Introduction Palliative care improves the quality of life, well-being and symptom control in patients with advanced disease. Globally only 14% of those in need are thought to receive palliative care. The most common symptom resulting in admission to a palliative care provider is uncontrolled pain. Regular use of symptom assessment measures such as the integrated palliative care outcome scale (IPOS) improves the identification and management of pain. Despite the benefits, the proportion of IPOS completion is around half of what it should be, and these rates are much lower in ethnic minority patients. This study compares the pain scores of patients according to their diagnosis, age, sex and ethnicity.

Methods This study was an audit of pre-collected retrospective data from St Gemma’s hospice. The IPOS pain scores of 576 inpatients between 2019–20 were included. Exclusion criteria were patients with less than two recorded IPOS scores.

Results There was a significant increase from initial to final pain in the total sample, non-cancer conditions, females and younger patients. As well as a non-significant greater increase in the pain of ethnic minority patients. Lung cancer patients experienced a non-significant reduction in pain.

Conclusions High-quality UK based studies are required to expand on the current research demonstrating ethnic inequalities in pain assessment, management and care provision. The gender imbalance may be due to females more openly disclosing their needs, evidence also indicates that female pain is under-documented and overlooked by physicians. The lower pain levels reported by older patients has been attributed to their acceptance of pain as part of the end of life and willingness to reduce their activity levels as a result. The provision of care for chronic, terminal non-cancer diseases can be improved through early and sustained palliative intervention, that is offered without bias, based on clinical need.