Better provision for people from minoritised ethnic groups

HealthSociety

Background:

People from minoritised ethnic groups are less likely to access all forms of palliative and end-of-life care services than those from white British backgrounds.
Evidence based policy is unlikely to take full account of the needs of minoritised ethnic groups as they are under-represented in the populations of those who participate in research studies.
People from minoritised ethnic groups may wish to make different care choices. Choices may be influenced by many different factors including a range of worldviews about care, care settings, the role of family etc. It may be that current policy directions do not take account of these different perspectives, and care provision may not be appropriate.
We know that access to care, and the care given is not equitable. We understand much less about how we can successfully address this.

Most health and social care policies struggle to attend to the specific needs of people from minoritised ethnic groups as the evidence to support recommendations is scant. This work will provide actionable policy relevant recommendations to enhance the findings of the Fuller report on integrated care, facilitate appropriate commissioning at the ICB level, and inform future policies relevant to palliative and end-of-life care including in particular community-based policies and with a focus on integrated neighbourhood working. Recommendations may also include those related to training and education.

To understand and explain how improved palliative and end-of-life care outcomes (e.g., care access, quality of care, clinical outcomes) for people from minoritised ethnic groups have or could be achieved, and what contextual issues have influenced these outcomes.
To provide whole systems policy solutions, drawing from these mechanisms, to actively address how to improve end-of-life care outcomes for those from minoritised ethnic groups.

Part 1: A rapid realist review

Realist literature review exploring what works, for whom and in what circumstances, relating to facilitating and improving appropriate and effective use of palliative and end-of-life care services for those from minoritised ethnic groups.
The understanding of context, mechanism and outcome configurations from the review will be used to inform the way we will conduct the study in part 2.

Part 2: A mixed-method multiple case study

We will study five or six different areas across England where there are high numbers of people from minoritised ethnic groups.
We want to explore areas where there have been efforts to address whether and how people from minoritised ethnic groups access palliative care so we can understand what works and why.
In each area that we study we will look at different services within the area, across different health and social care settings, and including community based initiatives.
In one of these areas we will focus specifically on the care of children.

Project status: Ongoing