Background St Elizabeth Hospice serves an increasingly ethnically diverse population, under-represented within both hospice referrals and our compassionate communities engagement. We are committed to responding to the evidence base of inequalities in end of life care (Care Quality Commission. A different ending: addressing Inequalities in end of life care: an overview report. 2016; Hospice UK. Equality in hospice and end of life care: challenges and change. 2021) and co-producing hospice services with communities we hardly reach. A launch event held in June 2022, enabled a co-produced ‘Hospice for All’ action plan and the formation of a project group committed to improving end of life care and bereavement experiences for multi-ethnic communities.

Aim To improve end of life care and bereavement experiences for multi-ethnic communities.

Project methods

• World Café inspired methodology (Brown & Isaacs. The world cafe book: shaping our futures through conversations that matter. Berrett–Koehler; 2005) structured a launch open event followed by monthly meetings held in a community setting to progress the action plan.

• Compassionate Communities approach (Mills, Abel, Kellehear, et al. Lancet. 2024;404(10448): 104–106); with co–design, joint decision–making.

• Community Asset Based Development (ABCD) approach (Harrison, Blickem, Lamb, et al. Sage Open. 2019; 9(1)).

Research methods This project formed part of a PhD multi-case study ‘Co-production within integrated care: participatory action research’. Ethics approval was granted by the University of Suffolk.

Participatory research approach Following monthly project meetings, a further hour’s meeting was devoted to six co-researchers reflecting on the co-production approach.

Results Project:

• Co–designed poster distributed within diverse communities, QR code evidenced increased access to hospice website.

• Virtual tours produced in 11 languages.

• Compassionate conversations training culturally adapted.

• One community champion joined the Hospice Engagement Group.

• Increased referrals from multi–ethnic communities with increased use of interpreting services.

Research - key themes:

• Mutual learning and benefit.

• Co–delivery in and by the community.

• Group, organisational system culture.

Conclusion The co-production approach combined with Compassionate Communities led to a co-delivery model with and by the community. A participatory research process alongside a service development provides conversational learning, shared understanding and new insights towards becoming a ‘Hospice for All’.