Specialist palliative care services response to ethnic minority groups with COVID-19 : equal but inequitable—an observational study

Bajwah, Sabrina and Koffman, Jonathan and Hussein, Jamilla and Bradshaw, Andy and Hocaoglu, Mevhibe and Fraser, Lorna and Oluyase, Adejoke and Allwin, Caitlin and Dunleavy, Lesley and Preston, Nancy and Cripps, Rachel and Maddocks, Matthew and Sleeman, Katherine and Irene, Higginson and Walshe, Catherine and Murtagh, Fliss (2021) Specialist palliative care services response to ethnic minority groups with COVID-19 : equal but inequitable—an observational study. BMJ Supportive and Palliative Care. ISSN 2045-435X

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Abstract

Objectives To develop insights into response of palliative care services caring for people from ethnic minority groups during COVID-19. Methods Cross-sectional online survey of UK palliative care services response to COVID-19. Quantitative data were summarised descriptively and χ2 tests used to explore relationships between categorical variables. Free text comments were analysed using reflexive thematic analysis. Results 277 UK services responded. 168 included hospice teams (76% of all UK hospice teams). Services supporting those from ethnic minority groups were more likely to include hospital (p<0.001) and less likely to include hospice (p<0.001) or home care teams (p=0.008). 34% (93/277) of services had cared for patients with COVID-19 or families from ethnic minority groups. 66% (61/93) of these services stated no difference in how they supported or reached these groups during the pandemic. Three themes demonstrated impact of policy introduced during the pandemic, including: disproportionate adverse impact of restricted visiting, compounded communication challenges and unmet religious and faith needs. One theme demonstrated mistrust of services by ethnic minority groups, and the final theme demonstrated a focus on equal and individualised care. Conclusions Policies introduced during the COVID-19 pandemic may have adversely impacted those from ethnic minority groups making these at-risk populations even more vulnerable. The palliative care response may have been equal but inequitable. During the para-COVID-19 period, systemic steps, including equality impact assessments, are urgently needed.