Background Public opinion towards immigration remains negative (YouGov, 2018). Healthcare professionals are well adapted to putting aside personal prejudices whilst caring for people at their most vulnerable. This courtesy is not always reciprocated. Data on hospice staff experiences of racism/xenophobia from patients and their relatives is sparse.

Aims This work aimed to explore the prevalence of racism experienced by our hospice staff and whether adjustments were necessary to current policy and procedure.

Method Questionnaire developed in liaison with a former anti-racism campaigner. Aimed to capture a wide range of experience of direct and indirect racism and allowed for free commentary. Questionnaire distributed amongst 59 (clinical and non-clinical) inpatient facing staff.

Results 47.5% (n=28) surveys returned, majority from nurses. 5/28 of respondents were from ethnic backgrounds. However, the majority (82.1%) of respondents were subjected to direct or indirect racism/xenophobia:

‘So you are half as good as a British doctor.’

‘Patient referred to a colleague by a derogatory name, saying she doesn’t want colleague to look after her.’

Formal reporting was infrequent (34.8% 8/23):

‘…as the patient is terminally ill I didn’t like to use threatening language such as ‘reporting them’ or ‘discrimination laws’ and cause them distress/anxiety.’

‘It didn’t cross my mind to but while completing this I realise it’s also because I wondered if I was ‘reading too much into it’ but I know that I wasn’t.’

Conclusion These results are concerning. The impact of such incidents are shown to ‘cumulatively contribute to moral distress and burnout’ (Paul-Emile, Smith, Lo et al., 2016) and they demand further attention. The comments demonstrated a tendency towards maintaining professional duty and occasionally rationalising of behaviours however, this comes at a cost to personal integrity. Staff workshops are planned to formulate more effective protocols for these incidents.