Discovering meaning, purpose and hope through person centred wellbeing and spiritual care: framework

5. Conclusion

5.0.1 The challenges facing spiritual care services over the next few years are not insignificant. This framework sets out overarching areas for development in four key settings:

• A skilled and compassionate workforce
• The development of spiritual care in community social care settings
• Robust data collection and the development of an evidence base
• A professional specialist workforce

5.0.2 The key deliverables are intended to continue and deepen the re-shaping of spiritual care services and ensure services across Scotland will be fully assimilated into the new paradigm of integrated Register and the work of Health and Social Care Partnerships.

5.1 Governance Structures

5.1.1 The NPB for spiritual care has provided national leadership and direction for the delivery of spiritual care services through overseeing the development of a national framework. On-going oversight of this framework and the development of future strategy remains with the Healthcare Quality and Improvement Directorate within Scottish Government.

5.2 Scottish Spiritual Care Professional Leads Group

5.2.1 The Scottish Spiritual Care Professional Leads Group consists of: Spiritual Care Leads / Heads of Service from Health Boards and the Association of Hospice and Palliative Care Chaplains. The group will provide professional leadership in the area of spiritual care and advise the Scottish Government and other relevant bodies on the provision and delivery of spiritual care.

5.2.2 The group will provide a forum to share best practice, learn from each other at a national and local level and inform the quality ambitions of ensuring a person centred, safe and effective service by:

• promoting standards of professional practice and service delivery, including agreed standards, capabilities and competencies in partnership with the UKBHC;
• leading on workforce and succession planning for spiritual care in conjunction with workforce colleagues locally and nationally;
• developing and maintain networks with colleagues, senior leaders and those involved in delivering spiritual care to increase the awareness, benefits, influence and outcomes of spiritual care;
• maintaining relationships with professional bodies and overseeing nominations to such bodies; and
• providing a collective voice which contributes to and informs national policy, direction and initiatives which influence the current and future delivery of spiritual care.

5.3 Line Management

5.3.1 Each Health Board (including special Health Boards) should have an Executive Lead for Spiritual Care (Director or non-Executive Director) to take corporate responsibility for ensuring that spiritual care is promoted, and services are safe, effective, and fully integrated within clinical services. Within each Health Board there should be a designated Spiritual Care Lead, sometimes referred to as a Lead Chaplain or Head of Department.

Recommendation 30: All health boards, if they do not already have one, should appoint an Executive Lead for Spiritual Care confirming with the Scottish Government once they have done so.

5.4 Next Steps

5.4.1 This framework reflects the considerable developments in the increased professionalism of spiritual care provision over the last twenty years and seeks to establish spiritual care as an integral part of health and social care provision.

5.4.2 Professional advisors are responsible for providing policy and strategic advice to Scottish Ministers and provide professional advice on practice, standards and guidelines.

5.4.3 The framework addresses existing inconsistencies in practice, clearly identifies expectations in terms of service and team development, articulates unambiguously shared, national priorities for the next five years, and importantly, will ensure greater accountability for practice.

Recommendation 31: The Scottish Government should appoint a subject specialist and advisor to lead on the implementation and co-ordination of the Spiritual Care Framework utilising the model of Professional Advisor roles currently used throughout Government.

5.4.4 This framework does not stand in isolation but supports and aligns to a number of national strategies and frameworks. At its heart is the vison that to be a healthy and happy nation depends on a wide variety of factors and we therefore need to take a whole system approach to promoting good health and activity. Spiritual care, which takes a human rights based approach, seeks to promote positive health, care and wellbeing and develop resilient communities as outlined in the National Performance Framework^[66].

5.4.5 Finally, the framework presents a direction of travel offering care providers the opportunity to develop contextually appropriate spiritual care services within health and social care settings. A number of areas for continued development or review, have been identified, not least is the expectation that spiritual care services should embrace the opportunities presented by developments within health and social care, and should be working actively to develop innovative and collaborative ways of meeting the spiritual needs of staff, patients, service-users, carers and families. It is essential that the current developments and the aims of this framework are supported at local level and nationally.

Recommendation 32: The Scottish Government should establish a cross agency Advisory Board on Spiritual Care with appropriate sectoral and external representation to oversee the implementation of this framework and to bring proposals for change where this is necessary.