Urgent need to address end-of-life care for people from Black, Asian and Minority Ethnic communities

by Dr Ian Gittens Senior Project Manager (Diversity) Dr Ian Gittens

Independent research by the Cicely Saunders Institute at King’s College London has found that end-of-life care is not meeting the needs of those from Black, Asian and Minority Ethnic (BAME) communities. In response to this, we need to ensure we provide appropriate end-of-life care that meets the needs of our changing communities.


Read the report (PDF 2MB) Population projections suggest that the number and proportion of people from BAME groups will increase in the UK, and they will represent a larger proportion of older people. In England and Wales it is predicted that by 2026 there will be over 1.3 million people from BAME groups aged 65+, compared to over half a million in 2001.  By 2026 almost half a million will be aged 70+ years. The new research - published on behalf of Marie Curie and Public Health England - highlights the need to tackle the reasons for low uptake of end-of-life care by BAME communities, which include poor communication between the healthcare professional and the patient/family. Associated issues include lack of sensitivity to cultural/religious differences, lack of availability of translators, unmet needs regarding religious or family requirements and lack of relevant training for healthcare professionals. Other barriers include lack of referrals and knowledge about services, information not available in different languages or formats, the assumption that the family will provide care and have the resources to do so and previous negative care experiences such as racism, insensitivity and lack of cultural awareness by heathcare professionals. In response, the report recommendations include:

  • inform and train staff to be culturally sensitive, improve communication skills

  • non-judgemental, open communication: listen to patients, address each of them individually and be aware of stereotypes

  •  provide information about the services in different languages/formats

  • share good practice

  • ensure appropriate capture of ethnicity monitoring information so that we know who is accessing the service and the quality of care they receive

This new report builds on findings from The End of Life Care Strategy, which makes clear that, although much has been done, inequalities still exist in the care that different groups of people receive at the end of life. It is critical to understand the influence of ethnicity and culture in the context of end-of-life care and to examine strategies and recommendations to address inequalities. There are no second chances to address failings in end-of-life care, which is why Marie Curie is committed to working with other key partners to ensure that end-of-life care is appropriate and accessible for all.