Background In the UK, palliative care is a growing specialty; however, national inequalities in access to services persist. Those who are male, older, more deprived, belong to ethnic minority groups and have non-malignant disease are relatively under-represented in clinical services. An open-access service in the North of England provides a breadth of support to people affected by palliative diagnoses, without requiring clinical referral, with dedicated support to address some of these inequalities. We report on an evaluation of this service.
Method This study was conducted as a secondary data analysis of an annual service evaluation. Characteristic data of service users was collected through an anonymous cross-sectional survey. One-hundred and fifteen responses were acquired via convenience sampling over the period of one week. Data was compared against the characteristics of local specialist palliative care services, local census data and historical MDS data through descriptive and inferential techniques (chi-squared test).
Findings The open-access service was found to have a significantly higher proportion of non-cancer patients (75%) compared with clinical services (27%) and MDS data (24%), highlighting that this is a potentially valuable approach to improving access for this under-represented group (p0.05). Conversely, attendees were more likely to be female (<0.001), under 75 (<0.001), live in the local area (<0.001) and have religious beliefs (<0.01), highlighting areas for further development.
Conclusion This service evaluation has highlighted a potential approach for improving access to specialist support for people with non-malignant disease and members of minority ethnic groups; formal research evaluation is recommended. Outstanding challenges include broadening access for men, older people, non-religious people and the wider area.
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