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Palliative care for homeless and vulnerably housed people: scoping review and thematic synthesis
  1. Richard James1,
  2. Kate Flemming2,
  3. Melanie Hodson3 and
  4. Tammy Oxley4
  1. 1 Public Health, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  2. 2 Department of Health Sciences, University of York, York, UK
  3. 3 Hospice UK, London, UK
  4. 4 Palliative Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  1. Correspondence to Dr Richard James, Public Health, Leeds Teaching Hospitals NHS Trust, Leeds LS97TF, UK; richard.james14{at}


Introduction People who are homeless or vulnerably housed are subject to disproportionately high risks of physical and mental illness and are further disadvantaged by difficulties in access to services. Research has been conducted examining a wide range of issues in relation to end-of-life care for homeless and vulnerably housed people, however, a contemporary scoping review of this literature is lacking.

Objectives To understand the provision of palliative care for people who are homeless or vulnerably housed from the perspective of, and for the benefit of, all those who should be involved in its provision.

Design Scoping review with thematic synthesis of qualitative and quantitative literature.

Data sources MEDLINE, Embase, PsycINFO, Social Policy and Practice and CINAHL databases were searched, from inception to May 2020. Citation chasing and manual searching of grey literature were also employed.

Results Sixty-four studies, involving 2117 homeless and vulnerably housed people were included, with wide variation in methodology, population and perspective. The thematic synthesis identified three themes around: experiences, beliefs and wishes; relationships; and end-of-life care.

Conclusion Discussion highlighted gaps in the evidence base, especially around people experiencing different types of homelessness. Existing evidence advocates for service providers to offer needs-based and non-judgemental care, for organisations to use existing assets in co-producing services, and for researchers to address gaps in the evidence base, and to work with providers in transforming existing knowledge into evaluable action.

  • cultural issues
  • communication

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  • Contributors RJ (corresponding author)—design of work, data collection, data analysis and primary author. KF—concept and design of the work, drafting of the work and supervision, and drafting content. MH—concept and design of the work, drafting of the work and supervision, and drafting content. TO—data collection and drafting content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.