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Letter of Competence Subdermal Contraceptive Implants Techniques Insertion and Removal (LoC SDI-IR)

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This training programme is aimed at doctors and nurses already working in general practice and community sexual health services who want to develop the necessary knowledge, attitude and skills to support women seeking contraception. It will enable them to provide and remove subdermal implants competently, and manage any complications or side-effects that may occur.

The training involves both theoretical knowledge and practical training. We recommend that you start by reading the training requirements and the learning outcomes for the LoC SDI. You may find our list of General Training terminology helpful to reference alongside these documents.

 

FSRH also offers these two options for this qualification:

Training Details LoC SDI-IR

You can ensure you fulfill all the entry requirements for the Letter of Competence in Subdermal Contraceptive Implant Techniques (LoC SDI-IR) to allow a successful application. Successful applicants must meet the following entry requirements: 

The entry requirements for the Letter of Competence in Subdermal Contraceptive Implant Techniques

Successful applicants must:

  • Be a Healthcare Professional who is registered with a UK medical professional regulatory body (that has been approved by FSRH Council) and have a licence to practise if that is required by their regulator. The FSRH recognises the following regulatory bodies:
    • The General Medical Council (UK)
    • The Nursing & Midwifery Council (UK)
  • Have completed the e-SRH Module 17
  • Have passed the eKA (Electronic Knowledge Assessment) or holds current FSRH Diploma, MFSRH or FFSRH. 
  • Be competent in consultation skills
  • Have resuscitation and anaphylaxis training in line with current UK guidelines (certificate or screen-shot of completion successful required)
  • Be Competent to give intramuscular injections
  • Have read the current FSRH guidance on subdermal implants and be conversant with its content

 

Read more information about entry requirements and the next steps towards achieving your qualification:

1. Pass Module 17 of the e-SRH and Read the Guidance on the 6 Principles of Care

Everybody must complete Module 17 of the e-SRH, which is hosted on the e-LfH website. This is an e-learning package, free to NHS professionals, which contains interactive learning modules on various topics. Each module lasts around 20 minutes.

For access you will need to register with e-Learning for Healthcare (e-LfH). This e-SRH is free to anyone holding an nhs.net email address. If you have previously registered on e-LfH site and have forgotten your details you can request a reset , or if you are having issues logging in you can contact e-LfH. 

 

At the time of application for your FSRH qualification, you need to confirm you have read the 6 principles of care as outlined in the “Guidance for those undertaking or recertifying FSRH qualifications whose personal beliefs conflict with the provision of abortion or any method of contraception” and agree to abide by them in practice. It is, therefore, important to have read this document prior to commencing training.

2. Purchase and Take the eKA (Electronic Knowledge Assessment)

The eKA is an online single best answer test that runs for 2 hours and must be completed in one sitting. It costs £75 per attempt.

 

If you do not hold a current FSRH Diploma, MFSRH or FFSRH, you must pass (or have recently passed) our online knowledge assessment (the ‘eKA in SRH’). Find out more about the eKA. 

If you hold a current FSRH Diploma, MFSRH or FFSRH, there is no need to take the eKA.

 

There are maximum timeframes allowed between completing the eligibility requirements and completing the Letter of Competence (LoC).

  • eKA pass and LoC application – 2 years

However, if you already hold one LoC from FSRH, this timeframe will increase to 5 years to allow you to submit your application for a second LoC.

 

At the end of the eKA you will see if you have passed or failed on the screen. You will not be told a score or given any other feedback aside from whether or not you have passed or failed.

You should save this webpage as a PDF by clicking the 'print' button and selecting a PDF writer instead of a printer. Please note that we do not issue certificates for the eKA as it is not a qualification. Therefore you will not see the eKA under ‘My Certificates’ or 'My Qualifications' in MyFSRH.

3. Find a Trainer to Undertake Practical Training

Trainees must first use a model arm to practice inserting and removing subdermal implants. 

The training then moves to live volunteers: you must complete as many supervised insertions and removals as necessary until your trainer is satisfied that you are competent.

Please note: 
Your practical training must be completed through a Faculty-recognised General Training Programme – you can find a list of them on our 'Find a Trainer' page when you register or log into 'My FSRH' and click on 'Take a Qualification' behind log in. Select the required qualification/s and enter your postcode and a list of contacts will be displayed. The area searched can be increased and decreased.

4. Download LoC SDI Record of Training

You must document all your practical training and obtain the signature of your trainer when you competently complete each stage. Please ensure all parts of your form are completed in full. If any part of your application is not complete or it does not meet the required standard, your application is likely to be delayed. Download a training record.

5. Submit your Record of Training

Once you and your Primary Trainer have completed all sections of your Record of Training Form, you may submit this form along with the supporting documents and LoC registration fee for a certificate award.

 

To do this, log into ‘My FSRH’ and then complete: 

 

1. Your LoC SDI training record / application form 
2. The online evaluation of your training experience – you can find links to this in ‘My FSRH’.  Your feedback will be shared with the FSRH's General Training Committee to help us improve our programmes.

 

Intellectual Property Rights

All intellectual property rights for any FSRH qualification including documents, materials and content belonging to and produced by the FSRH should not be used for purposes other than FSRH training. Should you wish to use any of the IPR for purposes other than FSRH training you must seek the FSRH’s approval in writing with your request via our copyright request form. We aim to respond to submissions of this nature within one working week.

 

Recertification & Membership

If you hold Letters of Competence in Subdermal Contraceptive Implant Techniques (LoC SDI), we require recertification every five years. This is to ensure that you have developed and maintained the knowledge, skills, attitude and behaviour needed to provide safe and effective sexual and reproductive health care (SRH).

As a member you can recertify free of charge, as this is a benefit included in your annual membership fee. However, you must have paid your membership fee continuously for the five years leading up to recertifying.

How do I apply for my LoC SDI Recertification?

You can apply for recertification by filling in the online form.

Before filling in the online form, please have all the relevant information to hand before starting it, you will not be able to save it and then revisit it later, it must be completed in one sitting. You will also need a stable internet connection while completing the online forms:

Form for Recertifying Letter of Competence in Subdermal Implant Techniques (LoC SDI):

Please make sure to apply for recertification not more than six months before your recertification date and no later than six weeks afterwards.

To apply successfully for recertification, you need to demonstrate:

  • at least two credits of relevant CPD over the past five years 
  • completion of the relevant e-SRH module (for NHS professionals) or Faculty-approved distance learning (for non-NHS professionals) 
  • proof of basic life support and anaphylaxis training 
  • a log of IUT insertions 
  • a log of SDI insertions and/or removals

You can find more information on each of these requirements below. You can also find a calendar of CPD courses, meetings and events on this website.

Read some FAQs about Letters of Competence Recertification.

What are the CPD Requirements for my Letter of Competence recertification?

To recertify for either LoC IUT or LoC SDI, you need to collect at least two credits of CPD activity over the past five years. This activity must be relevant to IUT / SDI, and may be gained in the following ways.

 

  • Attendance at courses/meetings relevant to SDI
    Evidence: certificate of attendance, programme of meeting and brief reflection on how this will influence your future practice.

  • Reading of appropriate current peer reviewed publications e.g. JFPRHC, BMJ
    Evidence: reference of article, and brief reflection on how this will influence your future practice: 1 CPD credit per article
    Reading of FSRH CEU guidelines on subdermal contraceptive implant methods and completion of self-assessment questions Reading: 1 CPD credit and completion of self-assessment questions: 1 CPD credit. This may not be counted towards CPD if used to fulfil section 3.
    Evidence of reading: date read and brief reflection on how this will influence your future practice. Evidence of questions: mark sheet, date completed and brief reflection on how this will influence your future practice.

  • Peer observation: For LoC IR you can claim 1 CPD credit for observing a peer perform an insertion or removal and giving feedback afterwards, 1 CPD credit for being observed performing an insertion or removal by a peer and discussing feedback afterwards.

  • For LoC IO you can claim 1 CPD credit for observing a peer perform an insertion and giving feedback afterwards, 1 CPD credit for being observed performing an insertion by a peer and discussing feedback afterwards.

  • For LoC RO you can claim 1 CPD credit for observing a peer perform a removal and giving feedback afterwards, 1 CPD credit for being observed performing a removal by a peer and discussing feedback afterwards.The observer/person being observed must hold a current LoC SDI. Evidence: date and name of observer/person being observed and brief outline of what you learned from this, either as an observer or from being observed)
  • Audit of SDI – personal or local

Evidence: date, summary of audit, brief description of your role in audit: 1 CPD credit

What evidence of CPD do I need to submit?

You do not always need evidence of CPD activity when you are applying for recertification. However, the General Training Committee audits 10% of all applications and reserves the right to ask for supporting documentation for all your activity. 

 

What other requirements and resources are there for my ongoing CPD?

If you are an NHS professional, you must also complete e-SRH module 18 (for LoC IUT) or e-SRH module 17 (for LoC SDI) during the two years before your recertification date.

To access the e-SRH learning modules, please register with e-Learning for Healthcare (e-LfH).

If you are not an NHS professional, you may instead complete Faculty-approved distance learning e.g. the latest CEU IUT / CEU SDI guidance and self-assessment questions.

You should also be up-to-date with basic life support and anaphylaxis training in accordance with your employer’s policy.

Finally, please submit a log covering a consecutive 12 month period that started no more than 24 months before your recertification date. 

  • For LoC IUT, this log should show 12 insertions, showing at least two different types of IUT method in conscious women. 
  • For LoC SDI Insertion and Removal (LoC SDI-IR), the log should show 6 procedures including at least one insertion and one removal.
  • For LoC SDI Insertion only (LoC SDI-IO), for individuals who work in an abortion or maternity services, the log will need to show a minimum of 6 insertions.
  • For LoC SDI Removal only (LoC SDI-RO), for individuals who work in deep implant services, the log will need to show a minimum of 6 removals.

Women's Health Library

Bringing together national guidance, resources produced and accredited by the RCGP, and resources from the Royal College of Obstetricians and Gynaecologists (RCOG) and the Faculty of Sexual and Reproductive Healthcare (FSRH), the Women's Health Library is a resource relevant to GPs and other primary healthcare professionals.

The Library is divided into four sections for ease of use with the free resources clearly marked:

  • Maternal Health
  • Sexual and Reproductive Health
  • Pre-Menopause
  • Peri/Post Menopause

Access the library here. 

I'm late for my recertification, what should I do?

If you apply for recertification more than six weeks after your recertification date, you must: 

1. gain the necessary CPD credits and the Basic Life Support and anaphylaxis training outlined above
2. complete the relevant e-SRH module no more than 12 months before your recertification application date  (as opposed to within 24 months of recertification date) 
3. provide a log (described above) covering a consecutive 12 month period within 24 months of your recertification application date (as opposed to recertification date)
4. stop training or supervising anybody working towards an LoC.

If you are absent for more than a year and wish to apply for an extension on your recertification date,  please fill in our extension request form and we will get back to you shortly. 

If it is 10 years or more since your qualification was awarded or last recertified, you will need to retake the full training programme for your qualification. For Letters of Competence, this may be via the experienced practitioner route, if appropriate.

I'm a lapsed FSRH member and I want to recertify my qualification, what should I do?

FSRH Council believes that membership of the FSRH – and therefore access to the latest clinical guidance, standards, Journal, CPD questions and regular updates – is an important part of the membership and recertification process. The rules surrounding back payment of subscriptions were tightened up in 2015 by FSRH Council. 

Recertification is free to current FSRH members.  Recertification is one of our member benefits and supports you professionally in a number of ways.

It helps you to:

  • demonstrate the learning outcomes achieved from your qualification(s) have been maintained
  • show you have the knowledge, skills, attitudes and behaviour needed to provide safe and effective sexual and reproductive health care (SRH)
  • meet the requirements of commissioners, who often require clinicians to have certified qualifications

If your membership has lapsed and you would like to re-join FSRH past the 31 March cut-off date for the current membership year or after one or more years, you will be required to pay back your 'missing' years to ensure you have continuous membership which is required for recertifying your primary qualification.

You can easily do this by contacting us by phone on 020 7724 5534 or by email to info@fsrh.org. We can take payment by phone using a debit or credit card, it will take a few minutes to do this for you.

You can also pay for a one-off recertification for Letters of Competence qualification. This is £368 per LoC. This option is not available for Diploma recertification. You can pay your Diploma membership back fees by telephone on the above number.

Read more about the recertfication requirements of our qualifications here. 

How much will I be paying if I'm a Member re-joining FSRH after a break of two or more years?

Membership Category

& Annual Fee amount (2020)

Amount Payable

 

Diplomate £108

2 years (2019 and 2020) - £216 

3 years (2018, 2019 and 2020) - £324 

4 years (2016, 2017, 2018 and 2019) - £432

5 years (2016, 2017, 2018, 2019 and 2020)- £540 

Associate £92

2 years (2019 and 2020) - £184

3 years (2018, 2019 and 2020) - £276

4 years (2017, 2018, 2019 and 2020) - £368

5 years (2016, 2017, 2018, 2019 and 2020)- £460

Member/Fellow £228

2 years (2019 and 2020) - £456

3 years (2018, 2019 and 2020) - £663

4 years (2017, 2018, 2019 and 2020) - £912

5 years (2016, 2017, 2018, 2019 and 2020) - £1140

If you think you might qualify for a reduced subscription on your back fees, please contact the FSRH office on 020 7724 5534 or by email at info@fsrh.org to find out how to claim. Or, you can fill in our form here to claim your reduced subscription on previous year's fees.

 

Contact Us 

If you need any more help with recertifcation, please contact us by calling us on: +44(0)20 7724 5620 or by emailing kwells@fsrh.org.

How to Apply

To start your application process for the Letter of Competence in Subdermal Implants Insertion and Removal, please click on the register button (if you do not already have a 'My FSRH' website account). Registration on this website is free, you will not be required to make any payment until you are ready to apply for your qualification.

If you already have a log in for 'My FSRH', please click on login and then navigate to 'Take a qualification/recertify' behind log in. 

FSRH Register here  Log in to 'My FSRH'

Not sure how to register on our website? Watch our video for some help.

(You'll need sound or earphones on your device) 

Fees

Option 1: Associate Membership

Member rate per LoC application: £155 (Associate annual membership £92 + LoC registration £63) - for LoC applications between 1 Jan – 30 Jun
Member rate per LoC application: £109 (Associate annual membership £46 + LoC registration £63) - for LoC applications between 1 Jun – 31 Dec

Option 2: Non-member rate

The non-member rate per LoC application is £368, this fee will cover you for next 5 years.

 

Associated Fees and Costs for the Letter of Competence Subdermal Implants Insertion and Removal (LoC SDI-IR)

*Join us as a member to benefit from a reduced LoC application fee and free of charge recertification every 5 years

You can apply to become an Associate member when completing your LoC training application online as part of the final step. This will allow you to qualify for the reduced member rate of £63 for each LoC application fee as well as giving you full access to all our membership benefits. 

The cost of full Associate membership annually is £92 (for initial LoC applications between 1 Jan – 30 June) or a reduced half-year subscription in your first year of membership of £46 (for LoC applications made between 1 July – 31 December).

The subsequent full annual Associate membership fee is due on 1 January 2020 and then the following years of your membership.

As an Associate member your recertification of your qualification is free of charge every 5 years, if you have retained and paid for your annual Associate membership each year. Recertification enables you to demonstrate you have retained the skills and knowledge required for your qualification. This evidence can be used in appraisals and for revalidation.

Electronic Knowledge Assessment (eKA)

£75 (per attempt)-Payable to FSRH

Clinical Training (Costs are set locally)

Between £300-£400 depending on location and provider

Letter of Competence Registration fee - Current FSRH Members (Associate, Members, Fellows and current holds of the FSRH Diploma)

OR

Non-FSRH members

£63-Payable to FSRH

 

£368-Payable to FSRH

Total (approximate)

FSRH Members

OR

Non-FSRH Members

 

£488 (approximate - depending on clinical training costs)

 

£850 approximately

Is your trust paying by invoice?

If your trust is making payment by invoice, we will need the following information in order to raise a purchase order: invoice address (accounts payable), a purchase order number (only if your trust requires one), and a finance/accounts payable email address. Please note, your trust can opt to pay for several individuals in a bulk payment if required. 

Please share this information with our Finance Manager, at finance@fsrh.org to raise the invoice or you can fill in our form online with all the information to raise the invoice.

Start your qualification now, by clicking on 'How to Apply' which will enable you to register for a free account on the FSRH website, no fees are payable until you are ready to start your application process.

 

Contact Us

Contact Us

If you have questions regarding applying for the Letters of Competence including queries related to e-KA requirement removal from your profile, please contact the Education Development Officer, Iftikhar by phone on: +44(0)20 7724 5647 or by email to iahmad@fsrh.org.

FAQs

Questions?

Check our FAQs here to find out some common questions and answers about our  Letters of Competence qualifications.

Training Route for Experienced Practitioners

This section would be useful for anyone who falls into one of the following categories:

  • If your initial LoC qualification was not registered with or awarded by FSRH
  • If you have attained a local Letter of Competence (LoC) certification and now wish to register or recertify it with FSRH
  • If you have not recertified FSRH LoC for more than 10 years, but have been fitting/removing implants for last 12 months

For all above scenarios, you may be eligible to undertake a shortened pathway which takes into account past clinical experience. The FSRH’s General Training Committee requires that, in order to obtain FSRH certification, the initial training would need to be completed. 

The General Training Committee is unable to offer exemptions to its published criteria. However, experienced practitioners can complete a shortened pathway in respect to the clinical component but all other parts of the programme, included the eKA pass, would need to be completed.

Where a local or other organisation’s certificate is held, please contact the issuer in respect to how they will re-accredit your qualification.

The General Training Committee hopes that you will decide to complete our qualification but if you do not wish to proceed in this way please discuss your circumstances with your employer if they have asked for a current FSRH Letter of Competence.

Below we have provided a breakdown of the experienced practitioner route with links for ease of reference but we advise to check the website for the current criteria at the time of commencing the training.

  • Complete the free e-SRH module 17 on the e-Learning for Healthcare
  • Pass the eKA (Electronic Knowledge Assessment)
  • Complete the LoC SDI Record of Training Form (This log must show six procedures to include at one insertion and one removal undertaken during the 12 months before commencement of training. The primary trainer, a Faculty Registered Trainer, must observe at least one insertion and one removal performed competently). 

 

Find a Trainer to be observed for 2 procedures: Click here to 'Find a Trainer' when you register or log into 'My FSRH'

 

Download LoC SDI Record of Training: Download a training record

Please ensure parts A, C, D and E are completed in full. If any part of your application is not complete or it does not meet the required standard, your application is likely to be delayed.

 

Submit your Record of Training

Once you and your Primary Trainer have completed all sections of your Record of Training Form, you may submit this form along with the supporting documents and LoC registration fee for a certificate award.

To do this, log into ‘My FSRH’ and then complete our online form by selecting:

My FSRH > Take a qualification > LoC SDI-IR > Qualify > Go to the last step of the page and click ‘Submit your LoC SDI Record of Training and pay your fee here’ and complete online form

 

Once you have successfully submitted the form and paid a correct registration fee, The Education Development Officer for LoCs will review your application and contact you by email within 5-10 working days.