Anal examination and proctoscopy are important skills needed to facilitate the diagnoses of STIs and cancer. Clinician (25 doctors/15 nurses) confidence was higher for anal examination versus proctoscopy (median Likert scores 4/5 vs 5/5, P≤0.05) and higher in doctors compared with nurses (median Likert scores 5/5 vs 4/5, P<0.008, 4/5 vs 2/5, P<0.005), and related to years of experience (5/5 vs 4/5, P<0.001, 3/5 vs 5/5, P=0.007). Barriers included lack of opportunities for training, concerns about patient reluctance, and lack of available equipment. We need to be innovative when up-skilling the specialist sexual health workforce using online training and optimising opportunities for clinical assessment of MSM.