Background Virtual reality (VR) is emerging as a potentially useful tool in the holistic management of patients receiving palliative care. Current evidence to date is mainly in the form of small feasibility studies, but shows encouraging improvements in anxiety and pain symptoms, and high levels of acceptability (Martin, Saredakis, Hutchinson, et al. Healthcare. 2022;10(7):1222; Mo, Vickerstaff, Minton, et al. Palliat Med. 2022;36(7): 1047–1058).

Aims Our hospice has offered VR to its patients for 3 years. This evaluation sets out to review how this service is currently used by patients and staff, what works well, and what gaps there are in the service. Our ambition is to be able to conduct further studies on VR, the results of this evaluation will be used to generate a service development plan.

Methods Semi-structured interviews of 13 patients using the VR kit over a 5 month period were conducted. Qualitative data about VR before, during and after its use was obtained. 30 staff from in-patient and community teams completed a survey about their experience of the VR service.

Results Patients who use VR find it beneficial. However, the equipment available is hugely under-utilised and only a very small proportion of current patients use it. This appears to be due to three main factors: poor staff confidence and skills throughout staff teams; the lack of clear infrastructure or operational guidance about the service; and problems with equipment reliability which led to loss of confidence in its use.

Conclusion Improvement in the service is needed for it to become a truly useful addition to our care. Staff training and confidence limits its use. Future expansion of the service would need investment in hard and software to expand the range of apps available. If the ambition to conduct further research into VR use is to be fulfilled effort needs to be put into embedding the service into our care.