No 21 March 2005
I'm sure that most of us will have admired the courage and sheer guts of Ellen MacArthur as she completed her record breaking round the world sail recently. The more land-lubbing group amongst may say, ‘What was the point?' but it's still pretty remarkable. The day that she was arriving back in Falmouth I happened to hear another round the world yachtsman, Robin Knox-Johnstone, interviewed on the radio. It took him about four times as long to complete his journey when he did it in 1969, about 300 days to Ellen's 71. One of the main reasons for that lies in the boat design and the materials used to build it. Another major factor was that he had to spend about two hours every day just finding out where he was, using technology that Captain Cook would have recognised.
I think something similar has been happening in the realm of spiritual care. The assumptions and values that informed and energised Chaplaincy a generation ago I suspect would have been quite familiar to Florence Nightingale. I'm not quite so sure that would be the case now. There have been monumental shifts in practice and in the understanding of what spiritual care is that do get us to our ultimate destination but in a way that is quite different to anything that has gone before. Now that spiritual care has become a policy issue, subject to the rigours of Performance Assessment, our managers will expect us to know where we are and where we're going pretty sharpish.
One thing remains constant. And that is the human element. Technology may have had its part to play in both sailors' endeavours but the fact is that we have to admire their spirit and determination. It should go without saying that the human element must be paramount in the spiritual arena. The danger is that we are distracted from our core purpose by clinical standards, spiritual care policies, pay and conditions and the like. All of these things are important and should of course be given due consideration but we must never allow them to get in the way of the relationship we build up with patients, their families and staff. Indeed, unless we think that all these pieces of work are going to enhance what we do at the bedside and in the corridor then are they worth pursuing?
How then do we balance these two aspects of Chaplaincy? Perhaps the only way is to be prepared to discuss the issues and examine them for challenges and opportunities. In December's Soundings I asked the question about where we thought we might be as a profession in five or ten years' time. The Spring meeting will give us all a chance to think about the direction that Chaplaincy is headed and I hope that even if you are unable to be in Perth you might give thought to what is happening and let the Executive know what you think.
I hope to see some of you soon. Sou'westers are optional.
I suspect that most of you will be aware that the Church of Scotland agreed at its 2004 General Assembly to proposals to restructure the apparatus of boards and committees organised from its Offices in 121 George Street, Edinburgh.
A Council of Assembly was appointed with unprecedented power and authority to take forward the proposals and set up 6 new councils to replace the existing boards and committees.
The Board of National Mission is to be no more and from 1 June 2005 its work is to be split amongst 3 of the new councils. For chaplaincies this has resulted in a place within the new Ministries Council which is not a straightforward successor to the present Board of Ministry but a much wider body with the remit of “recruitment, training and support of recognised ministries for the mission of the Church, and assessment of patterns of ministerial deployment and parish staff.”
The committee structures have been substantially reduced and within the interim structure (with a lifespan of 3 years) Chaplaincies is one of 5 Task Groups reporting via the Council Co-ordinating Executive to the Ministries Council. There are no plans at present for separate sub-committees for Healthcare, Universities, Prisons or Industry with the Chaplaincies Task Group having only 14 members to cover all existing responsibilities plus Ministry among Deaf People. The principal behind this leaner set up is to enable the council staff to be allowed to get on with their jobs more effectively and efficiently with the support of a small group of focussed and committed members of councils or task groups. There is of course also a funding aspect to the process with the aim of achieving substantial cost savings, and this is a clear indicator that the Church is facing up to the reality of the projected reduction in its financial resources.
With all this change in the Church's structures it would not, on the face of it, be the best time to be planning huge changes in its administration of healthcare chaplaincy. However this ball was rolling well before the Church's internal arrangements were being examined. The introduction of the Spiritual Care Guidance in 2002 was the catalyst for change and as time went on it became clearer to the Board of National Mission that the current employment and appointment system was hindering the development of chaplaincy and spiritual care. Again it's fair to say that financial considerations played a part with the Board no longer able to fund indefinitely its support of chaplaincy at current levels.
The establishment of the NHS Human Resources Forum Short Life Working Group on Chaplaincy in late 2003 has facilitated meaningful dialogue amongst the key players in the discussions, eg National Mission, the Scottish Executive Health Department, NHS Boards, CHCC, SACH and the Training & Development Unit. After a series of meetings in January this year a set of proposals has been remitted to the NHS HR Forum which, in essence, recommends that all generic chaplains currently either appointed or employed by National Mission be transferred to the employment of NHS Boards and that, in future, responsibility for the employment of generic chaplains rests with NHS Boards. It is envisaged that NHS HR departments will take advice from local spiritual care committees and that local faith communities, eg presbyteries, will be involved in the recruitment and selection of healthcare chaplains.
At the time of writing a response from the NHS HR Forum is awaited. It should be noted that the above proposals included a target date of 1 April 2005 for commencing the revised arrangements. It will take a yet unknown period of time to complete the process of change.
John K Thomson
Chaplaincies Administrator,Board of National Mission
22 February 2004
Data Protection/HDL – Data Protection continues to be problematic. "HDL (2002) 76" – a draft revision of certain parts is being prepared. A revised edition will be sent to chief executives and others shortly. It includes sections on
a) Data Protection,
b) a paragraph on likely change of employer of chaplains,
c) A World Health Organisation description of the necessity of spiritual need as an integral part of health, alongside physical, psychological and social need.
A new leaflet talking about Muslim attitudes to healthcare and a brief introduction to this faith community is being prepared. It is hoped to have this ready in the next few months. It will be a development of the presentation made by Hafiz Sadiq to a recent meeting of the (Multi-cultural) Spiritual Care Development Committee.
A Report from the Short Life Working Group of the HR Forum has been submitted to the Departmental HR group in February. It proposes to the SEHD HR group that Healthcare chaplains be transferred to direct NHS employment from a suggested date of 1st April 2005. This date was felt to be optimistic. FAQs (frequently asked questions) to be produced for chaplains; if these and the report are accepted, the process should move forward. Amidst some concern from the three largest non NHS employers - the Roman Catholic Church, the Scottish Episcopal Church and from some areas of the Church of Scotland, the Department has offered meetings along with myself to listen to what these concerns are. So far we have met with representatives of the Catholic Bishops.
Glasgow Caledonian University has been negotiating with us about the accreditation of courses on chaplaincy into their BSc in professional studies. A module descriptor for the CPE basic unit has been submitted and should be available in accredited form from the Autumn. The Chaplaincy Academic and Accreditation Board - with representation from chaplains throughout the UK has also agreed to give credit points to this and to our new introductory two day course.
All Boards have recently filled up self assessment questionnaires to do with their compliance and progress on PFPI ( Patient Focus and Public Involvement) This also includes the Equality and Diversity initiative, and feedback on spiritual care progress is part of this. I am currently taking part in some of the review meetings along with members of the Involving People Team of the SEHD.
A day conference for lead managers in spiritual care takes place on 10th March. This will allow them to see what is happening in other boards, to hear of Harriet Mowat and John Swinton's recent research, to share good practice in spiritual care provision, and hopefully be inspired to continue and increase their efforts.
Life is full!
Training and Development Officer
At the Association AGM in October 2005 the current secretary will stand down.
This position is open to full members of the Association
Term of office is one year, after which the holder is eligible for re-election
What is involved?
- organize and attend Executive meetings, currently held in Perth four times a year
- organize AGM
- minute taking
- co-operate closely with President, Membership Secretary and Treasurer
If you are interested in this position or would like more information, please contact Monica Stewart on 01224 554907
or E-mail email@example.com
or write to Chaplains Office, Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB25 2ZN
Where the Gulf of Mexico gently intrudes into the Texas coast, I practice hospice chaplaincy for VistaCare Hospice in Corpus Christi. The reason I'm writing to SACH Soundings is that I want to tell you all about my trip in October 2004, to Inverness where I spent the evening with the Rev Dr Derek Brown. During our time together I had two very opposing observations.
First, hospice care in Great Britain and hospice care in Texas, USA, have very basic differences. And yet, my second impression was that at the point of contact, chaplain to patient, there was absolutely no difference whatsoever.
Derek proved a gracious and knowledgeable host. When I'd first emailed him in March, he was transitioning from Highland Hospice into the new role as Lead Chaplain (North) in NHS Highland and Raigmore Hospital in Inverness. Despite his ministry/career move, we made plans to visit when I arrived in October.
I wonder if he knows what an excellent first impression he made on me when I shook his hand upon introduction and asked, “Will you go to church with me?” After all, it was late afternoon on Sunday, October 21, and I am a woman who loves corporate worship.
“Yes,” he said, “where are we going?”
Now that's a chaplain, in my book! In the United States, Medicare (our public health provider) requires that I be nondenominational. The Scottish chaplain's immediate response made my heart smile in recognition. First he said "yes" and then he asked, "where," as if saying that the "what" was much more important than the "where."
St Andrew's Cathedral's evensong service would begin in a few minutes, and so we were off, walking from my bed and breakfast lodging across the River Ness bridge and down to the Cathedral. There we were, two of twelve attending services.
Perhaps you know that where I live, the so-called Bible Belt of the United States, church attendance hovers around 60 percent. I am always awed by the lovely, old churches in Scotland. Now I was a worshiper in one! Derek, non-Anglican that he is, was much quicker at locating our place in the prayer book than I was and his help made my worship journey easier. (That's chaplaining, isn't it?)
As we left, one of the worshipers stopped us. She had recognized him and offered her gratitude for his ministry to someone she cared for. I am quite tempted to name the patient, or at least give you his title, but professional boundaries prevent my so doing. It would, however, make you more appreciative of what happened next.
As we walked away from the cathedral, Derek told me about the chaplain visit of which the parishioner spoke. When he told me the story, deep called to deep. That's when I knew that he could come to Corpus Christi and minister immediately to my patients in Nueces County, Texas. He spoke of being asked to do the improbable, of not knowing how to respond, and, as always, of being used by God to meet the patient's needs.
That's often where I find myself with my patients. Maybe you do, too.
After a short walk, we arrived at Highland Hospice where staff welcomed Derek like a long lost son. For the next half hour, he gave me a grand tour of the facility, all along telling me stories of patients who had touched his life, as I'm sure, he'd touched theirs.
We compared hospice funding: ours is per patient which means that the more patients we serve, the more income our company makes. Derek explained that in Scotland, the marketing effort is toward raising volunteer donations to fund care for patients. We look for patients to serve and the government pays us to care for them. I was amazed to learn that in the country where modern day hospice care was revived and blossomed, that patients are dependent on donations of others. When I shopped at TESCO later in my trip, my shopping bag asked me to “Support Your Hospice.” In Stornoway, I shopped in the thrift store operated by Bethesda Hospice. Hospice fundraising seemed to be everywhere.
I shudder to think how we would fare if we depended on donations to fund our care of patients in Corpus Christi. During my tour of the Highland Hospice, I learned about both day and in-house care of hospice patients. Where I live, hospice is provided in the patient's home or at the long term care facility where they reside. For acute care for our patients, we use our hospitals.
As I said, there are so many differences in funding and delivery between the South Texas and Scottish Highland hospices.
And yet there are similarities.
1. The biggest challenge is teaching the value of hospice to our communities.
2. The chaplain, over the long haul, becomes a recognized figure. What are the odds? One of twelve worshipers knew Derek. Since the population of Inverness is about 50,000, perhaps that incident reminds us that as chaplains, we touch lives in ways that last. People remember us.
3. The chaplain, too, is touched by those to whom he ministers and his stories are filled with their journeys.
4. The chaplain is open to new relationships and “yes” is the first answer he or she gives, always seeking how to say “yes” whether it's to walk to worship or to fulfil a patient's request. The chaplain is able to create intimacy quickly, almost as if to say, "be comfortable with me and we will walk together for a little while."
And so it was that as we parted company, this highland chaplain and this Texas chaplain, I asked for what the other patient had asked for: I asked for Derek's blessing.
And he gave it, there on the banks of the Ness. And may God bless him right back, packed down and running over. And may He bless all of you, too, who minister to strangers in times of crisis and fear. God bless you as you bless others.
And when you get to Texas, be sure to look me up. We can worship together in a church or on the Gulf shores. And I'll tell you my stories of South Texas patients who bless me every day.
Spiritual Care Coordinator
Corpus Christi, TX
I USED TO BE A NURSE
NOW I'M A HEALTHCARE PROVIDER
I USED TO PRACTICE NURSING
NOW I FUNCTION UNDER A MANAGED CARE PATHWAY
I USED TO HAVE PATIENTS
I NOW HAVE CLIENTS OR CUSTOMERS
I USED TO TREAT
NOW I WAIT FOR AUTHORISATION TO PROVIDE CARE
I USED TO SPEND TIME LISTENING TO MY PATIENTS
NOW I SPEND TIME JUSTIFYING MYSELF AND MY ACTIONS
I USED TO HAVE FEELINGS
NOW I HAVE AN ATTITUDE
NOW I DON'T KNOW WHAT OR WHO I AM!
John S. McKinnon
Aberdeen Royal Infirmary
I am the Managing Editor of "PlainViews - an e-newsletter for chaplains and other spiritual care providers." I would invite any member of SACH to subscribe - it is free. This is a vehicle for chaplains to talk with other chaplains all over the world. We currently have about 6,800 subscribers from various parts of our world. We started one year ago with 3,100. Please check us out at
I also welcome submission of articles for consideration -articles are about 500 words each.
Rev Martha R. Jacobs
At the November 2004 meeting of the editorial board we received the resignations of Stewart MacGregor and Lorna Murray, and would wish to record our thanks for their support and expertise over their time of service. The development and professional credibility of the journal has very much been driven by the active participation of members of the editorial board, and both Stewart and Lorna have contributed positively to that development.
At our May 2005 meeting we look forward to welcoming the following new members :
Ewan Kelly, former hospital chaplain, now lecturer in theology and ethics at New College;
Heather Walton, lecturer in practical theology at Glasgow;
Iain Telfer, chaplain within the University Hospitals Division of NHS Lothian, and much involved with SACH as a member of the executive; and Janet Foggie, recently appointed as mental health chaplain based at Royal Dundee Liff Hospital.
We anticipate that our new members will help the board to continue building up the quality and reputation of the journal.
In our forthcoming edition we will address topical issues such as agenda for change, and registration of chaplains, as well as providing our usual mix of diverse and thought provoking articles. To echo Derek Brown's suggestion in the December edition of Soundings – why not write for the journal? Share your reflections, your research, your good practice, your thoughts on the burning issues. Contact us, and we'll be happy to advise you.
Meanwhile, our thanks are due as ever to the board and to James Falconer, our business manager.
Here's to volume 8!
Georgina Nelson and David Mitchell
Just a wee note to let you know that the 2005 subscription reminders for SACH will start going out soon. SACH is changing to a new way of collecting subscriptions from February 2006 . From that date you will be asked to set up a standing order with your bank and pay your subscription yearly, quarterly or monthly.
That's for next year! For this year you will be asked to pay for the proportion of the year between your renewal date and February 2006, so that the renewal date for everyone will become February.
Sounds complicated? Not really, and all will be explained in the letter which you will get from Margaret Clark, the membership secretary.
Give her a ring (01224 553316) if you have any questions or problems.
You can find this (and previous) editions of SACH Soundings in full colour
on the SACH Website:
If you would like to receive the colour version of SACH Soundings by E-mail in Acrobat PDF Format, send your E-mail address to: Fred.Coutts@sach.org.uk
Send news, articles, pictures, stories and ideas s soon as possible to:
Rev Fred Coutts
Aberdeen Royal Infirmary
Tel: 01224 553166