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

CovPall study team; Sabrina Bajwah; Jonathan Koffman; Jamilla Hussain; Andy Bradshaw; Mevhibe B Hocaoglu; Lorna K Fraser; Adejoke Oluyase; Caitlin Allwin; Lesley Dunleavy; Nancy Preston; Rachel Cripps; Matthew Maddocks; Katherine E Sleeman; Irene J Higginson; Catherine Walshe; Fliss E M Murtagh

doi:10.1136/bmjspcare-2021-003083

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

CovPall study team, Sabrina Bajwah, Jonathan Koffman, Jamilla Hussain, Andy Bradshaw, Mevhibe B Hocaoglu, Lorna K Fraser, Adejoke Oluyase, Caitlin Allwin, Lesley Dunleavy, Nancy Preston, Rachel Cripps, Matthew Maddocks, Katherine E Sleeman, Irene J Higginson, Catherine Walshe, Fliss E M Murtagh

Research output: Contribution to journal › Article › peer-review

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.

Original language	English
Journal	BMJ Supportive & Palliative Care
Early online date	12 Sept 2021
DOIs	https://doi.org/10.1136/bmjspcare-2021-003083
Publication status	Published - 13 Sept 2021

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CovPall study team, Bajwah, S., Koffman, J., Hussain, J., Bradshaw, A., Hocaoglu, M. B., Fraser, L. K., Oluyase, A., Allwin, C., Dunleavy, L., Preston, N., Cripps, R., Maddocks, M., Sleeman, K. E., Higginson, I. J., Walshe, C., & Murtagh, F. E. M. (2021). Specialist palliative care services response to ethnic minority groups with COVID-19: equal but inequitable-an observational study. BMJ Supportive & Palliative Care. https://doi.org/10.1136/bmjspcare-2021-003083

@article{d48b28ff72e74eb3a347eef40dd24497,

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

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.",

author = "{CovPall study team} and Sabrina Bajwah and Jonathan Koffman and Jamilla Hussain and Andy Bradshaw and Hocaoglu, {Mevhibe B} and Fraser, {Lorna K} and Adejoke Oluyase and Caitlin Allwin and Lesley Dunleavy and Nancy Preston and Rachel Cripps and Matthew Maddocks and Sleeman, {Katherine E} and Higginson, {Irene J} and Catherine Walshe and Murtagh, {Fliss E M}",

note = "{\textcopyright} Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.",

year = "2021",

month = sep,

day = "13",

doi = "10.1136/bmjspcare-2021-003083",

language = "English",

journal = "BMJ Supportive & Palliative Care",

issn = "2045-435X",

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CovPall study team, Bajwah, S , Koffman, J, Hussain, J, Bradshaw, A, Hocaoglu, MB , Fraser, LK , Oluyase, A, Allwin, C, Dunleavy, L, Preston, N, Cripps, R , Maddocks, M , Sleeman, KE , Higginson, IJ, Walshe, C & Murtagh, FEM 2021, 'Specialist palliative care services response to ethnic minority groups with COVID-19: equal but inequitable-an observational study', BMJ Supportive & Palliative Care. https://doi.org/10.1136/bmjspcare-2021-003083

TY - JOUR

T1 - Specialist palliative care services response to ethnic minority groups with COVID-19

T2 - equal but inequitable-an observational study

AU - CovPall study team

AU - Bajwah, Sabrina

AU - Koffman, Jonathan

AU - Hussain, Jamilla

AU - Bradshaw, Andy

AU - Hocaoglu, Mevhibe B

AU - Fraser, Lorna K

AU - Oluyase, Adejoke

AU - Allwin, Caitlin

AU - Dunleavy, Lesley

AU - Preston, Nancy

AU - Cripps, Rachel

AU - Maddocks, Matthew

AU - Sleeman, Katherine E

AU - Higginson, Irene J

AU - Walshe, Catherine

AU - Murtagh, Fliss E M

PY - 2021/9/13

Y1 - 2021/9/13

N2 - 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.

AB - 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.

U2 - 10.1136/bmjspcare-2021-003083

DO - 10.1136/bmjspcare-2021-003083

M3 - Article

C2 - 34511409

SN - 2045-435X

JO - BMJ Supportive & Palliative Care

JF - BMJ Supportive & Palliative Care

ER -

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

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