Background Advance care planning is a decision-making process about future health care for patients made in consultation with clinicians, family members and significant others. Currently completion rates are low and there are arguments to suggest that this is due to the current implementation. This paper aims to gain deeper insight into whether an advance care planning tool and professional training supports the exploration of the whole person or not - does it lend itself to heteronormative cultural stereotyping and a falling back onto the notion of treating everyone the same?

Aims To identify whether staff confidence in inclusive personalised support impacts upon advance care planning for LGBT individuals. Are there opportunities to develop the advance care planning document to create opportunities for professionals to deliver more inclusive discussions regarding sexuality and identity?

Methods Qualitative research with convenience sampling of specialist palliative care professionals.

Results Assessment

• Practice experience of the professional was identified as effective in developing an open and honest relationship. The focus becomes on holistic assessment in relation to the individual over time.

• The participants wanted to see a clear section within the care planning tool that asks about specific pronouns and identities.

• The importance of creating a safe place.

• Language, confidence and competence.

• The importance of language in the wider context when supporting individuals who identify as LGBT.

Relationship building

• The importance of relationship building between practitioner and client.

Conclusion

• Staff confidence in delivering personalised care for LGBT patients does appear to be a significant issue across multiple disciplines.

• The beneficial addition of direct questions relating to pronouns, sexuality, and identity in the patient details section of the document.

• Internal annual mandatory training to encompass all aspects of LGBT needs.

• Introduction of visual tools such as genograms within advance care planning.