Background Access to high quality palliative care at the end of life is becoming of increasing public health concern, and UK policy has highlighted a need to improve palliative care in the hospital setting. The majority of deaths in the UK occur in acute hospitals, and the numbers of patients dying in this setting are predicted to increase over coming years.

Aim The aim of this qualitative study was to explore the perspectives of patients with palliative care needs regarding recent care received in the acute hospital setting.

Methods Sixteen patients with palliative care needs participated in semistructured interviews to explore views and experiences of a recent hospital admission. Patients were identified during a survey of palliative care needs at two UK acute hospitals, interviews were conducted postdischarge. Data were analysed using the principles of thematic analysis.

Results Findings indicated that most hospital admissions were emergency/crisis led, and a palliative approach to care was rarely evident. Patients reported particular issues relating to (1) continuity of care, both within the hospital setting and after discharge; (2) communication between care providers in secondary care and communication with the patient; (3) communication between primary and secondary care, and issues surrounding discharge from hospital.

Implications The palliative care needs of patients within the acute hospital setting may not be adequately addressed. Improved communication and continuity of care are necessary to enhance the provision of quality palliative care. The study highlights a need to further explore palliative care provision in the acute hospital setting from the perspectives of both patients and providers, and to further define and expand the role of generalist palliative care providers in acute hospitals.