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CHAPLAINCY-SPIRITUALITY-HEALTH  June 2018

CHAPLAINCY-SPIRITUALITY-HEALTH June 2018

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Subject:

Re: Pateint Records

From:

Mark Newitt <[log in to unmask]>

Reply-To:

A network for chaplains, educationalists and researchers

Date:

Tue, 5 Jun 2018 09:22:31 +0000

Content-Type:

text/plain

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Parts/Attachments

text/plain (1 lines)

Dear All, 
 
Just adding to this that, following a serious case review where chaplaincy had vital information about a patient but it was only found out later that chaplaincy had  been involved in the patient care, we are meant, at a minimum, to document that we are involved in supporting a patient. 
 
In relation to writing in patient notes I sent around this JISCM mail list last month an article from the USA that clearly stated it felt that chaplains should have access to notes as part of MDT working.  
 
When writing in notes it is worth thinking carefully about what you write. A 2016 article (that I also sent around this list) looked at what chaplains wrote in notes in a ITU in the USA. It found that chaplains mostly wrote descriptive notes that either conveyed information that would already be known to an MDT (patient has lung cancer) of would be of little use to them without an interpretation of its significance (patient is Presbyterian). There was little evidence of any assessment of pastoral or spiritual need.  
 
There is a reflection on the article and its findings here: 
https://www.linkedin.com/pulse/chaplains-notes-patient-charts-raymond-j-lawrence-hankins-hull 
 
Best wishes, 
 
Mark 
 
 
 Save Paper - Do you really need to print this e-mail?  
  
Mark Newitt 
Specialist Chaplain 
Sheffield Teaching Hospitals NHS Foundation Trust 
Chaplaincy Dept, 
Royal Hallamshire Hospital, 
Glossop Road, 
Sheffield 
S10 2JF 
  
0114 27 13616 
bleep  - via duty chaplain (2492) 
   
This E-mail and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. 
Any views or opinions expressed are those of the author and do not represent the views of the Sheffield Teaching Hospitals NHS Foundation Trust unless otherwise explicitly stated. 
The information contained in this E-mail may be subject to public disclosure under the Freedom of Information Act 2000. 
Unless the information is legally exempt from disclosure ,the confidentiality of this E-mail and your reply cannot be guaranteed. 
If you have received this message in error, please notify me and remove it from your system. 
 
 
-----Original Message----- 
From: A network for chaplains, educationalists and researchers [mailto:[log in to unmask]] On Behalf Of carl aiken 
Sent: 05 June 2018 00:44 
To: [log in to unmask] 
Subject: Re: Pateint Records 
 
Hi Mark 
 
Thanks for the background. Being from Australia it is a different beast.  
All the best with the advocacy for change. 
 
A thought or two. Margaret makes a good point about information  
governance. This could be extended to include possible compromised  
patient care if the chaplain's interventions and conversations are not  
shared with the wider team. Duncan is right in the safe, effective  
person centred care too. And Paul's comment about professionalising  
chaplaincy is strategic. 
 
For us at our shop it was advocating much of the above and claiming our  
place at the table - as part of the multi-disciplinary team. And, isn't  
advocacy hard without sounding harsh! It took me over 10 years of gentle  
pressure to get our new sacredspace! 
 
Go well 
 
Carl 
 
 
On 5/06/2018 7:38 am, Mark Stobert wrote: 
> I thought that it would be helpful to give some of the background to the issue. 
> 
> The problem has been intractable from the original interpretation of the Data Protection Act by the then Data Commissioner.  It was wrongly assumed that chaplains were not employed by NHS but came in from local faith communities and were not healthcare professionals alongside other AHPs.  It meant that we have to have explicit consent to be able to receive personal and sensitive information.  As I understand it this still stands. 
> 
> This even includes what religion someone self declares as.  It also means that participating in MDTs and consultations should require explicit consent for us to be told patient information.  Trusts get around this by deeming it important for us to be involved in their holistic care and receive information on a need to know basis. 
> 
> Not only can a trust be liable for breaching the act and be prosecuted, knowingly receiving information without explicit consent also opens us up to being personally prosecuted. 
> 
> As some have pointed out, not having access to the records makes assessing levels of safety in visiting patients outside the hospital setting very difficult and may make us vulnerable, it is also of concern when reporting instances of safeguarding issues. 
> 
> The issues was revisited in the writing of the 2015 guidelines, but NHS England Information Governance was adamant that chaplains needed to comply with the commissioners interpretation. 
> 
> My understanding is that as it is an interpretation, it therefore is a president in law and would need an act of parliament to be challenged. (ie its not going to happen). 
> 
> That it has been an issue for all this time makes me feel like the circle cannot be squared and chaplains have to develop their practice around it.  Some years ago I explored ways round it with the Information Managers Professional body because it was and still does cause them headaches.  That trusts take different approaches suggests that there is no one answer.  This will depend upon how risk averse your trust is.  Some trusts have decided that the risks of non-compliance is far outweighed by the  benefit of chaplains receiving necessary information. 
> 
> UKBHC will continue to push for better access.  As Paul Nash states, registration and Accredited Register Status with PSA is a major gamechanger which we intend to exploit to the best of our ability. 
> 
> Regards Mark Stobert 
> 
> 
> -----Original Message----- 
> From: A network for chaplains, educationalists and researchers <[log in to unmask]> On Behalf Of Margaret Whipp 
> Sent: 04 June 2018 19:25 
> To: [log in to unmask] 
> Subject: Re: Pateint Records 
> 
> Hello Mike 
> 
> I work in the Oxford University Hospitals where Fiona Caldicott is Chair of the Trust. We have full access to notes, and have developed an excellent electronic interface with the PAS system to inform our own chaplaincy database so as to track patients being readmitted etc. We have access, where appropriate, to paper and electronic patient records, using this facility where most clinically and pastorally relevant to our model of embedded working in multi-disciplinary teams. We restrict direct access to records to salaried and honorary chaplains who are thoroughly trained in information governance. Volunteers read limited lists prepared by staff chaplains. 
> 
> Ours is an acute Trust. 
> 
> In our Trust there is a clear understanding that it would be a failure of information governance to prevent access to information which is necessary for excellent multidisciplinary care! 
> 
> Best wishes 
> 
> Margaret Whipp 
> 
> 
> -----Original Message----- 
> From: A network for chaplains, educationalists and researchers <[log in to unmask]> On Behalf Of Rev Mike Oates 
> Sent: 04 June 2018 12:15 
> To: [log in to unmask] 
> Subject: Pateint Records 
> 
> My line manager is supporting my access to the patents records system ( RIO) but the Trust gatekeeper for the service is unsupportive. My line manager has suggested collecting comments from other Chaplains as to their experience and the value they have found in being able to access patient notes. To me ( and him ) this is clear but I don't want to write anyone's responses for them ! 
> 
> I am a Chaplain in a Mental Health Trust 
> 
> Thanks Mike 
> 
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--  
Carl Aiken 0413 743 627 
 
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