Background With more than 65% of adults actively using social media each week it is important to ensure that hospices are developing new ways to engage with this population group to encourage fundraising and provide support to patients and carers. Social media provide exciting opportunities for hospices to widen their influence and activity, but also raise practical and ethical issues which must be addressed.

Methods This research appraised 150 hospice websites in England and Wales to determine the prevalence of social media and how it is being used to engage, educate and support hospice users, volunteers and staff. Numbers of users and type of use (fundraising, support, awareness raising) were recorded and factors such as prominence on website explored. Social media sites were also searched for links to hospice and palliative care issues.

Results In total, 35% of hospice websites used Facebook and 33% used Twitter to communicate with the public, 28% of websites accessed did not use any form of social media. The majority of social media sites were used to encourage and provide information regarding fundraising. Very few websites used a forum, an opportunity for hospices to provide support to hospice users whilst also educating and encouraging fundraising in a more secure environment. The extended search of social media sites highlighted areas of discussion, support and awareness raising distinct from and not tapped into by hospice sites.

Discussion The rewards and disadvantages of forum use for hospices are explored alongside recommendations for improving public awareness of the hospice social media sites. To date, UK hospices are underusing social media both in volume of traffic and scope (overwhelmingly for fundraising only). This leaves hospices self-excluding from much of the potential of social media to inform, support and debate, and at risk of being left behind.