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Healthcare provision in relation to faith issues:
issues for healthcare employers
Paper for the Equality and Human Rights ...
the diversity of the customer/service user population. And indeed there is good and
growing evidence for this1
,2
.,3
.
Th...
public interest to support equality for LGBT populations. Both the APA and the British
Psychological Society have member d...
(or realistic depending on your viewpoint) numerical estimates of religion in the UK
put it at around a third of the popul...
Psychological research has shown that the process of sharing one’s identity as
LGBT or T, otherwise known as “coming out” ...
Lessons from scientific literature would suggest that…”any consideration of
employees well-being must of necessity address...
A healthcare system which does not address religion as an issue is a healthcare
system which is missing opportunities for ...
While few healthcare employers would feel this is all they do, the fact remains from
research cited above that healthcare ...
a. A fundamental insight here is that EVERYONE has a belief system,
no one is neutral or exempt
ii) Staff should think thr...
5. Celebrate every faith and spirituality. If you celebrate Pride for LGBT staff why
not celebrate Ramadan and Eid as well...
20.Establish a faith reference council.
Conclusion
The roadmap is developmental for fruitfully addressing religion and fai...
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faith in health settings : issues for employers

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A paper for a round table held by the Equality and Human Rights Commission on faith issues in healthcare settings

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faith in health settings : issues for employers

  1. 1. Healthcare provision in relation to faith issues: issues for healthcare employers Paper for the Equality and Human Rights Commission Invited Rountable on Religion and Health, 23rd July 2015 Jim McManus, CPsychol, AFBPsS, FFPH, FRSPH, Jim McManus is Director of Public Health for Hertfordshire and Vice-Chair of the Health and Social Care Advisory Group for the Catholic Bishops of England and Wales. He is a Visiting Fellow at the Heythrop Institute for Religion and Society at Heythrop College, University of London, a Chartered Psychologist and Chartered Scientist and a member of the Faith Action advisory council. He has over twenty years’ experience of work in Equality and Diversity including producing a guide for NHS Trusts on Making Religious Diversity work for your Trust, producing toolkits on hate crime reduction for the Home Office and previously holding appointment from the Lord Chancellor to the ETAC Committee of the Judicial Studies Board, which advised the Judges and Magistrates of England and Wales on Equality and Diversity issues. Key Points UK diversity action seems to do better on some strands than others, and lessons from these high-performing strands can be learned and shared. Employers also need to deal better with complex diversity (most people do not have just one protected characteristic.) Faith needs to be seen in this context. A healthcare system which cannot address and manage positively and sensitively the religious and spiritual concerns of its staff is not going to succeed in managing the religious and spiritual concerns of its patients. There are well evidenced benefits of spirituality for staff in employment, and for patients in recovery. Healthcare workers of faith who work in an atmosphere where their own beliefs are respected can both enhance their professionalism and augment patient outcomes. Employers need to take a structured approach which enables organisation and employees to reflect on faith and values. The paper makes some points from shared and studied experience about how to do this. Valuing diversity in the workplace It has become a commonplace observation that valuing the diversity of the workforce is an important tool for any organization to both secure best productivity, build a positive psychosocial working environment to bolster that productivity, and represent
  2. 2. the diversity of the customer/service user population. And indeed there is good and growing evidence for this1 ,2 .,3 . The style and culture of the organization, the psychosocial work environment, and indeed the style of leadership deployed by its leaders and managers all have a role in shaping the value placed on different diversity strands within that organization4 . There is even some evidence that leadership styles which may affirm those of one protected characteristic within the Equality Act 2010, may disaffirm those of other protected characteristics, and that sensitivity to this is important5 . Consequently, valuing diversity for those of all protected characteristics seems both sensible and important. Yet at least one study6 found that most NHS employers find different diversity strands more or less challenging. The one most found easiest to deal with often seems to be sexual orientation. The one most NHS trusts are finding most challenging was, and anecdotal evidence seems to suggest continues to be, religion. Many would argue that disability and race are also still problematic. Learning between and across diversity strands in the workplace Estimates for the Lesbian, gay, bisexual and transgendered (LGBT population of the UK vary from 1.5% according to the Office for National Statistics7 with up to 6% according to estimates derived from the Treasury and Out Now Consulting8 . The evidential, moral and legal case for equality and diversity work for this section of the UK population is well made for employers9 , yet many commentators feel employers still have a long way to go on this10 . The American Psychological Association set up an office for LGBT concerns11 , aimed at disseminating psychological science in the 1 Jones, J et al (2013) The Psychology of Diversity. Chichester: Wiley 2 Neal, J (2012) Handbook of faith and spirituality in the workplace. New York: Springer 3 Stockdale, M et al (2003) The Psychology and management of workplace diversity. Oxford: Blackwell 4 McDermott, A, Conway, E, Rousseau, D, & Flood, P 2013, 'Promoting Effective Psychological Contracts Through Leadership: The Missing Link Between HR Strategy and Performance', Human Resource Management, 52, 2, pp. 289-310 5 Fassinger, Ruth E. ; Shullman, Sandra L. ; Stevenson, Michael R. (2010) Toward an Affirmative Lesbian, Gay, Bisexual, and Transgender Leadership Paradigm American Psychologist, Vol.65(3), p.201-215 6 Brass, V and McManus, J (2008) Religious Diversity and NHS Trusts in England. A mixed methods study Oral Presentation and supporting report. National Catholic Healthcare Conference, St Marys University, Twickenham 7 Source: National Household Survey, Office for National Statistics 8 The Observer, Sunday 11 December 2005 http://www.theguardian.com/uk/2005/dec/11/gayrights.immigrationpolicy 9 Metcalfe, H and Rolfe, R (2011) Barriers to employers in developing lesbian, gay,bisexual and transgender friendly workplaces. London: National Institute of Economic and Social Research. Accessible at https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/85514/LGBT-equality- workplace.pdf 10 LGBT diversity: why business is far from a level playing field. The Guardian, October 10 th , 2014. http://www.theguardian.com/sustainable-business/2014/oct/10/lgbt-diversity-business-equality-burberry- christopher-bailey 11 http://www.apa.org/pi/lgbt/about/index.aspx
  3. 3. public interest to support equality for LGBT populations. Both the APA and the British Psychological Society have member divisions and networks dedicated to psychological science on this diversity strand. While there are member networks on psychology of religion, they have been more focused on scientific study than engaging in public interest debates. So employers have sometimes not had readily presented in digestible form the kind of science to support them in addressing religious diversity which they have had in LGBT issues. The same can be said to varying degrees for disability and some other protected characteristics. LGB equality (equality for transgender persons seems to have a longer way to go still) does seem to have captured the imagination of some employers, and the passionate commitment of employees and national agencies like trades unions and stonewall in a way in which disability and religious diversity does not seem to have. Guides to LGBT equality in the workplace are commonplace. Guides to help employers with religious diversity are not so readily available. The then NHS guidance on religion produced a few years ago was withdrawn after the intervention of the then Archbishops of Canterbury and Westminster on the grounds that faith communities neither recognized it as supportive or helpful not felt recognized by it12 . It would seem that LGBT people are becoming more and more a publicly affirmed aspect of civil society, in the workplace and outside it, with concomitant benefits for them and for society as a whole, many would argue. Identifying populations of identity even through census questions can be notoriously problematic and fickle13 , yet it would seem we have some consistent evidence about both the comparative size of the LGBT and religious populations, and their change and distribution, from a variety of sources. The picture with religion seems to be more one of contrast and nuance. Taking from Grace Davie’s landmark work in this field14 neither employers nor civil society seem well equipped to deal with the “religious supermarket shelf” which is modern Britain, and the persistence – despite enormous change – of both believing in a faith or spiritual issue and “belonging”, or formal membership. There is a trend in reduction in “belonging” - formal membership of many Christian denominations, expressions of “believing” seem to be on the increase - an interest in ultimate issues and the divine growing in various aspects of private life and formal membership of some faiths (Islam, some Christian denominations) is being bolstered, not least from immigration (e.g. Eastern European Catholics.) Religion is, formally and informally, alive and well in modern Britain and more prevalent than many other protected characteristics. Religious belief even if not belonging affects up to 70% of the British population. The 2011 Census found that 59% of persons in the UK still identify as “Christian” compared to 71.6% in 2001 15 . Even the surveys which give the most conservative 12 The author had a hand in drafting the letter 13 Aspinall, P (2009) Estimating the size andcomposition of the lesbian,gay, and bisexual population in Britain. London: EHRC. http://www.equalityhumanrights.com/sites/default/files/documents/research/research__37__estimatinglgbp op.pdf 14 Davie, G (1994) Religion in Britain: believing without belonging. Oxford: Blackwell and Davie, G (2015) Religion in Britain – a Persistent Paradox. Chichester: Wiley Blackwell 15 Source: Office for National Statistics, Census 2011.
  4. 4. (or realistic depending on your viewpoint) numerical estimates of religion in the UK put it at around a third of the population16 . Indeed, Woodhead and Catto17 case studies together present a nuanced and complex picture of a broad and changing religious landscape including decline and revival in institutional Christianity simultaneously (along with other faiths) and new energies in Islam, some forms of Christianity, Hinduism and development of “public spiritualties “ in culture. The explicitly religious, and the perhaps less formalized but nonetheless deeply felt concerns with issues of ultimate value we might call “spiritual” are alive and well, and employers need to take account of them. We seem, paradoxically, to do better on equality and diversity for a smaller population than for a much larger one. That should not be taken as an argument to row back on any diversity strand but should at least give healthcare employers pause for thought about how their good work in one area may not be being replicated in another. There are a number of issues, arising from employers, to consider here from the qualitative work by Brass and McManus (cited above) and a further (as yet unpublished) follow up by McManus in 201318 . 1. Religion seems to be becoming increasing privatized (and yet remain important for many people) so that employees and employers feel embarrassed about talking about it in the workplace. 2. A lack of learning from well-paced and well performing diversity strands to those less well performing. Race, disability and faith are often perceived to be areas where we can do better 3. An over-zealous assumption on the part of some employers that all religions are discriminatory about sexual orientation and therefore sharing this contradicts LGBT equality. (Note how this does nothing to deal with complex diversity, people both of faith who are also LGBT, for example.) 4. Straightforward embarrassment about religion 5. Lack of religious literacy on the part of employers and employees 6. A mechanistic assumption that people largely fall into one protected characteristic or diversity strand than another….so people of faith are often largely assumed to be heterosexual. Indeed, some research suggests that management handling of religion and sexual orientation as workplace diversity issues differs in tactics, or seems to come into needless conflict19 . 16 See https://humanism.org.uk/campaigns/religion-and-belief-some-surveys-and-statistics/ 17 Woodhead, L and Catto, R (eds) (2012) Religion and social change in modern Britain. London: Routledge 18 McManus, J (2013) NHS Leaders perceptions on religious diversity. Unpublished manuscript
  5. 5. Psychological research has shown that the process of sharing one’s identity as LGBT or T, otherwise known as “coming out” while potentially stressful, has positive effects on the person and the workplace and community, and can reduce prejudice20 . At a time when that lesson is being learned by employers on LGBT issues, we seem to have adopted an approach where people of faith are often asked to keep silent as a conscious or unwitting diversity tactic. Religion and the workplace For people of faith, their faith remains important to them even and especially in the workplace21 . If the psychological research on acceptance of diversity characteristics is to be believed, this cannot be good for a positive psychosocial working environment. There is significant and burgeoning psychological and social scientific interest in the role of spirituality in the workplace22 . Addressing this constructively and well, and recognizing that it is part of someone’s identity has been found to be salient in developing organizational loyalty and in addressing a range of concerns for employees, from creating a positive and valuing psychosocial workplace (and hence enhancing resilience against stress) to creating loyalty which enhances productivity23 . Recent research suggests that the science, nascent as it is, is outpacing employer based policy in this area, and that important lessons for managing religion and spirituality positively in the workplace are not being learned by many employers24 . Some commentators suggest that religious discrimination cases in the workplace can be seen as a byproduct of not having a properly though through ethical approach to Religion25 , and not learning the lessons which organizational sciences may have to offer26 . 19 Mitchell, M; Creegan, C and Dickens, S (2011 ) Management Handling of religion and belief in the workplace : challenges and solutions in Wright, T and Conley, H Gower Handbook of Discrimination at work. Farnham: Gower. 20 American Psychological Association Officer for LGBT Concerns. http://www.apa.org/pi/lgbt/resources/reducing-sexual-prejudice.aspx 21 Park, C L (2012) Religious and Spiritual Aspects of Meaning in the Context of Work Life. In in Hill, P.C; Dik, B K and Dik, B J (2012) Psychology of Religion and Workplace Spirituality. Advances in Workplace Spirituality Series. Information Age Publishing. pp 25-42 22 Carroll, S.T (2013) Addressing Religion and Spirituality in the Workplace in Pargament, K I (Ed) APA Handbook of Psychology, Religion, and Spirituality. Washington, DC: American Psychological Association Press 23 King, Stephen M (2007) Religion, Spirituality, and the Workplace: Challenges for Public Administration. Public Administration Review (67) pp103- 114 24 Benefiel, M; Fry, L and Geigle, D (2014) Spirituality and religion in the workplace: History, theory, and research. Psychology of Religion and Spirituality, Vol 6(3), Aug 2014 25 Religious Discrimination in the Workplace: A Review and Examination of Current and Future Trends 26 Ghumman,S; Ryan, A M; and Barclay, L A (2013) Religious Discrimination in the Workplace: A Review and Examination of Current and Future Trends. Journal of Business and Psychology. 12,2013, (28 (4)
  6. 6. Lessons from scientific literature would suggest that…”any consideration of employees well-being must of necessity address the religious/spiritual domain of employees’ lives27 . It is arguable, and the contention of this paper, that the issue of managing religion or spirituality in the workplace is both problematic and problematized by our response. significant debate, and ethical issues, but with one or two notable exceptions28 there has been little policy or guidance for employers on the ethical issues in addressing religion in the workplace, or indeed potential issues arising between religious freedom on one hand, and the rights of other diversity strands to be and feel valued and included on the other. Much guidance has been focused on law and legal issues, with precedent handed down which creates issues for employers. But to date this issue remains one where policy, ethical thought and guidance remains under- powered, despite the size and resources of religious communities in the UK. McManus29 produced and revised annually a guide aimed at the NHS, but while this was seen by some trusts, many NHS leaders felt much more needed, and remains still to be done30 . King contends that religion brings specific challenges to the public administrative workplace, because of the complex interplay of diversity and other human rights law31 . Overlaid with the concerns of NHS leaders laid above, it may be unsurprising why this issue remains problematic, but it is hardly satisfactory either from an employer or an employee perspective. Religion and human health: issues for healthcare employers If the evidence on the importance of recognizing and addressing religion and spirituality is growing and significant, then the evidence on the importance for understanding and address religion and spirituality in healthcare is even more so32 . Issues of ultimate meaning occur when someone is faced with serious or even uncertain illness, and many people of faith understand and make sense of their health in terms which are explicitly or implicitly religious or spiritual33 ,34 ,35 . 27 Davis, E B and Hill, P C (2012) Promoting the career well-being of religious/spiritually oriented employees by supporting their emotional resilience an spiritual fitness in Hill, P.C; Dik, B K and Dik, B J (2012) Psychology of Religion and Workplace Spirituality. Advances in Workplace Spirituality Series. Information Age Publishing. pp 89-112 28 Webley, S (2009) Religious Practices in the Workplace. London: Institute of Business Ethics http://www.ibe.org.uk/userfiles/op3_religious_practices.pdf 29 McManus, J (2009) Making religious diversity work for your Trust. London: Catholic Bishops’ Conference of England and Wales 30 McManus, J (2013) NHS Leaders perceptions on religious diversity. Unpublished manuscript 31 King, Stephen M (2007) Religion, Spirituality, and the Workplace: Challenges for Public Administration. Public Administration Review (67) pp103- 114 32 Pearce, M J (2013) Addressing Religion and Spirituality in Healthcare Systems. In Pargament, K I (Ed) APA Handbook of Psychology, Religion, and Spirituality. Washington, DC: American Psychological Association Press 33 Masters. K and Hooker, S (2013) Religion, Spirituality and Health in Paloutzian, R and Park, C (Eds) Handbook of the psychology of religion and spirituality. London; Guildford, p 519-539 34 Park, C and Slattery, J (2013) Religion, Spirituality and Mental Health in Paloutzian, R and Park, C (Eds) Handbook of the psychology of religion and spirituality. London; Guildford, p 540 - 559
  7. 7. A healthcare system which does not address religion as an issue is a healthcare system which is missing opportunities for healing, adjustment, coping and resolution in its population of patients. It would seem self-evident from the research literature that a healthcare system which cannot address and manage positively and sensitively the religious and spiritual concerns of its staff is not going to succeed in managing the religious and spiritual concerns of its patients. The commitment of the NHS Constitution to value the religion and spirituality of patients, underpinned by the Public Sector Equality duty in respect of both patients and staff, seems not always to have firm universal foundations in the practice of healthcare organizations. Issues of managing what the spiritual concerns of patients are, and how staff who may have very different religious viewpoints from staff help and support patients make understanding of their journeys, is part and parcel of everyday social life. The management task is to find how to address this sensitively and supportively for both staff36 and for patients. Some agencies and some professions, like the resource, experience and skill of Chaplains, are better at doing this than others37 ,38 . But healthcare employers who positively seek to address religion and spirituality in the workplace and in patient life may run fewer risks of litigation and complaints and may be better positioned to gain workplace and patient gains, if the scientific literature is to be believed, than those who take an avoidant approach because of anxiety or wishing – however well-intentioned – to avoid offending others. The example of prisons39 shows both the potential to be gained, and the pitfalls to be avoided, if this is done effectively. Webley40 summarizing his research with organisations advises that It is sensible to consider issues around the practice of religion in the workplace before they become a matter of public concern. It is always preferable to address sensitive issues in a constructive and calm way rather than having to make up policy under time constraint without careful thought about the consequences of its implementation. Allegations of discrimination on the grounds of religion are increasing in the workplace. Merely to include a clause in the corporate code of ethics that this will not be tolerated is insufficient. 35 Idler, E (2014) Religion and Physical Health from Childhood to Old Age in Idler, E (Ed) Religion as a Social Determinant of Public Health. New York: Oxford University Press. Pp203-250. 36 Bond, S; Holland E and Colgan, F (2009) Integration in the workplace: emerging employment practiceon age, sexual orientation and religion or belief. London: Equality and Human Rights Commission Research Report 36 37 NHS England (2015) NHS Chaplaincy Guidelines 2015. Leeds: NHS England 38 It is the author’s experience that chaplains themselves would often acknowledge their own continued journey in this respect. 39 Beckford, J (199) The Management of Religious Diversityin England and Wales with Special Reference to Prison Chaplaincy. International Journal on Multicultural Societies (IJMS), Vol. 1, No. 2, 1999: 55 - 66 40 Webley, S (2009) Religious Practices in the Workplace. London: Institute of Business Ethics http://www.ibe.org.uk/userfiles/op3_religious_practices.pdf page 21
  8. 8. While few healthcare employers would feel this is all they do, the fact remains from research cited above that healthcare employers consider this area one of enduring challenge. Some Guidelines and salient steps: values reflexivity Yet there are some tried and trusted mechanisms which organisations can avail themselves of to address equality and diversity issues. Some of these as research conducted for the EHRC pointed out41 , are better suited to larger employers such as using employee networks. But using employee networks, making use of NHS chaplaincy teams, working with local faith fora and setting both ethical and policy boundaries around equality and diversity work are important. These steps can often bolster the approach of the Equality Delivery System42 which some managers have referred to as “mechanistic, tick box but fundamentally unhelpful to resolving difficult, ethical and interpersonal issues43 ” The following is some reflections and pointers from the practice of the author in acting as a consultant, advisor, trainer mediator and problem-solver to NHS agencies and faith groups over the past fifteen years. This paper contends that those trusts and employers who do well on employee relations and patient experience on religion and spirituality tend to meet these criteria. The first part of these pointers is what the author calls the principles of religious reflexivity. Derived in part from the traditions of theological reflective practice44 ,45 ,46 and NHS reflective practice47 ,48 , and being put in place by many chaplains, experience suggests that four principles of religious reflexivity are salient are salient. Indeed a very recent book on theological reflection49 suggests the value of this reflexivity as a tool for working across as much as within faith traditions. i) Staff should be encouraged to be reflexive about their faith and belief systems (and all staff. This applies equally to staff who are humanist or atheist and those who may feel theistic religion has no place.) What does my faith or belief system mean about me, about others, about my workplace and especially about those who may be challenging to my belief system? 41 Bond, S; Holland E and Colgan, F (2009) Integration in the workplace: emerging employment practiceon age, sexual orientation and religion or belief. London: Equality and Human Rights Commission Research Report 36 42 http://www.england.nhs.uk/ourwork/gov/equality-hub/eds/ 43 Personal communication to author, May 2015 44 5.Killen. P. O and J. De Beer. (1995) The Art of theological reflection New York: Crossroads Herder Publishing Company 45 2.Heather A. Warren, Joan L. Murray and Mildred M. Best (2002) 'The discipline and habit of theological reflection.' Journal of Religion and Health Vol. 41, No. 4. 46 Trokan, J (2013) Models of Theological Reflection: Theory and Practice. Catholic Education Journal. Accessible at http://digitalcommons.lmu.edu/cgi/viewcontent.cgi?article=1032&context=ce 47 Fook, J. and Gardner, F., (2007). Practising critical reflection: a resource handbook. Maidenhead: Open University Press. 48 Bolton, G., (2010). Reflective practice: writing and professional development. 3rd ed. London: Sage Publications. 49 Foley, E (2015) Theological Reflection across religious traditions. New York: Rowman and Littlefield
  9. 9. a. A fundamental insight here is that EVERYONE has a belief system, no one is neutral or exempt ii) Staff should think through and explicitly share and discuss where the limits are between being true to one’s own belief system and those of others and seek guidance in the workplace about boundaries and acceptability. For example, understanding how our own values work and how a patient’s values may differ means we can avoid imposing our values on them, or allowing their values to be imposed on us. iii) Staff should come to common ground on values in the work they do and for the patients they serve, expressed as commonly as possible, but which people of different faiths and none can see their role in. So, for example, Catholic nurses have a very strong sense of vocation to nursing. This should be respected and enhanced. It is different from, not better than, the reasons others go into health; but for almost all, their work in healthcare is part of their value system as much as it is a career choice. iv) Staff should continue to reflect on that in the workplace and their clinical practice, especially in supervision, and seek to ensure that they develop a practice which can be informed by their beliefs and values, and upholds common values. Seek to turn these into principles of sensitivity in practice. In this way religion and spirituality is explicitly recognized, and accepted to be a contributor to common ground. This does not mean there will never be conflict. That is important to state in any organization. So how might employers do this in practice? Experience from across the country, which is yet to be rigorously researched or written up, suggests the following points are salient: 1. Adopt the principles of religious reflexivity as an organization and deliver training on this, and then set it down in supportive policy and Provide training on this 2. Use chaplains and other resource people to develop training and policy on the religious and spiritual dimensions of healthcare for patients. a. Organise some ongoing staff training on this to share the research practice and consider identifying a clinical leader or leaders for spirituality in the workplace. This will benefit not only patients but staff. 3. Identify resource people from and for faiths and offer training to employees on reflexivity 4. Educate people about what different faiths and spiritualities say about health. Most chaplaincy departments seek to do this. HR and Chaplaincy teams could work together on this.
  10. 10. 5. Celebrate every faith and spirituality. If you celebrate Pride for LGBT staff why not celebrate Ramadan and Eid as well as others? 6. Recognise that in a diverse workplace there will be clashes. Offering training on what is and is not acceptable 7. Develop a policy with staff from all diversity strands represented 8. Consider working with an agency like Faith Action (www.faithaction.net) on a covenant between faith communities and the NHS organization for both patients and staff, and do this as part of the NHS Equality Delivery System 2. 9. Include in the policy providing time off for employees for religious reasons. Do this in a way which does not discriminate against others. 10.Provide space for worship where it is available 11.Encourage employees to consider their differences and discuss them, and reach common ground 12.Have a clear policy on staff exemptions e.g. abortions, morning after contraception on grounds of conscience 13.Monitor areas where there is clear discord or difficulty and provide and encourage space for discussion 14.Seek to avoid over-reaction. Use grievance or disciplinary processes as a last resort 15. In your policy be clear on those areas which are unacceptable and enforce the no-tolerance approach to them. People need to know what constitutes unacceptable conduct 16.Provide literature for staff on the diverse faith issues for the patient population and issues like rituals and health. There are many resources readily available 17.Ensure you have clear and sensitive rules on praying with patients that put sensitivity to the patient’s wishes and allowing staff to discern what the patient wants in the centre; and learn from mistakes, do not blame 18.Have clear and consistent rules on staff dress and be clear why those rules are there. If you allow LGBT or racial symbols why do you not allow crosses? You need to be consistent here. 19.Consider explicitly in your business planning the religious and faith diversity of your staff and patient populations in order to meet your public sector equality duty in designing and delivering health care provision. And be explicit about what this means. If you are unsure, seek guidance
  11. 11. 20.Establish a faith reference council. Conclusion The roadmap is developmental for fruitfully addressing religion and faith in the workplace; and no two agencies seem to have adopted approaches which are alike. But it is important to ensure that these issues are addressed. The brief summary of research presented here can do no more than point to the wealth of evidence which describes the importance of doing this. And the pointers and practices identified here are from practice, they are yet to be written up and rigorously researched. But the feedback which the author has had from those who are using them is that they have value.

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