{
  "abstract": "Background Royal Trinity Hospice in southwest London serves a population of approximately 738,000 people. To support the organisational goal of equitable and accessible services, we undertook a project to better understand how individual characteristics influence the likelihood of accessing Royal Trinity Hospice services.Aims This project aimed to identify inequalities in access to Royal Trinity Hospice services based on demographic and clinical characteristics and to inform operational recommendations to promote equity.Methods Informed by themes identified in a literature synthesis and other research (Tobin, Rogers, Winterburn, et al. BMJ Support Palliat Care. 2022;12(2):142–51; Sleeman, Davies, Verne, et al. Palliat Med. 2016;30(1):45–53), we analysed data from 5,578 Royal Trinity Hospice patients registered between January 2020 and September 2022. Variables included gender, ethnicity, age, Index of Multiple Deprivation (IMD) decile, distance from the hospice, and primary diagnosis. Outcomes were: number of days between referral and death, patients as a proportion of the population (adjusted for confounders), proportion of patients with a recorded preferred place of death (PPD), and proportion who died in their PPD. Using routine statistics (Office for National Statistics. Deaths registered summary statistics, England and Wales. 2023 [internet]), we considered the number of patient deaths as a proportion of catchment area deaths by diagnosis and age.Results Men were underrepresented among Royal Trinity Hospice patients. Cancer and dementia were overrepresented, while chronic respiratory disease was underrepresented. People with non-malignant conditions tended to die more quickly after registration, suggesting later referral. Greater deprivation and distance from Royal Trinity Hospice were associated with lower rates of access. Age, gender, and IMD decile influenced likelihood of having a recorded PPD. No disparities were found by ethnicity.Conclusion We identified factors influencing access to hospice services. These have informed recommendations to promote equitable access which are now being worked into operational process, including targeted outreach, increased engagement with healthcare local providers, improved documentation demographic data collection, promotion of self-referral, and exploring feasibility of satellite service locations.",
  "authors": [
    {
      "affiliations": [
        "Royal Free London NHS Foundation Trust, London, UK"
      ],
      "name": "Sian Magee"
    },
    {
      "affiliations": [
        "Royal Trinity Hospice, London, UK"
      ],
      "name": "Samantha Lund"
    }
  ],
  "title": "P-160 Inequities in access to hospice services: a retrospective service level analysis",
  "uid": "18c56342-827d-53aa-a848-0b52be5ea11e"
}