Chaplaincy services cut in 40% of English NHS hospital trusts

Canon Chris Davies Canon Chris Davies

Anglican Canon Chris Davies is one of hundreds of ministers working for the NHS as a healthcare chaplain.

The 61-year-old grandfather will soon retire as head of spiritual and pastoral care for North Bristol NHS Trust and the University Hospitals Bristol NHS Foundation Trust.

Like many of his fellow healthcare chaplains, he combines his work for the NHS with his diocesan duties.

The funding of healthcare chaplaincy posts has reduced against a backdrop of increasing pressure on NHS budgets.

Canon Davies explained the role of a healthcare chaplain in the NHS to BBC Religion and Ethics.

How did you become a chaplain?

I became a chaplain in 1976 when I was working as a parish priest in the east end of London. There was a small hospital which is now part of the Royal London Hospital in the parish, and it was our responsibility to visit the patients and look after the staff and relatives in that hospital.

Can you describe a typical working day for a chaplain?

There isn't a typical working day for a hospital chaplain. The proactive role is to be involved in the life of a hospital, so chaplains will find themselves involved in operational groups, ethical groups, in end of life groups, in teaching around death, dying and spirituality.

Secular UK?

Map of the UK
  • The 2011 census of England and Wales found between 2001 and 2011 there was a decrease in people who identify as Christian, from 71% to 59% and an increase in those reporting no religion from 14% to 25%
  • In the same period there were increases in the other main religious group categories, with the number of Muslims increasing the most from 3% to 4%
  • Around a quarter of the population in England and Wales, reported they have no religion in 2011

I will have a duty round and I, or one of my team, will go to all the acute areas of the hospital each day to visit the staff, say hello, support them and find out what's going on and see if there are any key areas of concern we may be able to assist with.

The reactive side is where we are called to offer spiritual and pastoral care to patients, relatives and staff in a variety of different situations - for example early pregnancy loss.

A significant amount of my time is spent with couples who experience the death of a baby.

So in any given year in Bristol, the chaplains will be involved with 200-plus families and seek to offer them not only support from a spiritual perspective and a pastoral perspective, but we will also help them undertake whatever ritual and rites they would feel helpful to them as they say goodbye to their baby.

We will from time to time undertake an adult funeral, but that tends to be when there is no family and no church connections.

Do the patients you help usually come from a faith background?

People often criticise the NHS for employing healthcare chaplains who come from a faith perspective. What they fail to acknowledge is that chaplains are here for everybody irrespective of whether they have a faith or not. And very often most of our time is spent with people who do not have an allegiance to a denomination or a faith.

For many people in hospital who do have such an allegiance, their local minister will come in.

But our role is to be with people who may not have a faith, who are expressing spiritual needs and we come in with our experience, our expertise, our inclusiveness and that I think is the most important thing. We are inclusive in our activity and day-to-day work.

We do not judge people, we are not asking them what they believe, we are coming to listen to people and then to try and find the most appropriate ways, whereby their spiritual needs can be addressed by them, with our help.

Do you attend to people of different faiths?

We are a multi-faith chaplaincy here in Bristol. We have honorary chaplains from some of the key major faiths other than Christianity. We also have very good links through the Bristol multi-faith forum.

At times you are called on to talk to parents who have lost a child, how do you keep your own faith and remain strong?

National health service

Clement Attlee

The National Health Service was established by Clement Attlee's Labour government in 1948.

Before 1948 there was a National Health Insurance for workers, but this offered no benefits to dependents.

From 5th July 1948 the government took over responsibility for all medical services and gave free diagnosis and treatment for all.

The most important thing for a healthcare chaplaincy is to have a framework, within which to minister. That will include line management from someone such as me, who is senior chaplain, and supervision opportunities on a regular basis.

We do meet monthly for reflected practice. And we do offer one another support at times of crisis.

We are also involved in life and death situations for the whole spectrum of ages, ranging from people who are elderly and suffering from dementia right the way through to people with mental health problems who may or may not be within the mental health framework, but may have physical problems and find themselves in an acute hospital as well.

And we do offer a 24/7 emergency call out.

What kind of services can you offer staff in the NHS?

By being proactive, by being available, by being seen at the coal face, staff will talk to chaplains either in a corridor or in a room about issues that are confronting them.

We also offer opportunities for staff to come in a confidential way to have a one-to-one conversation with a chaplain.

They may have family issues, personal issues, they may be work-related issues, they may be issues that are confronting them from a medical, legal or ethical perspective.

They may find themselves questioning activities going on and wish to have somebody to talk to so they can work out for themselves whether or not what they are being asked to do, or what changes are happening, are in contravention with their faith position or no faith position, as the case may be.

Have you witnessed a greater need for hospital chaplaincy over your career?

I think because we have become a much more secular society, people are far less involved in what I would call institutional religion, yet people are still trying to make sense of why they are suffering, or why their loved ones are suffering, why they are dying or why their loved ones are dying, or why their loved one has died.

What would the NHS be without chaplains?

Start Quote

There are times when one has to sit down and think very carefully about one's own faith position and then have to work through that.”

End Quote Canon Chris Davies

The NHS would be impoverished in many respects, we are valued by the ward staff, we are valued by senior management because they see what we bring day in and day out to situations where they are caught up in doing things to patients and rightly so.

We are involved in ethical issues that come to light.

I'm very much involved in the issue of organ donation and am trying to encourage members of certain ethnic communities to engage more in the practice.

Some people have a genetic predisposition to diseases that lead to end stage renal failure and because of tissue typing, it is far more beneficial if a kidney comes from someone from their own ethnic group.

There are also areas of withdrawal and withholding treatment, whether this is God's will or whether they are being asked to go against God's will in terms of end of life issues.

In those ethical debates do you ever feel at odds with your religion or other faiths?

I think you are, as a professional healthcare chaplain, seeking to understand the fact that medical advances sometimes call into question a theological position that was set down many years ago. There are times when one has to sit down and think very carefully about one's own faith position and then have to work through that.

Do healthcare chaplains offer value for money?

I think healthcare chaplains offer incredible value for money. It is very difficult in a quantitative environment to measure the qualitative value of chaplains. For instance I will see a member of staff because of a personal crisis and I might see them once a week for say six to eight weeks.

That member of staff may have gone off sick, rather than stayed at work if they had not seen me.

Because of the nature of our work, in many respects I would say we give incredible value for money to the NHS, because the actual proportion of NHS spend on chaplaincy is miniscule compared to what the NHS receives from the chaplaincy.

We are here for people of all faiths and none.

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