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Caring for the Whole Person

Caring for the Whole Person

Tuesday July 17 2018

As the UK celebrates 70 years of the NHS, Jackie Macadam hears how chaplaincy has been central to the service from the beginning.


This year marks the 70th anniversary of the National Health Service, often described as ‘the Jewel in Britain’s Crown’. A system designed to put good health care into the hands of everyone who needed it, when they needed it.

Right from the beginning, the role of chaplain was seen as part of the health care team, and chaplaincy still has an important role to play today.

The Scottish Government claims that best practice in 21st century health care attends to the whole person – the physical, mental, social and spiritual aspects of human living. When emotional and spiritual needs are addressed, service users and staff experience a greater sense of wellbeing in dealing with ill health.

Health care chaplains are employed as part of NHS Scotland’s multi-disciplinary teams. They have a responsibility to attend to the existential and spiritual needs of all within health care communities including the specific religious and ritual needs of individuals, families and organisations.

The Rev Dr Derek Brown is Lead Chaplain for NHS Highland, based at Raigmore Hospital. He explains: “The NHS has had to adapt itself to the ever changing needs of society and its successes, which as well as boosting the health of the nation, have also presented us with fresh and very different challenges as people live longer.

“Despite all the change there are some constants which remain. One is the founding principle of care being given free at the point of need. Another is what undoubtedly is the greatest asset of the NHS, which is its staff and all their qualities. Without them, nothing would be achieved.

“There’s another constant in there too. That is the presence of chaplains in the health care system. The role of the chaplain, too, has changed over these last seven decades – reflecting the changes in society but importantly those chaplains continue to offer care that is tailored for each person they meet. The anxieties of receiving a diagnosis, or the worry about an operation, these things do not diminish just because the NHS has better tools at its disposal to treat conditions. People still need to talk, or to cry or rage and always, they need to be listened to.

“Walking with someone through some of the darkest moments of their lives is hard – but it is also very rewarding. Helping people find meaning in the midst of chaos, offering hope when all seems desolate is part of what a chaplain does. That help is offered from a basis of the chaplain knowing who they are and what they believe even if the person they are with does not personally share that faith in God.

“Health care chaplains can be found not just in hospitals these days. In NHS Highland I am involved in delivering a listening service in a GP surgery in Inverness which enables people to express their feelings and explore issues. I am also involved in teaching nursing students about spiritual care at the University of the Highlands and Islands and we also provide reflective practice to staff in wards and departments. We have just established a pilot staff support service to help people deal with the demands made on them and keep them in touch with why they entered their profession. I also serve in an ethical capacity on certain clinical bodies for the Health Board and during Death Awareness week I was involved in organising a bereavement stall with charities in the main shopping centre in Inverness.”

The Rev Michael Scoular is a newly minted hospital chaplain working in the Borders. Twenty-six years of parish ministry, and four years in the army before that, has prepared him for his new role.

“I am a new NHS Chaplain serving in the Borders,” he says. “I am fortunate that there is a wonderful purpose-built Chaplaincy Centre attached to Borders General Hospital. Amid all the activity, much of it stressful, some of it distressing, the Centre offers a comparative peace. A precious space for reflection and hopefully time for people, if they wish, to be listened to.

“The NHS is human in all the fantastic or flawed ways that we can be human. Any eulogy to it would have to include all those aspects, but it would be fitting to say what a magnificent gift it is to the nation; it’s much too easy to forget that. And it’s not indestructible. Caring for it means caring for the folk who work in it, so that they may better care, in all their many areas of expertise, for the folk who, for whatever reason, must use it.

“Caring for carers is not something we apprehend as quickly as we ought to, so a lot of chaplaincy is inevitably about that. Patients are in a peculiarly vulnerable situation. And as a fellow chaplain observed recently, the issue most on the mind of a patient may not even be the medical reason for their admission. It’s rewarding to sit by a bedside, even for only a couple of minutes, and feel you’ve eased something of the burden of someone’s predicament.

“Chaplaincy, in my opinion, stands or falls almost entirely according to the humanity of the chaplain, their capacity to build trust and respect. That is a daunting challenge for someone who knows even only some of their frailties.”

Professor Jason Leitch is National Clinical Director for Health Care Quality and Strategy, Scotland. Though he is not a chaplain himself, his job allows him to come into contact with the work the chaplains do regularly, and gives him a unique perspective on their work.

He says: “Chaplains are a crucial part of the health care team. They are one of over 50 professions who together provide the health and social care provision to the five and a half million people in Scotland. They are spiritual and compassionate guides in tough times and happier times. When included properly in care, in my experience, they add considerably to the experience of those they serve.”