How do health, social care and legal professionals support visa-dependent migrants affected by a terminal illness in the UK: a qualitative interview study.

OBJECTIVES: To understand barriers faced by migrants with terminal illness in accessing healthcare services and to document the strategies adopted to mitigate problems they experienced. DESIGN: Inductive thematic qualitative interview study. SETTING: Community and hospice settings in the UK. PARTICIPANTS: 22 people, comprising 14 working within health/palliative care settings, 4 in legal/policy settings and 4 in migrant support, all with experience of supporting people with a terminal illness. RESULTS: There are substantial and dire consequences for migrants with terminal illness. While patients and professionals struggle to understand migrants' entitlements, the expense of treatment and/or the prospect of being charged for healthcare deter access. Healthcare charges and discretionary support were variable. Patients risk accruing heavy healthcare costs/debts, and some avoid accessing care altogether for fear of immigration services being alerted, with consequent fear of removal/deportation. CONCLUSIONS: Service commissioners and palliative care practitioners must be cognisant of the complex constellation of circumstances in which migrants live and die. Strategies are needed to enhance knowledge around entitlements in order to widen access and promote equitable access to healthcare for terminally ill migrants.