OP-17 Financial insecurity for terminally ill migrants in the UK: double jeopardy at the end of life

<h3>Introduction</h3> Poverty and deprivation are invisible yet powerful influences over people’s experiences of palliative and end of life care. The socio-economic impact on terminally ill migrants on UK visas is extraordinarily high. <h3>Aims</h3> To understand the nature of financial precarity and ways in which terminally ill migrants have sought to address financial concerns. <h3>Methods</h3> A multiple methods study combining policy review, systematic review, media analysis and qualitative interviews. <h3>Results</h3> While policy positions migrants as a financial drain on society, the literature and our primary interview data tell a different story. While paying both an immigration surcharge (fee) and tax, people struggle to access basic services. Terminally ill migrants face destitution, have to continue working when ill or risk food and fuel poverty, and risk eviction, homelessness and deportation. Some experience barriers in accessing healthcare, and are prevented from planning their death and funeral arrangements due to the lack of finances and financial stability. Newspapers, surprisingly, reflects a compassionate and humane view of migrants that is missing from how services are designed and delivered. <h3>Conclusion</h3> Family finances and visas are the biggest and most pressing stressor, over and above the terminal illness. <h3>Impact</h3> There is an urgent need for actions within policy and practice including (i) streamlined and humanised communication processes with the Home Office; (ii) a route-map showing professionals the referral pathways through organisations in palliative care and immigration sectors; (iii) training initiatives ensuring workers are informed of processes and support. There is capacity to mobilise both the media and Ministers to highlight the precarious position of migrants when they have a terminal illness, to change the discourse toward a humane and compassionate approach.