6669 Diversity in ethnicity and main spoken language of children referred to a specialist paediatric palliative care service

Objectives To evaluate the diversity in ethnicity and main language spoken by children formally referred to a specialist paediatric palliative care service, and to compare this to both local and regional population demographics. Methods A retrospective case note review was carried out for children formally referred to a specialist paediatric palliative medicine (PPM) service over a 24-month period from 18/09/2021 to 18/09/2023. Each child's reported ethnicity and main language was identified from their Electronic Patient Record and recorded against a unique study identification number. This data was then compared with demographic information from the Office of National Statistics (ONS) 2021 Census¹ on a local level using pooled data from three local authority areas (Lambeth, Lewisham and Southwark), as well as the larger NHS regions of London and South-East England. Statistical comparisons were made using an online data processing tool² to compare proportions using the 'N-1' Chi-squared test. Results There were 343 cases that met the inclusion criteria. 46 cases had no recorded ethnicity and were excluded from ethnicity comparison analysis, giving a total of 297 cases. 21 cases had no recorded main language and were excluded from language comparison analysis, giving a total of 322 cases. There is an increased proportion of PPM referrals for children identifying as 'White British' compared to the demographics of the local area and of London as a whole. Children identifying as 'Indian' and 'Pakistani' were also more significantly represented compared to the local population. Children who identify as 'Black, Black British, Black Welsh, Caribbean or African' appeared to be under-represented compared to the local population. Full results are available in table 1. English was the most common main language across cases referred to PPM. Other languages that appeared disproportionately represented in children referred to PPM included 'South Asian languages' (with the exception of Gujarati), 'West or Central Asian languages' and 'Arabic'. Full results are available in table 2. Conclusion Children referred to specialist palliative care services come from a wide range of ethnic backgrounds. We should be aware that some populations may be under-represented, such as children who identify as 'Black, Black British, Black Welsh, Caribbean or African'. We should acknowledge the diverse range of languages spoken by children and their families and consider this when providing information and resources. References Office for National Statistics, Census Division, Northern Ireland Statistics and Research Agency (NISRA). 2021 Census: Aggregate Data. [data collection]. UK Data Service, 2023 [Accessed 24 October 2023]. Available from: DOI: http://doi.org/10.5257/census/aggregate-2021-1. Contains public sector information licensed under the Open Government Licence v2.0. MedCalc Software Ltd. Comparison of proportions calculator. https://www.medcalc.org/calc/comparison_of_proportions.php (Version 22.014; accessed October 28, 2023).