Background Research shows that LGBT+ people are under-served by hospice and end of life care and can face significant barriers accessing services; including discrimination, transphobia, homophobia, and lack of workforce awareness (Hospice UK. Equality in hospice and end of life care: challenges and change. 2021; Hospice UK. ‘I just want to be me’. Trans and gender diverse communities access to and experiences of palliative and end of life care. 2023). We wanted to address these barriers with credible co-produced inclusion work. We partnered with Derbyshire LGBT+, a local advocacy organisation, who run a Rainbow Accreditation scheme supporting organisations to develop inclusive practices.

Aims To evaluate and initiate improvements to working practice and culture for all LGBT+ service users, employees, volunteers and supporters within a 12 month period.

Methods The Rainbow accreditation scheme sets out six standards to achieve and provides a framework for assessment. Evaluation included data collection, policies, training provision, communications, service user and staff feedback, and a premises audit. We set up a project group to oversee the work, which included an LGBT+ ex-service user. Derbyshire LGBT+ provided ongoing consultation.

Results Ashgate Hospice was awarded Rainbow Accreditation in March 2024. The assessment identified further areas for improvement; some are actioned and others in progress.

• Training: staff receive bespoke LGBT+ awareness sessions and a pronouns information video was co–created with Derbyshire LGBT+.

• Data: plans are in place to improve diversity data collection.

• Increased visible symbols of inclusion: in all communications and across premises, including retail.

• Providing best practice guidelines for working with trans and gender diverse service users.

• Increased co–production: working with LGBT+ service users and workforce to develop more inclusive services.

• Reaching all areas of our organisation: to ensure everyone working across the hospice understands why this work matters and how to be an ally.

Conclusion Becoming an LGBT+ inclusive organisation is a complex and continuous process. Working with experts by experience and making sure we are accountable is vital in ensuring meaningful action and change.