Intended for healthcare professionals

Feature Christmas 2018: Christmas Spirit

Chaplaincy for the 21st century, for people of all religions and none

BMJ 2018; 363 doi: (Published 13 December 2018) Cite this as: BMJ 2018;363:k5223
  1. Richard Hurley, features and debates editor
  1. The BMJ
  1. rhurley{at}

Historically Christian services are adapting for the increasingly diverse populations served by the NHS. Many people in the UK today lack religion, but we all may need help with existential concerns about what it means to be ill and to die. Richard Hurley reports

“Lots of people perceive chaplaincy as a purely religious service. It isn’t,” says Simon O’Donoghue, head of pastoral support at Humanists UK, a charity that promotes non-religious people’s interests.

Since 2015, guidance from NHS England has been that non-religious people should have the same opportunities as religious people to speak to someone like minded in care settings.1 It’s down to individual trusts to provide chaplaincy, defined broadly as pastoral, spiritual, and religious care.

In the beginning, the Church of England offered religious support in NHS hospitals; other Christian groups and, more recently, other faiths followed suit. Today’s chaplaincy teams include Muslim imams and Jewish rabbis, as well as Catholics or Anglicans—and increasing numbers of non-religious, pastoral support carers (box).

Pastoral support in numbers

Employed chaplains in English NHS services cost at least £20m (€22m; $25m) in the year to June 2017, says NHS Digital. In that month it recorded 840 full time equivalent posts in England, 520 of them filled by men. These staff coordinate legions of volunteers.

In 2015 some 94% of employed NHS chaplains in England were Christian and 4.6% Muslim.4 England’s NHS now has nine employed humanist pastoral support carers, according to Humanists UK.

Nowadays most UK residents don’t identify as having a religion.2 Yet recent research by YouGov for Humanists UK found high demand among the public for someone to talk to about pastoral or spiritual matters in times of crisis.3 Almost 90% of those asked, however, said that they perceived chaplaincy as offering only Christian support.

Many people who might benefit …

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