1. Stigma and End of Life Care BME Health Forum Quarterly Meeting
March 7th

2. St John’s Hospice
St John's Hospice works in partnership with health and social care providers to provide specialist palliative and end of life care for people with progressive and life-threatening conditions.

3. St John’s Hospice
Whilst the majority of our patients are referred with cancer-related illnesses, our services are also open to patients with other conditions including HIV/AIDS, chronic heart failure, respiratory disease and long-term neurological conditions such as motor neurone disease, multiple sclerosis and Parkinson's disease.

4. St John’s Hospice
Our services break down into five key areas: Inpatient Unit, Day Services, Community Support, and Lymphoedema Services Additionally, access to Physiotherapy, Occupational Therapy, Dietetics, Speech & Language Therapy, Complementary Therapies and the Social Work and Bereavement Team, occurs internally within the service.

5. Stigma and Identity
Identity is both internally (self-) defined and externally (structurally) imposed, which has bearing not only in how an individual or group sees oneself but also in how they are treated in society.

6. Factors impacting on access for BME groups to End of Life Care
Attitudes to Palliative Care
Gatekeepers
Mistrust
Dissatisfaction with Health Care
Social Deprivation
Awareness of SPC Services
Ethno-Centralism

7. Attitudes to Palliative Care
Barriers to general health care that the poor and disenfranchised have traditionally encountered may affect their receptivity to palliative care.

8. Gatekeepers
Some healthcare professionals ‘gatekeepers’ to services among minority ethnic groups contributing to lower referral rates.

9. Mistrust
BME groups are less likely than white patients to trust the motivations of doctors who discuss end of life care with them.

10. Dissatisfaction with health care
Uptake of health and social services among certain minority ethnic communities has revealed lower utilisation of services due to dissatisfaction with services.

11. Social Deprivation
Low socioeconomic status has been positively linked to an increased likelihood of hospital deaths, albeit applying equally to all demographic groups.

12. Awareness of Specialist Palliative Care Services
There is evidence that BME groups are not aware of specialist palliative care services available to them, often magnified by poverty.

13. Ethno-Centralism
Demand for services may be influenced by the ‘ethnocentric’ outlook of palliative care services discouraging BME groups from making use of relevant provision.

18. Next steps
Assurance
St John’s Hospice carries out regular audit of access by ethnic group and reports on a quarterly basis to our funders
Pro-active awareness raising
A combination of ‘community open days’ and outreach work

19. Next Steps Individual Patient Feedback
Use face to face structured interviews carried out by people not involved in the patient’s care, covering whole experience of being a patient
‘What Matters To Me’
Opportunity for patients to highlight anything of importance or concern to them