Background Psychological distress is common amongst people with a terminal illness (Antunes, Pereira Rodrigues, Higginson, et al. BMC Palliat Care. 2020;19(1):69). NICE guidelines recommend that psychological support in palliative care be delivered via a stepped care model, moving from general to more specialised psychological support, dependent on need (NICE. Guidance on cancer services: Improving supportive and palliative care for adults with cancer. [CSG4]; 2004). Palliative care staff play an important role in providing psychological support, yet there is little research evidence regarding this aspect of their role.

Aim To describe current practices relating to the provision of psychological support by hospice staff to people impacted by terminal illness, and to explore staff confidence and any psychological support training needs.

Methods An online questionnaire consisting of closed and open free-text questions was emailed to 273 hospices in the UK and Republic of Ireland. Eligible respondents included nurses, doctors and allied health professionals. Quantitative data was analysed descriptively, and thematic analysis was used to analyse qualitative findings. Ethical approval was obtained from the University of Edinburgh Clinical Psychology Ethics Committee.

Results 151 respondents completed the questionnaire (Nurses 56%, Doctors 20%, Allied Health Professionals and others 24%). Most were female (88.1%), British (82.5%) and working in hospices based in England (65%). Most (84%) reported that over half of the terminally ill people they support experience psychological distress. Anxiety, adjustment issues and depression or low mood were commonly encountered. Overall, 80% regularly assess people with terminal illness for psychological distress, but over half (58%) have never used a validated assessment tool. Respondents reported high levels of confidence and competence in providing psychological support especially in recognizing psychological distress and openly discussing distressing topics with patients. Despite this, 72% reported that training in psychological support would enhance their practice.

Conclusion Palliative care staff felt competent and confident in providing psychological support, however, there was a strong desire for further training in this aspect of care.