Spiritual Care Framework Outline for Gender Clinics (NHS England Context)

From 2017-19 I led a project on spiritual care for people awaiting or undergoing gender transition with NHS gender clinics, funded by the Sir Halley Stewart Trust.

One of the resources I devised was a framework for spiritual care, adaptable to the needs of specific clinics and other gender services. The framework is now offered here on an open-access basis and can be used or adapted with appropriate credit.

Spiritual Care Framework Outline for Gender Clinics (NHS England context)

 Commission or petition for the commissioning of specialist chaplaincy services to oversee spiritual care for gender identity clinic (GIC) patients. Specialist chaplains will have a good knowledge and understanding of trans people and their particular concerns and challenges. A good many healthcare chaplains already have interests and expertise in gender identity, but because of gaps in commissioning services are not always called upon or resourced sufficiently to allow them to work with GICs.

 Where appropriate and necessary, support additional training on trans and non-binary people’s spiritual care for healthcare chaplains.

 Ensure that assessments of patients’ whole-life care, and pathways to wellbeing – including their support networks and their strategies for thriving after intervention – include explicit discussion of spirituality. Make sure that assessment of spiritual needs remains part of the conversation during review and monitoring, both during and after intervention.

 To this end, make the introduction of discussions of spiritual care a dedicated part of the remit of the patient’s Named Professional. (The Named Professional might subsequently devolve ongoing oversight of spiritual care to a colleague who liaises with the commissioned chaplaincy service.)

 As a tool for assessing a given patient’s need or desire for spiritual care, use a series of simple questions to find out:

- Whether the patient belongs to a religion and/or faith community.

- Whether they have particular spiritual beliefs that are significant to them.

- Whether these beliefs are likely to impact, positively or otherwise, on the patient’s wellbeing and journey to wellness.

- Whether the patient would like particular spiritual support.

Some teams and NHS trusts will already have a preferred spiritual needs assessment tool that can be used for this purpose. For those who do not, we recommend FICA. (Faith/belief; Importance; Community; how should it be Addressed in care?)

 Keep a repository of faith communities and leaders (including some in the region covered by the GIC, if possible) who are welcoming to trans people, so that patients who desire a referral to a particular faith group may be put in touch with a safe contact where possible. Make these details available to patients early in the process, ideally at the point at which patients are triaged by GICs after referral from primary, secondary or tertiary care, so that spiritual support may be provided even if the patient has to wait a long time for treatment to begin.

 Throughout a patient’s care with the gender identity service, ensure that processes, protocols and models of care focus as far as possible on understanding the reality of the patient’s life experience and what gives them meaning."

Citation: Cornwall, Susannah (2019), "Spiritual Care Framework Outline for Gender Clinics (NHS England context)", University of Exeter: Modelling Transgender Spiritual Care Project, https://susannahcornwall.blogspot.com/2021/11/from-2017-19-i-led-project-on-spiritual.html

This framework can be read and used in tandem with “Healthcare Chaplaincy and Spiritual Care for Trans People: Envisaging the Future”, Health and Social Care Chaplaincy 7.1 (2019), 8-27, DOI: 10.1558/hscc.37227