Nursing regulators have been implored to ensure that all nurses are "fully competent to deliver high-class care" following changes to the English language test requirements for nurses trained outside the UK.
The Nursing and Midwifery Council (NMC) announced changes to the test which mean nurses and midwives applying to join the UK register would be able to take the language assessment over two sittings rather than one.
The NMC said the amendments will "increase flexibility for applicants" but will ensure the appropriate standard for English language is still achieved.
Commenting on the changes, Katherine Murphy, chief executive of the Patients Association, said: "Many hundreds of nurses from other countries make a valuable and important contribution to healthcare in the UK.
"However, it is essential that the public have confidence that the nursing care they receive is safe and effective. The Nursing and Midwifery Council must ensure that all nurses are fully competent to deliver high-class care.
"We hear from patients on our Helpline that there are real issues with nurses from other countries, including problems with communication and a lack of understanding of processes and procedures.
"If the NHS does employ nurses from other countries, it must ensure that they are fully qualified and competent to carry out their duties and that they are competent enough in English to effectively communicate with patients. We are concerned that poor English skills may lead to mistakes and misunderstandings between healthcare colleagues or when patients are trying to explain their problems.
"It is essential that the Government increases the commissioned number of student nurses in order to ensure that hospitals are adequately staffed with competent nurses who can provide high quality care. The NHS must invest resources in the training-up and recruiting of nurses from within the UK, rather than embarking upon the costly recruitment of foreign nurses, who are often just a short-term measure to fill a gap."
Nurses will still have to earn a IELTS Academic Test Level seven in reading, writing, speaking and listening, the NMC said
NMC chief executive and registrar Jackie Smith said: "IELTS level seven provides us and the public with assurance that nurses and midwives applying to join the register from outside the UK meet the appropriate standard of English language required to work in the UK.
"We are mindful of the staffing pressures in the health service and after listening to feedback from stakeholders we have introduced changes to our process.
"We will continue to listen to feedback from nurses, midwives and their employers and assess any opportunities to introduce further flexibility."