Background Specialist Palliative Care Services (SPCS) face many challenges as palliative care expands to support people from different ethnic, cultural and religious backgrounds. In spite of high populations of Minority Ethnic Groups (MEGs) in East Berkshire, an audit of referrals to the Specialist Psychological Service for Oncology and Palliative Care (SPSOPC) accounted for only 8% of total referrals to the Psychology Service from 2010–2011.

Aims To investigate referring Healthcare Professionals' (HPs) perceptions and experiences of cultural issues when working in oncology and palliative care. A further aim was to explore potential reasons behind low referrals of MEGs to SPSOPC.

Method Semistructured interviews with a purposive sample of nine HPs (consultants, clinical nurse specialists, advanced nurse practitioners, social worker) who had referred to SPSOPC were conducted and analysed using Interpretative Phenomenological Analysis.

Results Healthcare Professionals reported a number of tensions in their work with MEGs and SPCS. This included difficulty treating patients from MEGs, assumptions and misconceptions about their care, and a conflict between traditional eastern values and western medicine. They also reported challenges to their sense of professionalism, feeling overwhelmed and out-of-their-depth and fear of causing offence when treating MEGs. There was an apparent lack of understanding of SPCS and of Specialist Psychological Services in particular, which could result in a ‘conveyor belt mentality’ in respect of service delivery.

Conclusions Healthcare Professionals would benefit from increased education about MEGs and ways to accommodate cultural differences in service delivery. It is vital that SPCS and Specialist Clinical Health Psychology become more culturally competent and language-appropriate in today's multi-ethnic society. Enhancing understanding, awareness and delivery of culturally appropriate psychological services for MEGs has the potential to increase referrals of MEGs to SPSOPC, and to improve the quality of end-of-life care for this patient population.