Specialist practice and services

Recent and future developments in abortion care continue to provide both challenges and opportunities for nurses practising at every level in this area of health care.

The development of designated roles to achieve this (for example, clinical nurse specialist, advanced nurse practitioner and consultant nurse roles) can shape local, regional and national practice in caring for women undergoing a termination of pregnancy.

All nurses and midwives have the opportunity to lead service provision and development while influencing change to improve services within the current legal framework.

Further information

• RCN Learn: Termination of pregnancy.
• RCN publication: Termination of Pregnancy and Abortion Care.
• RCN publication: RCN position on termination of pregnancy (induced abortion).
• RCN publication: Conscientious Objection - Termination of Pregnancy/Abortion Care.
• British Association of Abortion Care Providers website.
• Royal College of Obstetricians and Gynaecologists: Best Practice in Abortion.

Cervical screening (also referred to as a smear test) is an assessment to check the health of the cervix and help prevent cervical cancer. It can be carried out in primary care, acute services and some sexual health services.

Further information

• NHSCSP: National Health Service Cervical Screening Programme.
• NHS Screening Programmes: elearning for healthcare.
• RCN publication: Genital examination in women.
• RCN Position Statement on Nursing Associates and Cervical Screening.
• RCN publication: RCN Cervical Screening for Physically Disabled Women and Autistic Women.
• RCN publication: RCN Promoting Menstrual wellbeing.
• RCN Publication: RCN Human papillomavirus (HPV), Cervical Screening and cervical cancer.
• The Eve Appeal.

Contraception is used to prevent pregnancy, as management for other conditions such as polycystic ovary syndrome (PCOS) or heavy menstrual bleeding. Some contraceptive methods protect against certain sexually transmitted infections.

Contraceptive choice depends on an individual’s health, lifestyle and preferences. Consulting a health care provider is essential for choosing an appropriate option.

Contraception includes:

User-dependent methods: pills, patches, vaginal rings, male and female condoms, diaphragms and fertility awareness methods.

Long-acting reversible methods: intrauterine devices (implants and injections).

Surgical methods: sterilisation (tubal ligation and vasectomy).

Further information

• NHS: Contraception.
• The College of Sexual and Reproductive Health Care (CoSRH): Contraception choices.
• Sexual and Reproductive Health care – e-learning for healthcare.
• CoSRH: SRH Essentials for Primary Care.
• CoSRH: Essential Contraception for Abortion Care Providers.
• CoSRH Diploma (DCoSRH).
• Sexually Transmitted Infection Foundation (STI) Foundation Integrated Competency.
• CoSRH: Essential Contraception following Childbirth.
• RCN publication: Fertility Care and Emotional wellbeing.
• RCN publication: Male Factor Fertility.
• RCN publication: Advanced Practice in Fertility Nursing.

Preconception care is about optimising health and wellbeing before pregnancy to ensure the best possible outcomes for parents and newborns.

Formal education on preconception care is currently limited, creating a knowledge gap for health care providers. The RCN will address this with new preconception care guidelines due for publication in 2026.

These provide care and support for people experiencing gender dysphoria, offering psychological assessments, hormone therapy and support for social transition.

Further information

• RCGP eLearning module on gender bias in the context of assessment and management of pain in the primary care setting.

These are usually integrated health services that provide a comprehensive range of care related to sexual and reproductive health. This includes testing and treatment for sexually transmitted infections (STIs), HIV and other related conditions of the genitourinary tract, as well as contraception, emergency contraception and pregnancy testing.

A long-term condition (LTC) can be defined as a ‘health problem that requires ongoing management over a period of years or decades and cannot currently be cured but can be controlled with the use of medication and/or other therapies’ (NHS).

Diabetes, chronic heart disease, asthma, arthritis or COPD are among those conditions and would include HIV. From a sexual health and wellbeing perspective, it is important to understand the impact these conditions may have on a person's sexual wellbeing.

Some may require support to enable better sexual health, as well as to avoid sexually transmitted infections and related conditions.

Menopause is defined as the point in time when a person has not had a menstrual period for 12 consecutive months, due to a natural decline in reproductive hormones, particularly oestrogen.

It typically occurs between the ages of 45 and 55, with the average age in the UK being 51. Menopause can happen naturally or be triggered by medical treatments or surgery.

The experience is individual, and rare circumstances may occur earlier, requiring specialist care. Menopause is not usually abrupt (unless following a surgical intervention), but a gradual process during which women experience peri-menopause before reaching menopause (NICE).

Menopause affects most people’s lives, and all nursing teams must have a clear understanding of how it can vary across individuals and their families.

Further information

• RCN publication: Menopause RCN guidance.
• British Menopause Society (BMS).
• BMS: PPMC Resources Toolkit.
• The Menopause Course.
• BMS: Management of the Menopause Certificate.
• BMS: Advanced Certificate in the Principles and Practice of Menopause Care (PPMC).
• CoSRH: Essentials of Menopause Care.
• CoSRH: Menopause Care Professional Certificate.
  
  

These services provide care and support for individuals and couples with sexual issues. They combine clinical assessment, counselling and medical treatments to address physical and psychological factors that may be impacting their sexual wellbeing.

Further information

• Institute of Psychosexual Medicine: Training, learning and support.

These centres offer health, forensic, practical and emotional support to anyone who has been raped, sexually assaulted or abused.

Nursing career opportunities in these specialist services may not have been considered but can offer an opportunity to provide care and support to individuals.

The UK-wide forensic courses for nurses, midwives and paramedics are validated in accordance with the ASET (Advanced Standards for Education and Training) from the UK Association of Forensic Nurses and Paramedics (UKAFNP).

Further information

• Queen Margaret University, Scotland: Advanced Forensic Practitioners.
• NHS: Rape and sexual assault referral centres (SARC) in England.
• NHS Wales: Access a SARC in Wales.
• NHS Reform: Where to find support if you've been raped or sexually assaulted.
• NI Direct: The Rowan - Sexual Assault Referral Centre (SARC).