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Nursing workforce—fit for practice: an overview of the RCN education and training directory
  1. Jodie Roy Walker-Haywood1,
  2. Belinda Loftus2
  1. 1 Umbrella Sexual Health Service, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  2. 2 Sexual Health Service, Spectrum Community Health CIC, Wakefield, UK
  1. Correspondence to Jodie Roy Walker-Haywood, Umbrella Sexual Health Service, University Hospitals Birmingham NHS Foundation Trust, Birmingham B4 6DH, UK; jodiewh_82{at}

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In October 2019, the UK Government responded to the Health and Social Care Committee report on sexual health. The response focused on five key areas; a new national strategy, funding and commission, services, prevention and workforce.

The section on workforce acknowledged that the fragmentation of commissioning services has had a direct impact on the development and training of staff. Its recommendation is that the new national strategy will consider workforce issues by working with appropriate organisations. A highlight within the response is the recent work undertaken by the Royal College of Nursing, funded by Health Education England to develop a training directory highlighting training and qualification requirements for registered nurses, midwives, health advisers and nursing associates as well as unregistered healthcare support staff working in sexual health.

The mandate for the work on the Directory came from the Royal College of Nursing (RCN report on ‘the impact of changes to public health spending on nurses working in sexual and reproductive healthcare . Published in May 2018 the report identified four key themes: access to and availability of education and training at appropriate levels for nurses; complexity of commissioning arrangements; workforce planning and skill mix between support staff and registered nurses; and 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.

The pressures faced by sexual health services since the move of budgets to hard-pressed local authorities has left nurses feeling unsupported, with their training needs unmet. While the main focus was on the changes to services following the health and social care act in England, feedback from members in the devolved nations showed that the issues were of concern across the UK. Changes to services and reductions in funding have affected the services they provide.

The RCN have developed a suite of resources, by establishing a professional UK-wide working group directly involved in sexual healthcare and nurse education, to support those working in these services:

An 'education directory', a 'professional development tool', videos and career stories to support sexual health career progression for nurses and midwives. To aid what levels of education and training staff need in integrated sexual health through to support workers and those working in other services which may have a sexual health component in their role such as midwives working in termination services or practice nurses delivering contraception.

The resources will support individual nurses, managers and commissioners to make sure there is a safe, trained, effective and efficient workforce in order to deliver a holistic model of care that contributes to good patient and public health outcomes. It is also useful to support the writing of job descriptions and ensuring equity and parity across newly amalgamated workforces and service delivery in all areas. Ultimately we all work with people who are having sex, and the holistic model of care ensures people are free from sexual ill-health and are supported to lead happy and fulfilling sex lives.

The aim of these resources is to support staff, provide clarity and ensure that nurses are able to practice safely, and deliver robust evidence-based holistic clinical care while meeting the expectations of their medical colleagues, managers and/or commissioners.

The new resources will help promote the specialism to nurses and direct them to the career development they need.

Nursing staff, for the first time in sexual health, at all levels from healthcare support workers, to nursing associates, through to advanced practitioners, can work out and develop their training needs in one place.

The directory, the key element of the resources and endorsed by BASHH, is split into the following sections:

Part 1: Education programmes for providing sexual health services and genitourinary medicine and HIV for entry-level, intermediate and advanced registered nursing level roles.

Part 2: Education requirements for providing sexual and reproductive health services in primary care.

Part 3: Education programmes for midwives and nurses in working in abortion care.

Part 4: Education programmes for sexual health advisers who are also registered nurses.

Part 5: Education requirements for nursing associates.

Part 6: Education requirements for healthcare support workers.

Part 7: Cervical cytology—education training and skills requirement for all areas of practice across England, Scotland Northern Ireland and Wales.

RCN public health resource for sexual health:

Section on:


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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.