Helen Donovan

Helen Donovan, Professional Lead for Public Health Nursing at the Royal College of Nursing (RCN), explains the new suite of resources for nurses working in sexual health, developed by RCN with the sexual health community, and why they are important.

Sexual health services have seen significant upheaval and transformation since the inception of the Health and Social Care Act in 2012. The move towards an integrated delivery of contraception and infection care under one roof is broadly welcomed. There have, however, been several unintended outcomes, particularly with the shift from NHS Commissioning to Local Authority Commissioning. Another was a workforce with incomplete skill sets for the new model of delivery.

The RCN report on ‘the impact of changes to public health spending on nurses working in sexual and reproductive health care’ (May 2018) followed a survey of nurses working in sexual health across many settings identified four key areas of concern: access to and availability of education and training at appropriate levels for nurses, the complexity of commissioning arrangements, workforce planning and skill mix between support staff and registered nurses, and the impact of current commissioning on services and users of services.

Nurses reported that there was a lack of understanding by service providers as to what level of education was or was not appropriate with no clear recognition of parity between courses. The lack of training for some nurses was being compounded by others being expected to duplicate training, all contributing to inefficient service delivery and confusion.  These issues were also clearly a factor across the UK.

As a result of this the RCN sought support from clinicians working across the UK alongside Health Education England (HEE), British Association Sexual Health and HIV (BASHH) and the Faculty of Sexual and Reproductive Health (FSRH) amongst others, to develop a suite of resources applicable to nurses working in sexual health in the UK. 

The resources incorporate: 

  • An education directory, which identifies the levels of education and development required for nurses and midwives in various areas of practice from entry level to advanced practice.
  • A career progression and development tool, to show how nurses can progress through the areas within the wider speciality of sexual health.
  • Two videos and a selection of career stories and case studies to demonstrate the speciality. 

The resources have been developed by nurses and midwives to support them to practice safely, deliver robust evidence based holistic clinical care so that people can be to be free from sexual ill health and lead happy and fulfilling sex lives.  They are intended to support individual practitioners alongside managers and commissioners to make sure there is a safe, trained effective and efficient workforce in order to deliver a holistic model of care. 

The directory, which is endorsed by BASHH, helps nursing and midwifery staff at all levels to work out and develop their training needs. It is split into the following sections and is relevant across England, Scotland Northern Ireland and Wales, unless stated:

  1. Education programmes for providing Sexual Health Services (SH) and Genitourinary Medicine (GUM) and HIV for entry level, intermediate and advanced registered nursing (RNs) level roles.
  2. Education requirements for providing Sexual and Reproductive Health services in Primary care. 
  3. Education programmes for Midwives and Nurses in working in abortion care. 
  4. Education programmes for Sexual Health Advisors (SHAs) who are also registered nurses. 
  5. Education requirements for Nursing Associates (NAs) [England Only].
  6. Education requirements for Health Care support Workers (HCWs).
  7. Cervical Cytology – Education training and skills requirement for all areas of practice.

We are calling for all service managers commissioners to use the tools to support service development and ensure workforce needs and education requirements are at the forefront of plans to ensure sustainable quality sexual health in the future.