A study of the role of the
Health Care Chaplain in England

School of Health and Social Welfare
Open University PhD 1998

James Woodward


This thesis explores the world and work of the acute health care chaplain in England through an examination of chaplaincy history, literature and experience. The core evidence used in the thesis is a body of empirical material within which health care chaplains articulate for themselves the key issues of working within Acute Care. This material provides an insight into how health care chaplains understood and managed their roles in hospitals during the early part of the 1990s.

The thesis falls into three parts. The first part sets the study within a particular framework explaining the method and sociological background to the study. Chapter 1 explains the rationale and content of the study. Chapter 2 sets out the objectives and methodology undergirding this study of the role of the acute health care chaplain. Chapter 3 places the study within the sociology of professions and contextualises the place of clergy in today's society.

The second part of the thesis presents the data. Chapter 4 provides the necessary historical background in order to understand how health care chaplaincy has developed since the establishment of the National Health Service in 1948. It also presents necessary information on the organisation and delivery of acute care in England, in order to contextualise the chaplains' responses to Health Service reorganisation in Chapter 6.

Chapter 5 evaluates chaplaincy literature in order to build up a systematic picture of how chaplains have described and reflected on their roles and functions. Chapter 6 presents the core empirical evidence and reveals how chaplains seek to come to terms with their particular environment and how their value and belief systems interact with practice. Chaplains describe how they do their work through their articulation of a range of roles, functions and activities. They express their understanding of the core tasks of chaplaincy work and discuss what helps or hinders them in fulfilling these tasks. In reporting the chaplains' perceptions about conflict, this study investigates how values operate in practice and how conflicts are resolved. Chaplains' use of time, and the literature they produce to communicate the nature of their chaplaincy departments, are also explored to examine the qualitative data and complete the picture of what chaplains do and why and how they do it.

Part three of the thesis presents the conclusions. Chapter 7 analyses the data in the light of both the methodology undergirding the study and the sociological context. It presents the picture that emerges from both the data and this analysis of chaplaincy in acute care. It discusses the range of roles, functions and models of chaplaincy presented in Part 2 of the work. Chapter 8 places the empirical evidence within the context of the impact of recent NHS reforms. It discusses the impact of organisational and managerial change on chaplaincy. Chapter 9 concludes the thesis by discussing its outcomes, limitations and possible ways forward for chaplaincy and chaplaincy research in the future.

Central to this thesis is the hypothesis that chaplains experience a measure of tension about both their role and function as they operate in the two worlds of the Church and the National Health Service. This study seeks to show how chaplains seek to resolve this tension; largely by giving priority to the needs and expectations imposed on them by the particular context within which they find themselves. There is little sign of grand theory or overarching strategy.