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

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 χ 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.