The film, ‘Palliative Care - shifting the focus from equality to equity’, aims to improve the understanding of what the needs of ethnically diverse patients are, so that care can be improved in future.
The film is informed by research led by Dr Sabrina Bajwah, consultant in palliative medicine and clinical senior lecturer at King’s College London. The research found that people from ethnically diverse groups may not receive the care they need and that treating all patients equally may result in unequal outcomes. It was carried out as part of the CovPall study which aims to explore experiences of palliative care during the pandemic.
Overall the film aims to understand:
The film is part of an online training package for healthcare, social care and hospice staff hosted by King’s Health Partners.
It highlights the importance of healthcare staff being aware of people’s culture, belief and religion. If these are not considered, then end of life care becomes very difficult because the health professional’s idea of ‘a good death’ may not be the same as the families’ ideas. Having greater understanding of ethnically diverse patients reduces frustration, complaints and conflict between families and healthcare staff around end of life care.
What is more important than treating everybody equally, is to treat everybody equitably and that means giving everybody the resources that they need to achieve the same outcome.
The film discusses examples where staff were concerned or anxious about saying or doing the wrong thing when providing care for patients from ethnically diverse backgrounds. It encourages clinical staff to have open discussions with colleagues from ethnically diverse backgrounds, ask advice, listen to patients and provide care from a position of compassion and kindness.
The research also found that sometimes there was tendency to place the deficit on patients and families from ethnically diverse groups. They are labelled as ‘hard to reach’ rather than acknowledging that the services themselves have barriers, such as language, or not having staff who understand the culture, which make it difficult for some communities to access palliative care services.
The CovPall research also found that there was a strong focus on personalised care, but focusing on personalised care alone ignores the structural and organisational factors which are in place which influence the care that is delivered to ethnically diverse patients. Organisations need to address structural racism within their institutions - for example, policies should not negatively impact one ethnic group over another.
The film includes a focus on the importance of measuring patient-reported outcomes and looking at them broken down by ethnicity. Data allows us to allocate more resources to those groups that need them most, or allocate resources differently to ensure that all patients receive the same outcomes and are treated equitably.
Dr Balwaj was also awarded a King's Changemaker Award in June for her work challenging structural racism in palliative care. The awards celebrate a graduate who uses their knowledge with purpose to challenge the status quo and shift traditional norms to address challenges in society.