The origins of Just Ask
Just Ask has been developed by Trainee Advanced Clinical Practitioner David Melvin as part of his Masters Degree in Advanced Clinical Practice, with the support of Paul Berry, Chaplain and Spiritual Care Co-ordinator.
David said while reflecting on areas of weakness in his own practice, he realised he hadn’t carried out any spiritual care training since joining the hospice.
“Spirituality is widely regarded as an essential component of palliative care, and yet it is an optional addition to the mandatory clinical skills training,” he said.
“During my research it was widely reported that if staff are not having the training to help them identify a patient’s spiritual care needs, the patient is very unlikely to have their spiritual care needs met.

This could have an impact on their symptoms as they approach end of life.”
After a series of staff surveys, open to all staff but for the purpose of the project was focused on the inpatient unit, David found that colleagues on the In-patient Unit value spiritual care highly, however confidence initiating conversations around spirituality was relatively low.
He also found that, in November 2021, only one third of patients were referred to spiritual care, and that during the audit it was clear that no standardised model of spiritual care assessment was followed.
Paul and David identified the way to increase referrals to spiritual care would be to increase staff confidence in initiating conversations around spiritual care.
David said: “We reviewed some of the spiritual care tools already available and most of it them, although relevant to chaplaincy and spiritual care practitioners, weren’t relatable for doctors, nurses and health care workers in the hospice.
“So we worked on developing our own that would provide colleagues with the confidence to ask simple and open questions to engage patients and their carers in conversations around spirituality and their spiritual care needs.
“We came up with the Just Ask model. We devised four simple, open questions to start conversations with patients to identify any unmet spiritual care needs and devised an awareness session to be included as part of clinical staff mandatory clinical skills day. Together, these will ensure that each patient upon admission to IPU and other hospice service will receive a spiritual assessment as part of holistic spiritual care.”