Healthcare professionals' experiences of delivering palliative and end-of-life care in ethnically diverse communities: a qualitative study

Background: Persistent inequalities in palliative and end-of-life care continue to affect ethnically diverse populations in the UK, with disparities in access, engagement, and quality of care. This study explored the perspectives of health professionals and service providers on barriers and facilitators to equitable palliative and end-of-life care in England (Bedfordshire, Hertfordshire, and Milton Keynes). The research was embedded within the KEEPNET initiative, a Research Partnership Network aimed at co-producing solutions to local healthcare inequalities. Methods: A qualitative design was employed using semi-structured interviews with six purposively sampled professionals across statutory and third sector palliative and end-of-life care services in Bedfordshire, Hertfordshire, and Milton Keynes. Participants included clinicians, service managers, and hospice-based practitioners. Data were collected in March 2023 and analysed thematically using an inductive approach to identify key patterns in professional experiences and perceptions of delivering care to ethnically diverse communities. Results: Three overarching themes were identified: (1) access to services (2), uptake of services, and (3) experiences of engaging with services. Barriers included language differences, mistrust of statutory services, cultural misconceptions around palliative and end-of-life care and limited outreach effectiveness. Facilitators included compassionate, individualised care; trust-building through culturally sensitive communication; and community engagement through faith and local leaders. Structural challenges such as workforce shortages and limited weekend provision were also reported. The Research Partnership Network model supported dialogue and capacity building between professionals and communities. Conclusion: Culturally competent, community-embedded approaches are essential to addressing disparities in palliative and end-of-life care. Research Partnership Networks offer a collaborative framework for developing responsive and inclusive care models that align with the lived realities of ethnically diverse populations. To ensure equitable care at the end of life, investment in cultural training, community partnerships, and co-produced service development is required.