This is the report of the Review of recent research into the potential for Efficacy of Healthcare Chaplaincy in the NHS (the Efficacy Review). The Efficacy Review was commissioned in 2006 as part of the Caring for the Spirit NHS Project led by NHS Yorkshire and the Humber. The report comprises five sections with supporting annexes. The NHS has laid down a requirement that health service treatment should be evidence based and this Review identifies and codifies this evidence. Against a background of evidence for the importance of spiritual care within health care, the evidence base for healthcare chaplaincy is limited for a number of reasons which are discussed throughout the report, and is focused on particular topics. There is thus a need for additional research and the areas on which this may concentrate are set out in later sections. Section Two explains the context in which chaplaincy is provided in the NHS. The changes in the NHS matching changes in society are also matched in healthcare chaplaincy. In particular, the development of a multi-faith society has challenged chaplaincy to update its structure and to evidence its knowledge and skills. Whilst these changes have progressed, healthcare chaplaincy has moved from an assumption of presence to affirming a case for chaplaincy of which this Review is part. The methods used to undertake this Review are set out in Section Three. The process followed was adapted from that used by the Joanna Briggs Institute for evidence-based practice which offers an opportunity to expand the scope for searching in fields where there is little research activity. The process used is an analysis of all the available literature (that is, evidence) using criteria for judgement of its usefulness and relevance to healthcare spiritual practice. The results of the Review (Section Four) are categorised in the main topic areas of the articles reviewed. This categorisation sets out a map by which the developing interests and concerns of healthcare chaplains can be plotted. The research literature is listed in the review annexes and as it stands does not directly or substantially address the issue of efficacy in healthcare chaplaincy. For this reason, proposals for a research strategy are included in Section Five. In Section Five, the Review considers the current profile of chaplaincy research against the patient’s journey in healthcare settings. Associations are made between the patient’s journey and chaplaincyspiritual care and a model is offered which suggests research topics to sit alongside the patient pathway. The research strategy proposes that the gaps in the evidence base can be filled through a focus on research into patient outcomes.