Skip to main content

‘Chaplains for well-being’ in primary care: analysis of the results of a retrospective study

  • Peter Kevern (a1) and Lisa Hill (a2)

Aim: To analyse quantitative changes in patient well-being concurrent with chaplaincy interventions in a retrospective study of a group of Primary Care centres in Sandwell and West Birmingham, United Kingdom. Background: Anecdotal evidence suggests that support from trained Primary Care Chaplains may be particularly useful for those with subclinical mental health issues; it can reduce the tendency to ‘medicalise unhappiness’ and is a positive response to patients with medically unexplained symptoms. However, to date there has been no published research attempting to quantify their contribution. Method: Data were gathered from a group of Primary Care Centres, which make use of a shared Chaplaincy service. Demographic data and pre–post scores on the Warwick and Edinburgh Mental Wellbeing Scale (WEMWBS) were collected for patients who had attended consultations with a Chaplain. These were subjected to tests of statistical significance to evaluate the possible contribution of chaplaincy to patient well-being along with possible confounding variables. Findings: a substantial improvement in WEMWBS scores (mean=9 points, BCa 95% CI [7.23, 10.79], P=0.001) post-intervention. The improvement in scores was highest for those with initially lower levels of well-being. There is therefore evidence that chaplaincy interventions correlate with an improvement of holistic well-being as measured by a WEMWBS score. A prospective study on a larger scale would provide more detailed information on the interaction of possible variables. Further study is also required to evaluate the implications of this result for patient outcomes and GP resources. The efficacy of Primary Care Chaplaincy is under-researched and difficult to measure. This paper represents the first attempt to quantify a measurable improvement in the well-being of patients who are referred to the service.

Corresponding author
Correspondence to: Dr Peter Kevern, Faculty of Health Sciences, Staffordshire University, Blackheath Lane, Stafford ST18-0AD, United Kingdom. Email:
Hide All
Brush, B. and McGee, E. 1999: The Expanded Care for Healthy Outcomes (ECHO) Project: addressing the spiritual care needs of homeless men in recovery. Clinical Excellence in Nurse Practice 3, 17.
Brush, B. and Daly, P. 2000: Assessing spirituality in primary care practice: is there time? Clinical Excellence in Nurse Practice 4, 6771.
Bunniss, S., Mowat, H. and Snowden, A. 2013: Community Chaplaincy Listening: Practical theology in Action. Scottish Journal of Healthcare Chaplaincy 16, 4251.
Bryson, P., Dawlatly, S., Hughes, A., Bryson, E. and Petra, H. 2012: Honouring personhood in patients: the added value of chaplaincy in general practice. England: Whole Person Health Trust.
Care Services Improvement Partnership. 2008: Guidelines on spirituality for staff in acute care services. London: National Institute for Mental Health in England.
Cocksedge, S. and May, C. 2005: Pastoral relationships and holding work in primary care: affect, subjectivity and chronicity. Chronic Illness 1, 157163.
Cocksedge, S. and May, C. 2009: Doctors’ perceptions of personal boundaries to primary care interactions: a qualitative investigation. Community medicine 6, 109.
Das, J. 2012: A primary care approach to mental health and wellbeing: case study report. Retrieved 26 May 2013 from
Department of Health. 2003: NHS Chaplaincy: meeting the religious and spiritual needs of patients and staff. London: DoH.
Department of Health. 2009: Religion or belief: a guide for the NHS. London: DoH.
Ellis, M. and Campbell, J. 2004: Patients’ views about discussing spiritual issues with primary care physicians. Southern Medical Journal 97, 11581164.
Jaeschke, R., Singer, J. and Guyatt, G. 1989: Measurement of health status. Ascertaining the minimal clinically important difference. Controlled Clinical Trials 10, 407415.
Kliewer, S. 2004: Allowing spirituality into the healing process. Journal of Family Practice 53, 616624.
MacLean, C., Susi, B., Phifer, N., Schultz, L., Bynum, B., Franco, M., Klioze, A., Monroe, M., Garrett, J. and Cykert, S. 2003: Patient preference for physician discussion and practice of spirituality. Journal of General Internal Medicine 18, 3843.
Maheswaran, H., Weich, S., Powell, J. and Stewart-Brown, S. 2012: Evaluating the responsiveness of the Warwick Edinburgh Mental Well-Being Scale (WEMWBS): group and individual level analysis. Health and Quality of Life Outcomes 10, 18.
McCord, G., Gilchrist, V., Grossman, S., King, B., McCormick, K. and Oprandi, al. 2004: Discussing spirituality with patients: a rational and ethical approach. Annals of Family Medicine 2, 356361.
Mental Health Foundation. 2007: The impact of spirituality on mental health. Retrieved 26 May 2013 from
Mowat, H., Bunniss, S. and Kell, E. 2012: Community Chaplaincy Listening: working with General Practitioners to support patient wellbeing. Scottish Journal of Healthcare Chaplaincy 15, 2735.
Mowat, H., Bunniss, S., Snowden, A. and Wright, L. 2013: Listening as health care. Scottish Journal of Healthcare Chaplaincy 16, 3541.
National Council for Palliative Care. 2011: Palliative care explained. Retrieved 26 May 2013 from
NHS Education for Scotland. 2009a: Spiritual care matters. Retrieved 26 May 2013 from
NHS Education for Scotland. 2009b: Spiritual and religious care capabilities and competences for healthcare Chaplains. Retrieved 26 May 2013 from
Ronaldson, S., Hayes, L., Aggar, C., Green, J. and Carey, M. 2012: Spirituality and spiritual caring: nurses’ perspectives and practice in palliative and acute care environments. Journal of Clinical Nursing 21, 21262135.
Royal College of Psychiatrists. 2006: Spirituality and mental health. Retrieved 26 May 2013 from
Snowden, A., Telfer, I., Kelly, E., Burniss, S. and Mowat, H. 2013a: The construction of the Lothian PROM. Scottish Journal of Health Chaplaincy 16, 316.
Snowden, A., Telfer, I., Kelly, E., Burniss, S. and Mowat, H. 2013b: ‘I was able to talk about what was on my mind’. The operationalisation of person centred care. Scottish Journal of Healthcare Chaplaincy 16, 1326.
Stewart-Brown, S. and Janmohamed, K. 2008: Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) user guide version, 1. Warwick: Medical School, University of Warwick.
Stewart-Brown, S., Tennant, A., Tennant, R., Platt, S., Parkinson, J. and Weich, S. 2009: Internal construct validity of the Warwick-Edinburgh Mental Well-being Scale (WEMWBS): a Rasch analysis using data from the Scottish Health Education Population Survey. Health and Quality of Life Outcomes 7, 1522.
Taggart, F., Friede, T., Weich, S., Clarke, A., Johnson, M. and Stewart-Brown, S. 2013: Cross cultural evaluation of the Warwick-Edinburgh Mental Well-being Scale (WEMWBS): a mixed methods study. Health and Quality of Life Outcomes 11, 2738.
Tanyi, R., McKenzie, M. and Chapek, C. 2009: How family practice physicians, nurse practitioners, and physician assistants incorporate spiritual care in practice. Journal of the American Academy of Nurse Practitioners 21, 690697.
Taylor, D., Mulekar, M., Luterman, A., Meyer, F., Richards, W. and Rodning, C. 2011: Spirituality within the patient-surgeon relationship. Journal of Surgical Education 68, 3643.
Tennant, R., Hiller, L., Fishwick, R., Platt, S., Joseph, S., Weich, S., Parkinson, J., Secker, J. and Sarah Stewart-Brown, S. 2007: The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation. Health and Quality of Life Outcomes 5, 6375.
Vermandere, M., De Lepeleire, J., Smeets, L., Hannes, K., Van Mechelen, W., Warmenhoven, F., van Rijswijk, E. and Bert Aertgeerts, B. 2011: Spirituality in general practice: a qualitative evidence synthesis. British Journal of General Practice 61, e749e760.
Wilson, K., Lipscomb, L., Ward, K., Replogle, W. and Hill, K. 2000: Prayer in medicine: a survey of primary care physicians. Journal of the Mississippi State Medical Association 41, 817822.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Primary Health Care Research & Development
  • ISSN: 1463-4236
  • EISSN: 1477-1128
  • URL: /core/journals/primary-health-care-research-and-development
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed