expert language assessors from Liverpool University.

That means they will, for the first time, be able to evaluate whether the standard of nurses' written and spoken language is good enough.

In November 2000, Health Secretary Alan Milburn agreed with the Spanish government that up to 5,000 of the country's nurses could eventually be employed in the NHS.

Language barriers

Trusts in the north-west of England, which employ 185 Spanish nurses have found it difficult to cope with the communication difficulties.

Karen Westwood, international recruitment co-ordinator in the region, told Nursing Times magazine: "The Department of Health's solicitors said we couldn't do formal English language testing so we have until now left the judgement up to NHS trusts.

"The feedback from trusts is that they are not qualified to make language assessments which is why we have now changed things."

Maggie Oldham, a nurse from Greater Manchester, said it was to be expected that language would be a problem as English was the Spanish nurses' second language.

She said: "Working with colleagues on the wards can be problematic because clinical areas are so pressured and language can create barriers."

Other hospitals have also reported problems.

A Department of Health spokesperson said nurses coming to work in the NHS had to be proficient in speaking, listening, reading and writing.

He said: "Employers are advised to consider carefully the level of language competency and communication skill necessary to do the job safely and effectively."