Exploring the Future of Sexual Health Advising: A National Scoping Exercise

Why Sexual Health Advisers Matter

SHAs play a critical role in delivering safe, effective, and patient-centred sexual health care. Their work extends far beyond partner notification and contact tracing, encompassing HIV prevention and support, safeguarding, psychosocial assessment, behavioural interventions, complex case management, and service navigation.

As sexual health services continue to evolve, the contribution of SHAs has become increasingly important. Growing rates of sexually transmitted infections (STIs), expanding prevention programmes such as PrEP and DoxyPEP, and increasing safeguarding responsibilities all require skilled professionals who can support individuals through often complex care pathways.

A Workforce That Looks Different Across the Country

Despite the importance of the role, there is currently no standard model for how Sexual Health Advisers are deployed across UK services.

Variation exists in areas including:

• Role definitions and scope of practice
• Workforce structures and banding arrangements
• Integration within multidisciplinary teams
• Involvement in prevention, safeguarding, outreach, and clinical pathways
• Commissioning requirements and service specifications

These differences have largely developed through local commissioning decisions, workforce pressures, and changing service demands rather than a coordinated national approach.

Addressing a Critical Knowledge Gap

One of the key challenges facing the profession is the lack of a comprehensive national overview of Sexual Health Adviser models.

Currently, there is limited information available on:

• How SHA services are configured across different organisations
• Which workforce models deliver the best outcomes
• Whether variations impact quality, safety, efficiency, or equity of access

Without this intelligence, opportunities to improve and strengthen services may be missed.

The Proposed Scoping Exercise

To address this gap, a national scoping exercise has been proposed to map and analyse Sexual Health Adviser workforce models across UK integrated sexual health services.

The exercise will seek to understand how SHAs are currently deployed, the range of responsibilities they undertake, and how they contribute to patient outcomes and service delivery.

Key objectives include:

• Mapping workforce structures, staffing models, and skill mix
• Assessing the scope of clinical and non-clinical practice
• Exploring integration within multidisciplinary teams and care pathways
• Identifying challenges, risks, and workforce pressures
• Showcasing innovative and effective models of care
• Informing future recommendations for workforce development and commissioning

Gathering Evidence from Across the UK

The project is expected to use a mixed-methods approach, combining quantitative and qualitative data to build a comprehensive picture of current practice.

Proposed methods include:

• A national survey of sexual health services
• Engagement with Sexual Health Advisers, clinical leads, managers, and commissioners
• Case studies highlighting different service models
• Review of relevant guidance and workforce frameworks

Partnership working with professional organisations, including the British Association for Sexual Health and HIV (BASHH) and the Society of Sexual Health Advisers (SSHA), will help ensure broad participation and robust findings.

What Could Be Achieved?

The exercise has the potential to deliver significant benefits across the healthcare system.

For Patients

• Improved consistency and quality of care
• Enhanced safeguarding and risk management
• Better access to holistic support services

For Services

• Greater clarity around workforce roles and responsibilities
• More effective use of specialist skills
• Stronger multidisciplinary team working

For Commissioners and the Wider System

• Evidence-based insight to support commissioning decisions
• Greater recognition of the SHA role as a core component of integrated sexual health services
• Better alignment with national priorities around prevention, health inequalities, and workforce sustainability

Looking Ahead

With support from SSHA and BASHH, the next steps will include establishing a project group, developing data collection tools, engaging stakeholders across the UK, and undertaking analysis of the findings.

Ultimately, the project aims not only to understand the current landscape but also to inform future workforce planning, professional development, and service design. By identifying best practice and highlighting opportunities for improvement, the scoping exercise could play an important role in strengthening the Sexual Health Adviser workforce and ensuring services are equipped to meet the challenges of the future.

As sexual health services continue to evolve, understanding and investing in the people who help deliver them has never been more important.