Professor Riste?rd ? Laoide:

The retention of staff is a very broad subject because there are many issues outside the control of the HSE and the NCCP such as the cost of living in our city, the fact young people want to travel, and family reasons. There are many reasons it can be difficult to retain staff. We are doing a lot of workforce planning to ensure we have an appropriate number of people in training to take up posts as we expand. We try to give education and training opportunities to staff within our system so that they are working at the top of their licence. An example of that is our systemic anti-cancer therapy, SACT, competency framework which we introduced in the past year or two. It has been a great success. It is training people to give chemotherapy in the wards. Giving chemotherapy is a specialised task that nurses do. In the past year we put in place a framework where people can get trained at any point within our system. For example, it used to be that if you went into a cancer centre, you had to wait six or eight months before you could get trained and then you were working in a difficult scenario within the day ward. What we have done is to have created a structure whereby staff can get trained every month. Each of the cancer centres rotates and provides the training for the nursing staff so that they can get regular training and they get a passport, so that if they move from one centre to another, they are not told they cannot work in a daycare ward anymore because they are not trained in St. James's, for example, or wherever else. They can bring their passport with them and work.

There is that kind of training and competency for the nurses. They are also using their skills to maximum effect. I think that is what people want when they are working within the cancer system. We need to develop new roles like cancer support workers to relieve workers on the oncology ward so that they can do oncology work. We have put in clinical skills facilitators in nearly all of the cancer centres now. These people give training and development to the nursing staff within the institution. All of these things together can encourage people to work to the top of their licence, work in a system which values them and educates them, but there are other elements outside our control. For example, post Covid in radiography and in radiation therapy, typically, younger graduates within the system could not leave the country. Many of them want to go abroad, which is very good for the country, because they learn new skills abroad and, it is hoped, come back again. There was an egress from our system of a significant number. That caused difficulty in our healthcare system, but it is not something we can directly control. We do not want to stop that either.

We do workforce planning. We try to do education in the workplace. One of the other points that is very important and that we must address in this country is the conditions people have at work and the infrastructure that is in place, so that people are working in a safe, comfortable environment.