Hospital-based pastoral care is a privileged yet complex area of ministry. It involves spiritual journeying to the heights and depths of human experience, often in brief and transient pastoral encounters. Illness and fear lay bare life's realities and there is often need for reconciliation as well as healing. Chaplains, visiting clergy and the growing number of lay volunteers need to be able to interpret pained silences or body language - and often in a matter of minutes. This warm-hearted and practical handbook explores the pastoral sensitivities surrounding patient encounters and the challenges of current socio-political pressures. Through stories and examples it explores key biblical themes of love, loss, hope, grace and forgiveness, and worldly themes of dignity, discrimination, identity and choice. It explores the essential skills needed for this kind of ministry: the importance of ritual, difficult pastoral tasks, deflecting anger, caring for the carers, working in multi-faith contexts and more.