Royal Trinity Hospice, a leading provider of end of life care (EOLC) in London and champion for lesbian, gay, bisexual and trans (LGBT) inclusion, has called for action to address the EOLC inequalities identified in a Marie Curie report released today. ‘Hiding who I am: Exposing the reality of end of life care for LGBT people,’ found nearly three-quarters (74%) LGBT people are not confident that health and social care services provide sensitive end of life care for their needs.

Trinity has pioneered practical ways of addressing barriers to EOLC for LGBT communities. Trinity established an LGBT Friends group to help shape service provision and has forged links with other local LGBT groups. Trinity was the first hospice to march in London Pride in 2014 and this year will lead 8 other hospices in the march. Trinity is a Stonewall Diversity champion and features in the top 300 of the Stonewall Workplace Equality Index. Trinity regularly hosts inspirational LGBT speakers for staff, like Ayla Holden and Lord Browne. Trinity’s Chief Executive Dallas Pounds has been nominated Positive Role Model for LGBT in this year’s National Diversity Awards.

Dallas Pounds said, “I am saddened but not surprised by the findings. The taboo around death and dying combined with the reluctance of LGBT communities to engage with healthcare services, through fear or lack of knowledge, is a significant challenge.

At the heart of quality end of life care is providing care which takes into account individual needs and wishes. To do this we must create an environment in which LGBT people feel comfortable and supported to be themselves, as patients, carers or as staff.

More action is required across hospices, hospitals and in the community to ensure all LGBT people are treated with dignity and respect in their final days.”

The report draws on interviews with LGBT people living with a terminal illness, and their partners, by the University of Nottingham (The Last Outing) and King’s College London (ACCESSCare). It includes examples of indirect and direct discrimination, including a dying lady whose doctor refused to see her without a chaperone because she was a lesbian. Many people interviewed said they felt anxiety about having to hide who they are when accessing end of life care, with one in four experiencing discrimination from health and social care professionals in their lifetime. Others feared ‘outing’ themselves to care professionals, having grown up at a time when being gay was illegal.