Dr. Paul D'Alton:

The programme we ran a couple of years ago was aimed at upskilling medical and nursing staff working in the area of oncology and palliative care. We trained 102 health care providers at St. Vincent's and Beaumont hospitals and St. Francis's and Harold's Cross hospices. At the end of the training process there was a significant shift in the level of confidence in providing care for members of the lesbian, gay and bisexual community. Working in St. Vincent's Hospital I had probably seen some of the most dedicated nurses and doctors delivering care to patients, often towards the end of life. It was the lack of confidence which sometimes got in the way in this regard. It was this lack of confidence with stymied conversations between patients and staff on partners, boyfriends or girlfriends. This was only because of an intention not to hurt, but then the silence sometimes led to hurt. The programme has been very successful and published internationally, with recommendations to the effect that all health care service providers receive similar training. However, it is important to view it in the context of wider training needs. Ms Keegan drew the committee's attention to the forthcoming competency framework in palliative care. This framework will cut across all disciplines providing care. It will also detail skills required at particular levels. This is the idea of moving away from specialism to a whole-system approach. The competency framework will provide a way to devise and plan undergraduate and postgraduate training.