BackgroundInequalities in access to hospice care is a source of considerable concern; white, middle-class, middle-aged patients with cancer have traditionally been over-represented in hospice populations.ObjectiveTo identify from the literature the demographic characteristics of those who access hospice care more often, focusing on: diagnosis, age, gender, marital status, ethnicity, geography and socioeconomic status.DesignSystematic literature review and narrative synthesis.MethodSearches of Medline, PsycINFO, CINAHL, Web of Science, Assia and Embase databases from January 1987 to end September 2019 were conducted. Inclusion criteria were peer-reviewed studies of adult patients in the UK, Australia, New Zealand and Canada, receiving inpatient, day, outpatient and community hospice care. Of the 45 937 titles retrieved, 130 met the inclusion criteria. Narrative synthesis of extracted data was conducted.ResultsAn extensive literature search demonstrates persistent inequalities in hospice care provision: patients without cancer, the oldest old, ethnic minorities and those living in rural or deprived areas are under-represented in hospice populations. The effect of gender and marital status is inconsistent. There is a limited literature concerning hospice service access for the LGBTQ+ community, homeless people and those living with HIV/AIDS, diabetes and cystic fibrosis.ConclusionBarriers of prognostic uncertainty, institutional cultures, particular needs of certain groups and lack of public awareness of hospice services remain substantial challenges to the hospice movement in ensuring equitable access for all.
incidents. A weak positive relationship (0.36) was identified with incidents. GMC Conditions Seven doctors with pre-existing GMC conditions were aligned to the Trust. From 2011, four (57%) had concerns escalated to the Medical Director. From 2011-18, approximately 1,030 doctors were aligned to the Trust. Only 285 (28%) doctors had concerns escalated, indicating those with conditions were twice as likely to encounter difficulties. Conclusions There is evidence that recruitment practices impair quality and so it was necessary for the leadership team to act. Employing doctors with GMC conditions was suspended. Services could not operate if SR was immediately made mandatory so a programme of staff development has been instigated to reduce the need for this practice. This involves working with the clinicians, Health Education England, GMC and professional bodies to:. Reopen the Associate Specialist grade.. Overhaul the CESR offering.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.