Are the providers of spiritual care in your hospital capable? Narrative review of professional accountability in Australia

Although spiritual care practitioners, also variously known as pastoral care workers or chaplains, have had a foundational presence in most Australian hospitals, the discipline has been poorly regulated and does not have national standards of care. This leads to inconsistencies in the way hospital administrators are able to scrutinize the credentials, supervision processes and capability of the Spiritual Care workforce. This paper is a narrative review of the systems ensuring safe practice for the Spiritual Care workforce, focusing on the relationships between professional associations, clinical workforce capability and education in this field of practice in Australia. Substantial gaps and inconsistencies are revealed in the education and training of clinical practitioners, findings which align with variability of practitioner capability and which provide no assurance of quality or accountability. On the basis of these findings, recommendations are provided for relevant stakeholders with a view to improving safety and quality of care consistent with other health care professions and to assure the Australian public that accountability is core to the services provided in their name and under their jurisdiction.