Friday, 29 January 2010

CNM Submission to Welsh Assembly Consultation on Spiritual Care

This paper was submitted to the Welsh Assembly on January 20 2010 in response to a consultation on standards for spiritual care provision by the NHS in Wales and on the competencies and capabilities for those providing spiritual care.

Copies of the consultation documents are available on request from the Welsh Assembly, or by clicking the links above (including the supporting guidance from the Welsh Assembly).

This consultation closed on 22 January 2010


Christian Nurses & Midwives is a membership body & registered charity in England & Wales (No: 1119533) for Christian health professionals in those nations, with five aims:

1. To encourage Christian nurses and midwives to grow in the knowledge of Christ and to make Him known
2. To promote Christian principles within nursing and midwifery
3. To develop a network of Christian nurses and midwives for fellowship and prayer
4. To strengthen and support Christian student nurses and midwives
5. To support the work of nursing and midwifery missionaries throughout the world who are in agreement with our beliefs

We were approached by several of our members in Wales to make a submission on this consultation, who have also provided information and views that inform this submission. Our Welsh membership in particular includes several senior nurses, nurse academics and spiritual care specialists.

Response to Guidance & Capabilities Document

We feel that it is positive that there is an early clarification between Spiritual and Religious care, and that this can help unpack some of the more heated and ill informed recent controversy over the role of chaplaincy services within the NHS, and the nature and relevance of spiritual care.
We note the reference to the WHO’s recent statements on the spiritual dimension of health, and welcome a global recognition of this long held understanding amongst people of faith across the globe.

Under section 2.2.2 we welcome the recognition that the Chaplain’s own faith and beliefs have a bearing on the care she/he delivers. However, we feel that similar recognition should be given to the role other health professionals play in spiritual care within the NHS and the relevance and impact of their beliefs upon this.

Under section 4.2 we welcome the recognition that the spiritual health and development of Chaplains is integral to their delivery of effective spiritual care, and that space should be given in their professional development programmes to spiritual development. However, we also note that the spiritual care given by other health professionals also is affected in the same manner, and that space for a spiritual life within the workplace is important (e.g. supporting the role of faith based workplace groups in NHS institutions as part not just of diversity policy, but as a valuable source of spiritual support to all health professionals).

Response to Standards of Care Document
Standard 1 – we feel that there needs to be more focus on the multidisciplinary aspects of spiritual care, and in particular to the role of Chaplains in training and supervising medical and nursing staff in identifying the spiritual needs of patients and making appropriate referrals to chaplaincy services. We also feel that the role of nurses in particular as spiritual care givers needs more recognition, both in training and ongoing professional support – as van Leeuwen (2008) has noted[1] – nurses are uniquely placed to assess and deliver many aspects of spiritual care, but need to develop the core competencies and capabilities to do so . Furthermore, there is ample research on the role of nurses in particular as spiritual care providers, and the importance of engaging nurses in the spiritual care process[2].

The role of Chaplains as trainers and supervisors in this needs further development, and the importance of a team based approach that includes all staff (medical, paramedical, nursing and ancillary) in the spiritual care of patients needs further exploration and expansion in this document.

NB, we note a possible typographical error in the penultimate line of this standard talking about ‘religious transitions’ and wonder if the intended word should be ‘traditions’?

Standard 2 – again we feel that it is insufficient just to give patients written information about spiritual care services, but that all nursing and medical staff should be trained to make patients aware of these services as part of routine admissions procedures, to assess any needs and make referrals accordingly and during subsequent re-assessments of treatment and care the spiritual care needs of the patient should also be routinely re-assessed by these staff. Again, we would emphasise an vital role of Chaplains in the training and support of staff in this.

Standard 3 – we welcome the involvement of faith communities in spiritual care services, and the importance of developing and maintaining good relationships with these communities. Spirituality in most non-Western cultures and religions (and indeed for most practising Christians in the majority population) is not worked out primarily within the individual context, but in the context of wider family and community, and therefore the inclusion of the wider faith community (where appropriate) is more effective and beneficial than a purely individualised emphasis.

Standard 4 – we welcome a clear recognition of the role of chaplaincy services in the spiritual care and support of NHS staff. This is a vital, but often unrecognised role played by Chaplains. We also feel there should be recognition of the role of chaplaincy in supporting and sometimes facilitating faith based staff groups as a means to supporting the spiritual well being of staff.

Standard 7 – we welcome the input of chaplaincy services to major incident planning in NHS institutions, recognising the spiritual impact of major incidents on those directly affected, the wider community (including faith communities) and the NHS staff caring for those affected.
Overall we feel that Chaplains have a vital role in the induction and ongoing training of all NHS staff. It is vital that all staff are aware of the spiritual care services provided within each trust, why they are needed, and how to refer patients as appropriate. We also feel that there should be more recognition of the role of other NHS staff in spiritual care delivery in these documents, particularly that of nursing staff. Furthermore, in light of recent cases such as that of Caroline Petrie, good training and clear guidelines on spiritual care are vital to protect patients and staff from inappropriate interventions, or to disproportionate disciplinary measures due to misinterpretations of spiritual care interventions.

Finally, we would like to thank the Welsh Assembly for putting these guidelines out to public consultation, and for the recognition within the Assembly and Executive of the importance of the spiritual dimensions of healthcare.


1: Van Leeuwen, R (2008), Towards Nursing Competencies in Spiritual Care, University of Gronigen
2: E.g. Ross, LA (2006) Spiritual Care in Nursing: an overview of the research to date. Journal of Clinical Nursing 15 (7), 852-862

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