Background Palliative, end of life and bereavement support should be available to everyone (National Palliative and End of Life Care Partnership. Ambitions for palliative and end of life care: a national framework for local action 2021–2026.) with an individualised approach to manage needs. Despite attempts to improve the quality of end of life care across services, it is evident that the experience and outcomes of care is inequitable across different population groups. Reducing inequity is a high priority within current health and social care policy in England. To achieve equity, commissioners of palliative and end of life care services require good evidence of the needs of all disadvantaged groups, the impact of intersectionality and facilitators to reducing inequity.

Aim This study aimed to systematically review the evidence of the palliative, end of life and bereavement needs of people within population groups who experience inequity in care in England. The purpose of the review was to identify gaps, explore how communities have been grouped, consider the impact of intersectionality, and identify areas for knowledge development.

Method An umbrella review of relevant, published, peer-reviewed systematic reviews within healthcare databases and databases of systematic reviews including the EPPI-centre Database and Cochrane Collaborative Database of Systematic Reviews. Inclusion criteria were systematic reviews of any type, undertaken in any location, published in English in peer reviewed literature between 2013 and 2023. The review quality was critically appraised and data was thematically synthesised for patterns and gaps.

Results Findings indicate a paucity in high quality research. Needs and experience transcend population groups experiencing inequity (health literacy, cultural competence, inclusive practices). Structural determinants of inequity (including low income, poor health literacy, geographical barriers, language barriers) are more linked to people ‘at risk’ in terms of palliative and end of life care outcomes than using the population groups.

Conclusion/Discussion Rather than commission palliative and end of life care specifically for individual disadvantaged groups, commissioners could consider indicators of structural vulnerability when seeking to identify and reduce inequity.