Background People receiving end-of-life care and their family carers can experience significant psychological distress (Wilson, Chochinov, Graham Skirko, Allard et al., 2007; Galfin & Watkins, 2012; Braun, Mikulincer, Rydall, Walsh et al., 2007; Grov, Dahl, Moum, Fosså, 2005). Psychological support is a fundamental aspect of the holistic care provided by hospices (NHS. Hospice care [Internet], 2017; NHS England, 2019). However, there are limited clinical guidelines in the UK on how hospices should deliver psychological support services (National Institute for Health and Care Excellence, 2017). No recent research has explored how psychological services are delivered in UK hospices on a national level. A nationwide survey will highlight differences in practice and help focus future research.

Aims To increase understanding of the following aspects of psychological support services in UK hospices to help identify inequality and guide best practice development:

• Service organisation and structure;

• Types of psychological support available and who delivers them;

• Adequacy of and barriers to service provision.

Methods A 23-item online questionnaire developed for this study based on a literature review and related surveys (Atkin, Vickerstaff & Candy, 2017; Lawrie, Lloyd-Williams & Taylor, 2004; Lloyd-Williams, Friedman & Rudd, 1999; Price, Hotopf, Higginson, Monroe et al., 2006; Russell & Fountain, 2018) and in consultation with experts in palliative medicine and psychological services. The questionnaire will be piloted at nine hospices.

Data collection: The questionnaire will be emailed to all 200 adult hospices in the UK and will be open for six weeks in Summer 2019. It should be completed by one staff member who is closely involved in the organisation and/or delivery of psychological services at each hospice.

Data analysis: Percentages will summarise quantitative responses and statistical tests will be performed to compare groups. Thematic content analysis will be applied to free text responses.

Results and conclusions The results of the survey will be analysed in Autumn 2019. By identifying any variation in services across the UK, as well as examples of, and barriers to, good practice, the results could inform efforts to achieve equality in service provision. The results may also inform development and implementation of psychological interventions tailored to the UK hospice setting.