Evidence submitted by the Faculty of Family
Planning and Reproductive Health Care (WP 98)
During 2005 the Faculty brought to the attention
of the Department of Health and the Minister for Public Health,
serious workforce deficits in community Sexual & Reproductive
Healthcare services. If these issues are not addressed as a matter
of priority, there is a serious risk of losing these specialist
services which currently provide a significant area of preventive
health care particularly to vulnerable and marginalised groups.
In addition, capacity within the NHS for training in contraception
and holistic sexual health care will be lost. The issues raised
were:
— There is a serious shortage of trained
medical specialists currently available to replace retiring service
leads in Community SRH services. This is due to a shortage of
national training numbers (NTNs) for sexual and reproductive healthcare
which has not been increased in line with workforce requirements
in the specialty. There is also considerable anxiety amongst trainees
intending to enter training programmes in SRH due to the possible
disappearance of SRH consultant posts in the community, as PCTs
are reducing services and not looking to replace retiring service
leads.
These trained specialists are essential if there
is an intention within national policy to provide specialist services
outside hospital as well as improve access to high quality sexual
and reproductive health services. The recommended national standard
is for one consultant per 125,000 population which is far from
the current position of around 100 consultants across the whole
of UK (Faculty workforce census 2003-04). An additional 343 WTE
consultants/specialists would be required to achieve the recommended
staffing level (HPA Report on Sexual Health 2006).
— Recruitment and retention of nurses
and speciality trained non-consultant doctors is a serious problem
in community services, due to the lack of a career structure and
training opportunities for both groups.
— The problems in medical recruitment
are a result of the rapidly increasing pay disparity between general
practice and community SRH services. The latter operate mainly
during unsocial hours which further compounds the recruitment
problem.
— Nurse members of the Faculty report
that training and development of the enhanced role of nurses in
SRH care in the community is ignored by many PCTs who focus only
on general practitioner development.
Dr Meera Kishen
President Faculty of Family Planning and Reproductive
Health Care
November 2006
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