CLERICS who have volunteered to become temporary chaplains in emergency field hospitals in London during the coronavirus crisis have been advised not to have any direct contact with patients, even when wearing protective equipment.
The new guidance was issued by the Bishop of Chelmsford, the Rt Revd Stephen Cottrell, this week in a letter to diocesan and area bishops and others involved in chaplaincy provision. It has been produced in consultation with the Barts Health NHS Trust, which is hosting the recently opened 4000-bed Nightingale Hospital in Newham (News, 9 April).
Bishop Cottrell writes: “The need to maintain extremely strict discipline regarding contact with patients cannot be over emphasised. This means that direct personal contact between patients in ITU and all chaplains is not possible at the Nightingale Hospitals. This is true of other NHS Trusts, although protocols on non-ITU wards may differ.
“The Church of England supports this approach and, nationally and through the dioceses, should not seek exemptions as we try to model best practice on behalf of the whole community. The experience in Newham suggests that much can be done remotely and in support of hospital staff without breaching rigorous distancing protocols.”
Barts NHS Trust, which reportedly has only two fully qualified chaplains available to minister to coronavirus patients, made a call for volunteers. Bishop Cottrell confirmed that a “small number” of diocesan clergy or licensed lay ministers (Readers) had been seconded to work with the Trust “for short periods of weeks or months when additional capacity is needed among the existing chaplaincy team. This could be replicated elsewhere.”
But, while fully trained and qualified chaplains could minister to sick and dying patients, volunteer chaplains were advised not even to enter Covid-wards, he said, even if they were wearing personal protective equipment (PPE), because the risk of spreading the infection was too great.
“In the case of East London, these volunteer chaplains will be thoroughly checked by Barts Health NHS Trust occupational health advisers and trained in advance in appropriate infection control measures. Similar arrangements could be negotiated with the responsible NHS Trust elsewhere.
“The temporary chaplains will provide pastoral care and support to staff inside the hospital and accommodation units. They will work with the existing chaplaincy team to facilitate electronic communication between sick patients and relatives on the ward but distanced from patients (nurses will take iPads/phones to the bedside while chaplains facilitate on Zoom or similar).
“They will not themselves minister to sick or dying patients at close hand (such duties will be performed by fully trained and qualified chaplains) and they must follow hospital protocols and take all reasonable precautions to ensure that they do not contribute to the spread of infection within, into, or out of the hospital setting.”
General volunteers who had enlisted through the GoodSAM scheme were also advised not to have any contact with patients, including those who did not have symptoms of Covid-19, to avoid the spread of infection. “The dioceses are to encourage volunteers always to follow social distancing and personal hygiene rules as laid down by Government. Cross infection must be avoided, and volunteers must not go on to wards or near patients due the risk of cross infection.”
These volunteers could help in other ways, following the Government’s social distancing guidelines, he said, such as delivering groceries to hotels and other centres where staff are staying.
In an article in The Times on Thursday, the Rector of St Bartholomew the Great, Smithfield, in London, the Revd Marcus Walker, wrote that other denominations had found ways of “safely recruiting and dispatching people to minister to their own faithful — and quite rightly.
“It is only the Established Church which has decided not to allow the upscaling of its presence. The two chaplains, divided (by some miracle) over five different locations, and working all hours of day and night, will have to engage in this desperately important but hugely challenging ministry by themselves.”
Last week, the lead chaplain for chaplaincy and spiritual care with bereavement services at Croydon University Hospital, the Revd Andrew Dovey, said that providing God’s grace in all situations, regardless of the risk, was “the calling that Christ gave [chaplains] and our Christian responsibility” (News, 3 April).
Fr Walker writes that the new advice goes against this calling. “Today we are banned from doing this, not by a hostile government or a suspicious health service but by our own Church.”
In a letter circulated on Thursday, Bishop Cottrell, along with the Bishops of London, Barking, and Stepney, said that they did not recognise Fr Walker’s observations. “Priests’ every instinct is to be alongside those who are sick and dying, to offer prayer, to accompany people through suffering and minister at the time of death. However, we who are priests and chaplains also have a duty to prevent infection and so save lives. . .
“At Barts Health NHS Trust, which includes five hospitals, plus responsibility for the new Nightingale facility, there is a multi-faith team of chaplains. The Anglican lead chaplain had made us aware that additional chaplaincy provision is needed. We had agreed to facilitate this by seconding a small number of clergy from parish and other responsibilities to the hospital setting. The dioceses of Chelmsford and London had already begun to identify such suitable volunteers and to put them in touch with the lead Anglican chaplain.
“As things currently stand, these additional volunteers cannot assist in face-to-face patient contact as this would increase the risk of infection transmission within, into, and out of the hospital. They can, however, assist in pastoral support of patients via video call on phone or tablet, and in the vitally important task of providing pastoral care to NHS staff. This was what was discussed with the lead chaplain earlier this week and it is what we will continue to advise our volunteers, unless otherwise formally requested by the Trust.”
The Church of England’s chief medical adviser, the Revd Dr Brendan McCarthy, explained on Thursday: “NHS chaplains act according to NHS Trust protocols and practices, and we support that approach. As the letter said, it is beyond our remit to address varying practices across the NHS.
“Healthcare chaplains are healthcare professionals; ‘temporary’ chaplains are not trained to face all the circumstances that a professional chaplain has to face, including training in the proper doffing and donning of PPE. It makes good sense for temporary chaplains to act, in the first instance, as back-up to professional chaplains who will continue to be in the ‘front-line’.
“Where a Trust determines that a temporary chaplain is required to minister to patients face to face and where it is satisfied that he or she is adequately prepared for this, it is their call on how they deploy them. It is also worth pointing out that this is advice, not instruction.”
Dr McCarthy was one of the signatories of the accompanying letter. It was also signed by the Bishop of London, the Rt Revd Sarah Mullally, the Area Bishop of Barking, the Rt Revd Peter Hill, the Area Bishop of Stepney, the Rt Revd Dr Joanne Grenfell, and the Director of Mission and Public Aaffairs for the Archbishops’ Council, the Revd Dr Malcolm Brown.
It states: “Although there are likely to be minor differences in the approach taken by different NHS Trusts where Nightingale Hospitals are being established, we hope that by sharing the experience from Newham, we can help other areas to respond quickly and effectively.
“Of course, not every diocese will host a Nightingale Hospital, but we wanted to share this material with all of you as it remains possible that the need for further beds may result in the rapid expansion of the Nightingale hospital network.”
The Mission and Public Affairs team was preparing a similar note on chaplaincy at the new temporary morgues. It would be circulated over the weekend, the letter said. “The Bishop of St Albans also hopes to be in touch with details of a referral hotline that has been set up in his diocese for hospitals to seek pastoral care for bereaved families and which could be replicated elsewhere.”