Spiritual Care and Chaplaincy

5. Development of Healthcare Chaplaincy as a Regulated Profession

5.1 Registration

An initial notice of intention to apply for status as a registered health care profession has been made to the Health Professions Council, the UK body which regulates or recognises those professions who are or who wish to be a registered health care profession. This is a lengthy process which requires aspiring professions to demonstrate their unique body of knowledge, entry and training pathway, code of ethical practice and method of continuing professional development. Full registered professional status for healthcare chaplains, while not an immediate prospect, is being pursued.

The health service requires that the needs of individual patients or staff to be accommodated and taken into account with equal skill and compassion whatever a person's background and life stance happens to be. A particular and specialised area of training, practice and regulation has become necessary. The multi disciplinary team is now seen as the main unit of health care and the chaplain, the specialist spiritual care provider, is integrated into this team with his or her expertise and awareness enabling care to be more holistic or "whole" person.

Experience suggests that this more 'professional' approach is best achieved through the usual NHS educational channels, supplementing such training normally required and given by faith communities and belief groups themselves. There needs to be a degree of standardising. In the same way that spiritual care policies are in place to give people confidence that they will be treated consistently and well, so the training and regulation of the specialist spiritual care work force will give confidence in the quality and consistent approach of the chaplains. It is no less of a 'calling' to require specialist training, indeed it is one way of treating the idea of a calling seriously.

5.2 Capability and Competency Framework

Following the creation of Chaplaincy Service Standards, work has recently been completed in developing a "Spiritual and Religious Care Capabilities and Competences for Healthcare Chaplains" framework for those who are employed to deliver the service. This will guide the delivery of education and training and will help in the development of recognised professional qualifications in chaplaincy.

The framework, draws on the 'Ten Essential Shared Capabilities' ( DOH 2004) which encourages a multi professional understanding and approach:

Working in Partnership
Respecting diversity
Practising ethically
Challenging inequality
Identifying the spiritual needs of patients, carers and staff
Providing safe and responsive person- centred care
Promoting best practice
Promoting rehabilitation approaches
Promoting self care and empowerment
Pursuing personal development and learning

This framework includes the capabilities and competencies needed by a qualified and practising chaplain, grouped into a number of domains:

Knowledge and skills for professional practice:
Knowledge and skills for practice;
Practising ethically;
Communication skills;
Education and training.

Spiritual and religious assessment and intervention:
Spiritual assessment and intervention;
Religious assessment and intervention.

Institutional practice:
Team working;
Staff support;
Chaplain to the hospital or unit.

Reflective practice:
Reflective practice;
Personal spiritual development.

In the future there will be information or frameworks corresponding to specialties (e.g. Mental Health, Paediatrics) and increased levels of responsibility, experience and qualification required of those in lead and management positions.

It is further planned to produce a capability framework, or related document, on spiritual care for all NHS staff.

These documents are linked to the Knowledge and Skills Framework and will aid the curriculum development for certificate, diploma and masters qualifications in healthcare chaplaincy. All newly appointed chaplains will, in the near future, be expected to hold the certificate in order to be a fully qualified chaplain. The opportunity of working towards a diploma or masters degree will be encouraged, in part, by the increasing requirement for continuing professional development.

5.3 Remuneration

The introduction of Agenda for Change (AfC) into the NHS has had an impact upon the pay, terms and conditions of Chaplains employed by the NHS, in common with all other staff groups. The Accommodation Allowance which had been paid to Chaplains had been converted into a long term Recruitment and Retention Allowance. The out of hours on call duties of Chaplains have been recognised and payment for this work will be made under new agreements. Remuneration is based on an evaluation of the post holders responsibilities, which is underpinned by a nationally agreed Local Job Evaluation System. Individuals will be assigned to an AfC Pay Band created to facilitate a fair and transparent pay structure for NHS staff.

The AfC Knowledge and Skills Framework ( KSF) and Personal Development Plans ( PDPs) provides a single, consistent, comprehensive and explicit framework on which individuals can develop within their post and will ensure that all NHS Chaplains are undertaking ongoing training and development to meet the demands of their post. In a similar way, the Spiritual and Religious Care Capabilities and Competences for Healthcare Chaplains describes the education and training required in order to perform in the role of a Chaplain.