Background People with mental illness experience higher rates of many life-limiting conditions and die on average twenty years earlier than the general population. A literature review was carried out which revealed limited understanding of the end of life needs of this patient group. The role of clinical staff was highlighted as a key factor, yet their views were not reflected in the published research.

Aims The aim of this research was to conduct an exploratory study to develop further understanding of how to improve end of life care for people with severe mental illness through exploring the views and experiences of clinical staff working in both mental health and end of life services.

Methods Four focus groups with clinicians were conducted, using the CUbe method (Magee, Fielden, & Moody, 2015), across a large Mental Health Trust and a hospice. 23 participants from a range of professional backgrounds attended and shared their experiences and perceptions of the barriers to delivering good end of life care to people with mental illnesses. The data was analysed using the Framework Method (Gale, Heath, Cameron, Rashid, & Redwood, 2013) and themes and explanatory concepts were drawn.

Findings The findings of the study were clustered into five themes: Structure of The System, Presentation of the Patient, Confidence of the Clinician and the Problem of Partnership. Implications for practice were drawn from the themes which can be used to inform improvements to clinical practice.

Conclusions The barriers to providing good end of life care were described within the literature, which largely originated outside the UK. The findings of the analysis found many similarities and some new findings. Recommendations were made which include improvements to partnership working, involvement of patients, carers and clinical staff in improving care and the need to develop the confidence and knowledge of clinicial staff from mental health and end of life services.