ChaplaincyRoyal Bolton Hospital

2013

The journey

• Chaplaincy at Bolton has radically changed and will continue to do so

• As an on-going process we examine the needs of patients and staff and adapted our service accordingly

• Employment of Ethnic Minority Chaplains, first as volunteers, then as paid, part-time

• Training both internally and externally• On-going Supervision

Standards & Competencies• The College of Healthcare Chaplains, Multi-faith

Group for Hospital Chaplaincies worked together to produce documents for Standards & Competencies

• The Chaplaincy at Royal Bolton Hospital introduced these in the department and developed their role.

• Bolton Chaplaincy Department also developed their own “Spiritual Care Pathway” which was published and which is used in variant forms in many other Trusts

Spiritual & Religious Care

• All religious and spiritual care is based on a face to face relationship between the chaplain and the patient, their carers or member of staff

• The process is to help a person to find out where they really are (in spiritual terms) and assist them to move to another place more acceptable to them

The Role – Patients & Relatives• Spiritual Care: • Normalisation• Assessment of Spiritual need• Holistic Care• Discussion & support in stressful situations• Breathing and other techniques for reducing

stress• Support of relatives• In-house follow-up

• Religious Care:

• Multi-faith care• Prayer and sacraments (bedside)• Group services e.g. Jumah, Sunday

Communion etc.• Referrals to & from ministers of religion or

religious representatives at the request of patients

• End of Life & Bereavement Care: • Involvement in wedding planning and

blessings for the terminally ill• Liaison with MacMillan Nurses & terminal

illness group• Preparation of patients & family for death

situations• Reconciliation of estranged members of

families• Support for families leading to and at the

point of death• Baptism/blessing of Stillborn or Neonatal

death babies• Remembrance Services for Stillborn Babies• Interment of ashes (stillbirths etc.)• Funerals• Follow-up on an outpatient basis

The Role - Staff• Team members & volunteers support &

supervision • Team members & volunteers appraisals • Support Trust staff in times of stress, work stress or

home stress/keeping the workers in work • Meditation for stress with Trust individuals and

other stress reduction techniques

• Resource for faith specific information to trust staff

• Presentations to departments on chaplaincy, cultural or faith issues

• Assist in HR function in disputes involving religious or cultural issues.

• Supporting managers or departments in the management of change.

• Supporting Managers and departments when staff die in post

• Remembrance Services for staff • Occasional services for specific events • Liaison with Bereavement and Organ Donation

Group for patient input

• Input/presentations for Bereavement and Organ Donation training courses for Bolton staff and external participants

The Role - Corporate• Management of a multi-faith department &

volunteers • Data collection for Chaplaincy activity with patients • Manage Chaplaincy On-call service • Monitoring and control of faith specific rooms

• Liaison with local faith bodies for faith specific spiritual care of patients and staff

• Procurement of multi-faith acceptable food/meal sources and monitoring of those sources for faith specific requirements

• Involvement in creation of policy documents for religious and spiritual care of patients and staff

• Liaison with other chaplaincies to develop and promote good practice. (Bolton is regarded as a flagship Chaplaincy)

• Corporate Committees: • Staff Wellbeing• Best Employer Steering group• End of Life Strategy Group• Bereavement & Organ Donation Working Party• PCT. Equality Target Action Group (Religion &

Belief)

• Review NHS Documents relating to spiritual care and comment on drafts.

• Manage Chaplaincy Majax:

• Prepare or update documentation• Training of Chaplaincy Staff• Rostering• De-briefing of Chaplaincy Team or other members

of Trust staff• Review of “fitness for purpose” of chaplaincy

response

The Role - External• Assist in the procurement and

monitoring of multi-faith acceptable food sources in the NW Hub

• Member of the Greater Manchester

Chaplaincy Collaborative • Member of the Spiritual Care Group

of the Greater Manchester Cancer Network

• Bishop of Manchester’s Advisor on Healthcare

• Advisor to Hospital Chaplaincy Council on health issues

• Advisor/Assessor to the DoH & United Kingdom Board for Healthcare Chaplains for Hospital Chaplaincy Appointments

• Presentations to external groups about chaplaincy

• Chaplaincy Supervisor

• Liaison with faith groups through faith-leads

Activity 2011 2012 CommentsNationally Recommended Establishment

6.2 6.2 WTE

Bolton Chaplaincy Establishment 3.8 3.8 Jan-Oct

2.7 Nov-Dec. WTE

Chaplains’ paid time 7,410 7053 Hours per yearActual time worked 8,845.75 8549 Hours per yearChaplains’ unpaid time 1,435.75 1496 Hours per yearReduction in Salary due to loss of RRP

9.2% - 15.2% 5% - 10% Band 7 Pay point 34

Band 5 Pay point 16Volunteer Time 766.5 1014 Hours per year

Ward Visiting 43,000Approx.

40,000Approx.

Chaplains visit 85% of inpatients. The 15% include those who are away from their beds because of treatment (e.g. X-rays, Physiotherapy etc.) The reduction is due to the temporary staff shortage of 1.1 wte Nov. & Dec.

Significant Encounter Triggers (SE) 2,301 2,397

Triggers as of “Spiritual Care Pathway”. On average input to patients triggering this type of record required 30 minutes to 3 hours per visit, with the possibility of multiple visits of these durations.

Input to “In Danger of Death”

1165% of SE

1365.6% SE

Input to bereavement or potential bereavement situations is approximately only 10% of Chaplaincy work

Input to “Death” situations

1004.3% of SE

1174.8% of SE

Emergency Callouts 429 502 Out of HoursCommunicants (Chapel) 1,350 1546 Sunday and midweek services

Communicants (Bedside) 724

804

For those unable to attend chapel

Mindfulness Training for staff 153 From 15 Departments

Burial of Babies’ Ashes

31

35

Many of these involved input to parents before and after the burial. Duration for this input varied a great deal.

Memorial Service (patients) 270 310 Number of people attending

Memorial Service (Staff) 200 227 Number of people attendingOther Services (staff & patients) 110 98 Number of people attending

Mosque (staff & patients) 3,976 4,010 Number of people attending

Hindu Temple Festivals 1,200 1,100 Number of people attendingEmergency Baptisms 7 9 Largely babies in danger of deathEmergency Blessings 63 212 Largely stillborn infantsCommittee Meetings Attended 42 30 Internal

External Meetings Attended 12 9 Cancer Network, Interfaith Groups

etc

Spiritual care is yours and mine.

• To be aware of giving meaning to your own life and of your own concepts of spirituality.

• Comfort patients in stressful situations and bring to the forefront patients’ spiritual concerns and distress.

• To consider how ethics and spirituality inform the organisation to which you belong.

Look at your managers, is this where you want to be when you

get there?

• Are they alive spiritually as a leader and human being?

• How do they fuel and encourage the spirit of those they work with?

• How do they keep and strengthen spiritual care for patients and those they serve?

Consider

• Where is your own source of strength and spirituality?

• Where do you get your strength when things get tough?

• Do you appreciate others when things are tough for them?

• How can WE help?

A quiet, comforting word or just someone to be there and listen. Being a patient in hospital can be a frightening experience and sometimes an alien one - away from family and friends. The chaplains and their team at the Royal Bolton Hospital work behind the scenes, administering the kind of support that does not come on an NHS prescription. This multifaith team does a sterling job and sometimes religion appears incidental. The next time you are in hospital and need a sympathetic ear, the Reverend Neil Gray and his colleagues will not be far away. Bolton Evening News, 30 August 2010