Enfermero

District nursing

addressing the palliative care needs of minority groups
Lucy Philips and Vanessa Taylor discuss a project aimed at providing better end of life care to black and minority ethnic people in Yorkshire
Correspondence lucy.philips@bdct.nhs.uk Lucy Philips is a specialist practitioner (district nursing) and a district nurse team leader at Bradford District Care Trust VanessaTaylor is a senior lecturer and senior research fellow at the University of Bradford Date of acceptance October 17 2011 Peer review This article has been subject to double-blind review and has been checked using antiplagiarism software Author guidelines www.primaryhealthcare.net

abstract
Palliative care for minority ethnic groups remains a poorly accessed and limited area in district nursing. Thisarticle outlines a hospice apprentice programme that aims to promote and expand the use of specialist palliative and end of life care services for a South Asian community through increasing access and referrals, improving services by making them more culturally appropriate for black and minority ethnic (BME) people, involving BME people in the delivery of services, and creating betterrelationships between BME communities and providers. Keywords Palliative care, district nursing, black and minority ethnic groups, access Palliative and end of life care (elC) are core aspects of district nursing practice. the implementation of the end of life Care Strategy (department of Health (dH) 2008) and programmes including the liverpool Care Pathway for the dying Patient (the Marie Curie PalliativeCare institute 2008) and the Gold Standards Framework (thomas 2003) have emphasised the co-ordination, management and care delivery roles of GPs and district nurses and their ability to promote seamless care for people with palliative and elC needs and their families. Providing palliative care and promoting equal access to services for vulnerable and hard-to-reach groups remain high on thegovernment policy agenda (dH 2010, 2011). the most vulnerable people are least likely to die in their chosen places, with evidence suggesting that patients from black and minority ethnic (BMe) communities are most likely to die in hospital (Henley and Schott 2003). Palliative care remains a taboo subject for some

BMe groups, because it involves conversations about death and dying (thakkar and Faull2011). their end of life decisions are more family-focused; specialist palliative care services are poorly used by BMe communities (Worth et al 2009). despite attempts under national health policy to ensure services are delivered in ways that are accessible and sensitive to the needs of BMe populations, poor outcomes continue to be experienced by these patients (Gregory 2010). Factors that contributeto poor access to palliative care include: ■■ a shortage of referrals for patients from BMe groups. ■■ lack of knowledge and awareness of palliative care in BMe communities. ■■ Communication problems between palliative and elC service providers and users. ■■ a lack of trust between BMe communities and elC service providers. ■■ a lack of accessible information regarding the nature of illnesses andlikely prognoses (Worth et al 2009).

The project
the dH awarded the Sue Ryder Hospice apprentice Project, based in nHS Bradford and airedale’s district, funding for three years from 2009 to: ■■ increase access and referrals to palliative and elC services by BMe people. ■■ improve palliative and elC services by making them more culturally appropriate for BMe people. ■■ involve BMe people in thedelivery of palliative and elC services. ■■ Create better relationships between BMe communities and palliative and elC service providers. Key performance indicators (KPis) for the project are: ■■ Forging and strengthening new partnerships with BMe communities locally.
PRIMARY HEALTH CARE

26 February 2012 | Volume 22 | Number 1

■■ Raising the profile of Sue Ryder Care in BMe communities....