Analysis of training needs in a newly integrated Sexual Health Service (SHS).

Background: The integration of sexual health services has brought together two teams of nurses with differing skill sets, the Contraception and Sexual Health Nurses are highly skilled in contraception and the Genito-urinary Medicine Nurses are highly skilled in delivery Sexually Transmitted Infection care.  Integration of services requires that all nurses will be able to deliver both elements of care to patients attending services.  This is mandated by The Integrated Sexual Health Services: National Service Specification 2013, elements of which have been included in the commissioned services.  The specification includes;
•	Patients to receive their care in a “one stop shop.” 
•	Staff training should include accredited courses facilitated by BASHH and the FRSH.  
•	Key Performance Indicators that relate to the number of staff who are dual qualified.

Aim:  To identify the training needs of a newly integrated service in order to formulate a strategy which meets the training requirements of the team, whilst retaining high quality service delivery.  

Method: Nurses were identified by their nursing role, band, original speciality and their training needs.   Both the Head of Service and the individuals were questioned as to which competencies in Box 1 they currently held in order to establish the training needs of the service. 

Training for B6 nurses was considered as Essential; (that required to meet service specification) and Non Essential (that required in order to deliver a truly “one stop” holistic care package, or provide training to others).

Box 1. 

Essential 	Non Essential 
CASH Certificate 	
GUM  Certificate 	
Venepuncture 	
STIF +	
STI PGDS	
Contraception PGDS	
Implant  LOC
IUD LOC
	
	Prescriber 	
Cytology	
MI	
POCT	
PN
Mentor
Microscopy Skills 
Currettage
Cryotherapy










Results:
    
    


Questioning the staff identified that there were significant training needs and competency discrepancies across the nursing cadre.


Discussion:   The training needs analysis identified that Integration causes a significant training burden on SHS from a financial, organisational and workforce perspective.  The most significant deficit is that 100% of nurses do not have any formal GUM competency certificate.  Meeting integration training demands is likely to cause disruption to services and staff; resulting in additional stress, increasing sickness and staff turnover rates.   The training approach is based upon “quick wins” first targeting those B6 nurses as they made up the majority of the nursing workforce, many have, at least some level of competency with regard to delivering care in Level 2 Contraception and Sexual health services.  They spend most of their working week running clinics.  This approach should improve access for patients and enable the B6 nurses to be used in upskilling others.   B6 nurses considered “early adopters” were selected, as likely to have a positive effect on others.   The training needs analysis has been a useful tool to identify what the training demands are for the nursing team in order to deliver the contractual requirements.