Establishment and adoption of professional competency standards for NHS chaplains in the UK
Submitting Institution
University of GlasgowUnit of Assessment
Theology and Religious StudiesSummary Impact Type
SocietalResearch Subject Area(s)
Education: Curriculum and Pedagogy
Psychology and Cognitive Sciences: Psychology
Language, Communication and Culture: Literary Studies
Summary of the impact
A professional framework, establishing core competencies for healthcare
chaplains, has been
shaped by the expertise of Glasgow-based researchers in practical theology
and reflective
practice. The framework provides clear bench marks for the training, work
and supervision of
approximately 4,000 full- and part-time healthcare chaplains working in
NHS hospitals and
healthcare facilities throughout the UK. Reflective practice — as
championed by the research
findings of Walton — is one of the four key competency domains identified
in the framework. This
framework was adopted by the NHS Scotland in 2008, by the NHS in England
in 2009 and by the
Welsh Assembly in 2010.
Underpinning research
Heather Walton (Senior Lecturer, Theology and Religious Studies,
University of Glasgow 1998-present)
has researched and experimented with theological reflection methods and
their use in
reflective practice. The correlation of reflection and practice is the
central problematic in practical
theology and Walton's distinctive academic background in theology,
literary theory, ministry
training and social research enabled her to make innovative links between
narrative theory,
ethnographic enquiry, life writing and pastoral care. Walton developed
forms of reflection that were
narrative in character and drew both upon the historical theological
traditions of spiritual biography
and the techniques of autoethnography and poetics. This particular
combination of reflective
techniques was innovative within her disciplinary area and proved
particularly fruitful method for
reflecting upon healthcare contexts. In complex and challenging
situations, pastoral practitioners
must wrestle with inherited beliefs and bring them into fresh and
meaningful conjunction with the
pastoral needs and personal questions of people in pain and enduring
intense suffering. The
creative and narrative approaches developed by Walton's research have
enabled healthcare
workers to find the resources to meet such challenges more effectively as
well as enabling them to
find meaningful ways of interpreting their own roles in such encounters.
Walton's early work (1993-2003) was undertaken in response to her own
experience of infertility
and the medical responses she encountered to this frequently neglected
problem [outputs 1 and 3
below]. The experiences of women have been occluded in the literature of
pastoral care and
Walton found it necessary to use narrative/poetic processes in order to
bring her embodied
experiences into a fruitful encounter with theological thinking [outputs
1, 3 and 6]. While it was the
subject matter — the emphasis upon embodiment and the healthcare
environment — that initially
commended her work to healthcare professionals, it quickly became apparent
that Walton's
reflective techniques provided a creative means for Chaplaincy workers to
address important
dilemmas within their own professional practice [outputs 1, 2, 4 and 5].
References to the research
1. H. Walton, `Passion and Pain: Conceiving Theology Out of Infertility',
in The
Interdisciplinary Journal of Pastoral Studies 130 (1999), p. 3;
reprinted in D Willows and J
Swinton, (eds), Spiritual Dimensions of Pastoral Care: Practical
Theology in a
Multidisciplinary Context (London, 2000), p. 196-202.
ISBN-13:9781853028922/ISBN-
10:1853028924. [available from HEI]
2. H. Walton, `Speaking in Signs: Narrative and Trauma in Practical
Theology' Scottish
Journal of Healthcare Chaplaincy 5.2 (2002), pp. 2-6. [PDF
link]
4. H. Walton, E.Graham and F. Ward, Theological Reflection: Methods
(SCM: London 2005).
ISBN 9780334029762. [available from HEI]
5. H. Walton, E. Graham and F. Ward, (eds), Theological Reflection:
Sources (SCM: London
2007). ISBN 9780334029779. [available from HEI]
6. H. Walton, Imagining Theology: Women Writing and God (T and T
Clark: London, 2007).
ISBN 9780567031730. [available from HEI]
The reach of Walton's research can be evidenced by the combined Google
Scholar academic
citations for (4) and (5) number 82, which is comparatively high for works
of practical theology
whose readership is primarily in the practitioner community, and these
citations are international in
range, appearing in journals, monographs and collections published in
(e.g.) North America, Africa
(Ghana, Nigeria, South Africa), Europe, the Far East and Australasia.
Items (4) and (5) are now
standard reference-points for all researchers in the field. Item (3)
appears in the leading peer-
reviewed journal for its topic; item (2) was intended to have a more local
impact, but it has become
a standard reference-point in handbooks for hospital chaplains (e.g. Swift
2009, Kelly 2007). The
reprinting, almost immediately, of item (1) in a major handbook (still in
print in 2013) is another
marker of the academic quality of the research.
Details of the impact
- Reach: The practices of the 3-4,000 full- and part-time healthcare
chaplains in the UK and
chaplaincy services and patients and staff in NHS hospitals in the UK
have been impacted by
the policies informed by Walton's research.
- Significance: Walton's research has lead to the establishment of the
first competency
framework governing healthcare chaplains in the UK, their core
skillsets, training and
supervision (adopted and implemented by NHS Scotland, England and Wales,
and the UK
Board of Healthcare Chaplaincy) and directly shaping inclusion and
content of one of the four
key domains within the framework.
There are 187 NHS health care trusts in the UK, running over 2300
hospitals and other care
facilities. Since the establishment of the National Health Service in
1948, there have been
chaplaincy services available throughout the institution, primarily based
on the assumption of a
broadly shared religious belief system. Since the late 1990s, however, in
line with views emanating
from the World Health Organisation, the NHS has acknowledged a wider
definition of spiritual care
and the importance of its role in the `full-person' healing and care of
patients.
Today's healthcare chaplains work in an environment where they are
answerable to three different
and at times seemingly incompatible groups. Chaplains seek to offer care,
compassion and
understanding to individuals — patients, staff and others — who
often have no religious
commitment and struggle to express their spiritual concerns. Chaplains of
all faiths are employed
by an institution — the National Health Service — which is secular
in character. And most chaplains
belong to a faith community to which they have strong personal
allegiances and which may feel
that the faith organisation and not the NHS has first claim on overseeing
their work. Additionally,
healthcare chaplaincy work is stressful and frequently involves assisting
people who are
confronting traumatic situations that can be difficult to accommodate
within a traditional theological
framework.
Walton's work has focused the sector's attention on the particular
effectiveness in these complex
circumstances of narrative and poetic techniques in:
- providing a capacious and flexible way of acknowledging the diverse
challenges facing
healthcare chaplains and creating meaningful links between these areas
as a guide to practice;
- generating effective pastoral communication and responses in contexts
in which there is no
shared framework of belief; and
- enabling chaplains to become aware of their personal and professional
responses to difficult
challenges, thus becoming more effective reflective practitioners.
The link between Walton's particular research insights and the influence
on the competency
framework for chaplains in the UK healthcare system was her earlier work
(pre-2008) at major
Chaplaincy conferences where she presented practitioners with a
methodological base for
theological reflection but also enabled them to engage in these reflective
processes through
creative writing exercises. Examples of influential events include the
Irish Healthcare Chaplains
Conference (2003): `Narrative Methods in Theological Reflection'; the
National College of
Healthcare Chaplains Conference (2004): `Beyond Storytelling in Practical
Theology) and her
consultancy to the National College of Healthcare Chaplains beginning in
2005.
Walton's high-profile espousal of reflective practice led to the
invitation to join the working group
sponsored by NHS Education Scotland which in 2008 produced the Spiritual
and Religious CareCapabilities and Competences for Healthcare Chaplains.
This framework, which serves as the
basis for healthcare chaplains' training, professional development and
supervision, detailed core
competencies in four key domains:
- knowledge and skills for professional practice;
- spiritual and religious assessment and intervention;
- institutional practice; and
- reflective practice.
The identification of Reflective Practice as a core competency domain
drew directly on Walton's
expertise as the only academic working group member with this specialism.
Walton was one of
only two theologians on the 17-strong committee and her particular
influence is seen not only in the
emphasis upon reflective practice and theological reflection methods but
more specifically in the
recognition of the importance of creative skills and imaginative resources
as a professional
resource for Chaplains. Reflective practice within the framework focuses
specifically on
understanding the various models of reflective practice and utilising
these to address case-related
issues and therapeutic relationships. Reflection is seen as a key element
of a chaplain's
professional development and ability to e.g. understand how belief systems
and practice inter-
relate; how to reconcile personal beliefs with those of others,
particularly how one's own belief
system may affect the attitudes and behaviour of people using the
chaplaincy service; and how to
build professional relationships with vulnerable people in traumatic
circumstances.
In 2009, the framework was adopted by NHS England, and the UK Board of
Healthcare Chaplaincy
(UKBHC) released a statement saying that they "recognised the vision,
experience and expertise
of NHS Education for Scotland (NES) in the preparation and publication of
a capability and
competency framework and is grateful for their permission to adopt and
reprint this document as a
framework for healthcare chaplaincy throughout the UK." In 2010, the Welsh
Assembly adopted
the same framework: "These competences and capabilities have been adapted
from the `Spiritual
and Religious Care Capabilities and Competences for Healthcare Chaplains'
(NHS Education
Scotland, 2007). The Welsh Assembly Government acknowledges with thanks
the support and
permission of NHS Education Scotland to use and adapt these competences
and capabilities."
Implementation of the framework on the ground continues to be supported
by Walton's
presentations and training sessions at key sectoral events. For example,
she presented a session
on `Narrative, Trauma and Identity' at the 2009 National Conference of
Healthcare Chaplains,
introducing methods of reflection that provide a basis for chaplains to
respond to traumatic events
and begin to use these through reflective exercises. She ran a similar
training day in Bristol in 2010
on `Narrative Methods of Theological Reflection'. In relation to the 2009
conference, the
Chaplaincy Team Leader of the NHS Dudley Group of Hospitals and then
President of the College
of Healthcare Chaplains gave the following feedback:
What you were able to do was go beyond the (prosaic) narrative
theology to the idea of poesis.
This paradigm leap in to poetry was to me revelatory. It hits its mark
because of the constant
encounter that I face with life shattering trauma, which often escapes
meaning. At least the
search for meaning is never satisfied except by through the encounter of
a caring self-
possessed other through which meaning can be experienced. When you said,
"Trauma shatters
narrative" and replaced it with poesis it opened up many dimensions....I
am able to introduce
others to narrative and poetic methods as I lead development days for
NHS staff called `Caring
Heart and Soul: A Refresher day to recover the path to the heart.' It
introduces our chaplaincy
volunteers (as well as an increasing number of Queens Foundation and
post-ordination
trainees) to the principle of such theological reflection methods.
The NHS Scotland Manager for Education Projects in Spiritual Care created
a three-year
programme of ministerial training (pre-2008) that was `deeply influenced'
by Walton's research,
particularly `Passion and pain: conceiving theology out of infertility'
[1]. In 2013, he still finds that
many chaplains struggle to get beyond applied theology. In teaching
theological reflection and
in supervising I often refer chaplains to your article and encourage
them to `hear' the theology
that is present in the raw human experiences they encounter daily and
then, akin to what you
did, attempt to write a first person account which could end `this is
how theology is done'. The
results are not surprisingly variable in terms of end product but the
process provokes
transformative learning as stuck practice is interrupted with first
person insertion and the divine
presence is disclosed in hints and guesses.
The impact of Walton's focused work on reflective practice can also be
seen in the incidences of
healthcare professionals choosing to do their PhDs under her supervision
at Glasgow (5 since
2000).
Sources to corroborate the impact
Evidencing membership of working groups and contribution to framework
(see Domain 4:
Reflective Practice):
-
Spiritual and Religious Care Capabilities and Competences for
Healthcare Chaplains,
published by the UK Board of Healthcare Chaplaincy (2009). [link]
[Also available from HEI]
-
Spiritual and Religious Care Capabilities and Competences for
Healthcare Chaplains,
published by NHS Education for Scotland (2008). [link]
[Also available from HEI]
- Guidance on Capabilities and Competences for Healthcare Chaplains /
Spiritual Care
Givers in Wales 2010 (see `Acknowledgements, pg1) [link]
[Also available from HEI]
- Programme Director for Healthcare Chaplaincy and Spiritual Care, NHS
Education
Scotland [contact details provided]
Evidencing impact of reflective practice presentations/training on
personal practice and
wider training:
- Chaplaincy Team Leader, Dudley Group of Hospitals (NHS), Birmingham
[contact details
provided]
Evidencing of impact of theological reflection research on personal
practice and wider
training:
- Trainer in Value Based Reflective Practice for NHS Spiritual Care
Scotland [contact details
provided]