Background British hospices employ a wide range of support staff to provide services to patients and families. Support workers make an enormous contribution to the success of the organisation in which they work; however, little previous research has focused on these staff. The aim of this study was to explore the perceptions of support staff in relation to their roles and relationships with other groups of hospice staff.

Methods Semi-structured interviews were conducted with 14 support workers from two hospices in the North West of England. Participants included gardening, maintenance, clerical, domestic and kitchen staff. Two managers were also interviewed to explore their views of support workers in the hospice. Site visits and non-participant observation were carried out in both hospices. A thematic analysis of the interview and observational data was conducted.

Results Support workers perceived their roles to be vital to the care offered to patients and families. They reported substantial interaction with patients and families, and put patients' needs first. They were willing to be flexible in carrying out their duties, recognising the need to show consideration to patients and families, who they believed valued their contribution. However, although support staff perceived themselves as an important part of the wider hospice team, they sometimes experienced isolation and division from other staff groups.

Conclusion In some cases support staff felt that they were invisible workers within the hospice. Despite the importance they and their managers placed on their roles, this was not always reflected in the acknowledgement and appreciation they received, nor in support and training offered to them. In order to fully utilise this group of staff, their roles and contribution to patient care need to be acknowledged by hospices.