Speech Therapists Need a Higher English Score Than Doctors
The HCPC asks IELTS 7.0 from fourteen professions and 8.0 from speech and language therapists. That is above the score the GMC asks of doctors.
Everybody assumes doctors face the hardest English requirement in British healthcare. They do not.
The HCPC asks speech and language therapists for IELTS 8.0 with nothing below 7.5. The GMC asks doctors for 7.5 with nothing below 7.0.
SpeakShark is free for the skill both of those numbers are mostly about, three AI conversation sessions a day with no card.
In this guide: the two bars · against the GMC · the OET gap · TOEFL rescaled · the other rules · why · preparing · limits · method · FAQ
Key takeaways
- HCPC standard: IELTS 7.0, nothing below 6.5, for fourteen professions.
- Speech and language therapists: IELTS 8.0, nothing below 7.5.
- The GMC asks doctors for 7.5 overall, 7.0 in each area.
- OET moves too: 1400 / 300 for most, 1800 / 400 for speech therapy.
- No at-home tests, no superscores, and the certificate must be under two years old.
One profession out of fifteen
The Health and Care Professions Council regulates fifteen professions: arts therapists, biomedical scientists, chiropodists and podiatrists, clinical scientists, dietitians, hearing aid dispensers, occupational therapists, operating department practitioners, orthoptists, paramedics, physiotherapists, practitioner psychologists, prosthetists and orthotists, radiographers, and speech and language therapists.
Its English page sets one requirement for fourteen of them and a separate one for the fifteenth.
| Applicant | IELTS overall | No element below |
|---|---|---|
| All professions except speech and language therapists | 7.0 | 6.5 |
| Speech and language therapists | 8.0 | 7.5 |
The HCPC accepts IELTS Academic and IELTS General, and both UKVI and non-UKVI versions, which is unusually flexible on the product and unusually strict on the number.
How that compares with doctors
The General Medical Council requires 7.5 overall with a minimum of 7.0 in each of the four areas, which we set out in the GMC requirement for doctors.
Put the three side by side.
| Regulator and applicant | Overall | Floor under each skill |
|---|---|---|
| GMC, doctors | 7.5 | 7.0 |
| HCPC, fourteen professions | 7.0 | 6.5 |
| HCPC, speech and language therapists | 8.0 | 7.5 |
| NMBI Ireland, nurses | 7.0 | 7.0 in any three, 6.5 in any one |
A speech and language therapist is asked for half a band more than a doctor on the overall score, and half a band more on the floor beneath every individual skill. The floor is the harder half. A candidate can carry a weak skill to 7.0 overall with strength elsewhere; a minimum of 7.5 in every area leaves nowhere to hide.
Ireland's nursing rule comes from Irish nursing English, and it is a third design again: the 6.5 can fall in whichever single component the candidate chooses, where the HCPC simply puts a floor under all four.
The OET numbers move too
The Occupational English Test is profession specific, and the HCPC accepts it for six of its fifteen professions.
| Profession | OET test | Minimum |
|---|---|---|
| Chiropodists and podiatrists | Podiatry | 1400, nothing below 300 |
| Dietitians | Dietary | 1400, nothing below 300 |
| Occupational therapists | Occupational therapy | 1400, nothing below 300 |
| Physiotherapists | Physiotherapy | 1400, nothing below 300 |
| Radiographers | Radiography | 1400, nothing below 300 |
| Speech and language therapists | Speech and language | 1800, nothing below 400 |
Two things follow. The speech therapy gap is not an IELTS quirk; it is carried across to a completely different test with a completely different scale, which is what makes it look deliberate rather than accidental.
And nine of the fifteen professions cannot use OET at all. A paramedic, a biomedical scientist, an arts therapist or a practitioner psychologist has IELTS or TOEFL and nothing else.
That is worth knowing before booking, because OET is the healthcare specific option most international applicants hear about first. The GMC accepts it for doctors and Ireland's nursing board accepts it for nurses. For most HCPC professions it is simply not on the list.
TOEFL was rescaled in January 2026
The HCPC page carries a dated change worth reading carefully.
Before 21 January 2026, the minimum was 100 out of 120 for most professions, and 118 out of 120 for speech and language therapists.
From 21 January 2026, new minimum scores are in place to align with TOEFL's updated scoring system:
| Section | Most professions | Speech and language therapists |
|---|---|---|
| Reading | 4.5 | 5.5 |
| Listening | 5 | 5.5 |
| Writing | 4.5 | 6 |
| Speaking | 5 | 6 |
| Overall | 5 | 6 |
The old speech therapy figure is the one to sit with. 118 out of 120 leaves a candidate two points of slack across an entire four skill exam. That is close to the ceiling of the instrument.
When a test rescales, the regulator has to republish. The same thing happened when LanguageCert replaced its ESOL SELT product in July 2025 and the Home Office announced a two year transition, which we covered in English certificates that expire and LanguageCert Academic against General SELT.
Three conditions that catch people out
No at-home tests. For IELTS, TOEFL and OET alike the HCPC states the test needs to be taken at an official test centre and not at home. That matches CGFNS, which refuses at-home versions outright, and differs from the GMC, which accepts OET@Home.
No TOEFL taken in the United Kingdom. The HCPC does not accept TOEFL scores when the test is taken in the UK. It is a geographic condition on the test rather than on the candidate, and it has an echo in the Home Office rule that splits approved providers by whether you are inside or outside the country, covered in the provider split by side of the border.
No combined scores, superscores or MyBest results. The score has to come from one sitting. There is one exception, and it is narrow: the HCPC accepts an IELTS one skill retake if the retake is done within six months of the original test and the retake results appear within the same test report alongside the original results. The retake carries the same two year validity as the original.
Why this profession
No published reason appears on the page, so what follows is our reading rather than HCPC policy.
For fourteen of these professions, English is the medium of the work. A radiographer explains a procedure, a paramedic takes a history, a biomedical scientist writes up a result. Communication has to be good enough not to cause harm.
For a speech and language therapist, English is the instrument of the work. The clinician is listening to another person's speech and language in order to assess it, and modelling target sounds and structures in order to treat it. A therapist who cannot hear a fine distinction cannot diagnose one, and a therapist whose own production is off cannot model one.
That reading also explains why the gap survives the change of test. A regulator that raised the number for one profession by accident would not carry it across to OET's completely different scale and to TOEFL's rescaled bands as well.
What this means in practice
- Check which of the fifteen professions you are, because the number changes.
- If you are a speech and language therapist, budget for 8.0 with a 7.5 floor, which is above the doctor's bar.
- Check whether OET is available for your profession before you plan around it. Nine of fifteen cannot use it.
- Do not book an at-home version of anything.
- Do not sit TOEFL in the UK if TOEFL is your route.
- Take the certificate age seriously. Under two years when the HCPC receives the application.
A floor of 7.5 under every skill is a speaking problem more than a reading problem, because speaking is the skill candidates least often have a way to practise daily. Role play scenarios and a daily speaking partner are the practical routes, testing your speaking level free shows the gap, and CEFR levels for speaking explains what those bands describe. IELTS for UKVI by CEFR level maps bands to levels, and what C2 actually means covers the territory an 8.0 sits in.
For how examiners mark spoken English, Cambridge speaking criteria by level and Interactive Communication work from real scored candidates. For other healthcare regulators, CELBAN for Canadian nurses and MET for United States nurse licensure show two more designs.
What we could not verify
We did not read the HCPC standards of proficiency. The scores come from the registration document page. Whether the standards themselves justify the speech therapy figure is a separate document we have not opened.
Our explanation of why the bar is higher is inference. The HCPC publishes the numbers and not the reasoning, and we have marked it as our reading.
We did not verify the TOEFL rescale from ETS. The 21 January 2026 change and both sets of scores are as the HCPC states them.
We did not check what OET 400 means as a grade. We report the numeric thresholds the HCPC publishes and have not mapped them onto OET's letter grades.
We did not read the standards for the other UK healthcare regulators beyond the GMC and NMBI pages already read in this series.
The page was updated on 13 June 2025 as shown on the HCPC site, and rules change. Check on the day it matters.
This is not registration or immigration advice. It is a reading of published requirements, linked below.
How we researched this guide
We reached this by counting rather than by reading in order. The HCPC English page states one requirement and then a second one, and it is easy to skim past the second as a footnote. Setting the two in a table makes it obvious that one profession out of fifteen carries a different rule.
The comparison that makes it a story came from outside the page. We already had the GMC figures from earlier work, and the moment both sit in the same table the ranking is the wrong way round from what anybody expects.
The confirmation came from the OET row. A single high IELTS number could be a drafting quirk. The same profession also carrying 1800 against 1400 on a different scale, and 118 out of 120 against 100 on a third, is a deliberate policy expressed three times.
We also counted the professions rather than trusting the summary. Fifteen regulated professions, six with an OET route, which means nine applicants in that list have two tests available and not three. That number is not stated anywhere; it comes from comparing the professions page against the OET table.
Practise speaking, from SpeakShark
SpeakShark is an AI English speaking practice app, and a floor under every skill is exactly the situation it suits.
An overall score can be rescued by strength somewhere else. A minimum of 7.5 in each of four areas cannot. Whichever skill is weakest is the one that decides the application, and for most candidates that is speaking, because it is the one with no obvious way to practise alone.
You talk, the AI answers what you actually said, and you get speaking feedback while the conversation is still running. The free tier gives basic feedback; the detailed pronunciation and grammar breakdown is on Premium.
Being straight about the limits: a free session runs five minutes with four turns, and we issue no certificates. We are not affiliated with the HCPC, IELTS, ETS or OET, and nothing here is clinical language training.
Start free with three sessions a day and no card. Paid sessions run ten minutes with unlimited turns. Limits are on the pricing page, and how it works walks through a session. Sign up here if a 7.5 floor is what stands between you and the register.
We are a speaking improvement tool. We are not an exam preparation provider, and we are not affiliated with Cambridge English, the IELTS partners, Pearson or any exam board. For test format, booking and official practice material, go to the exam body directly. Use SpeakShark to make your spoken English stronger, and use official material to learn the test.
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Sources
- HCPC, certificate of English language proficiency: the IELTS 7.0 with nothing below 6.5 standard, the 8.0 with nothing below 7.5 requirement for speech and language therapists, the OET table with 1400 and 300 for five professions and 1800 and 400 for speech and language therapy, the TOEFL scores before and from 21 January 2026, the refusal of at-home tests, of TOEFL taken in the UK and of combined, super or MyBest scores, the one skill retake conditions, and the two year certificate age
- HCPC, the professions we regulate: the fifteen regulated professions and their protected titles, used to establish how many have an OET route
- General Medical Council, using your IELTS certificate: the 7.5 overall and 7.0 per area requirement for doctors, used for comparison
- NMBI, English language requirements for applicants qualified outside the EU: the Irish nursing figures used for comparison
FAQ
What English score does the HCPC require?
Is that higher than the requirement for doctors?
Why is the bar higher for speech and language therapists?
What is the OET requirement for HCPC professions?
Does the HCPC accept a test taken at home?
How long is an HCPC English certificate valid?
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