OP-6 Unreached – a study of advanced illness and financial insecurity

Introduction People living with advanced illness often experience prolonged financial insecurity due to reduced income and rising costs associated with care, travel, heating, and medical equipment. Geographic context - rural, island, coastal, or urban - can intensify these challenges, shaping how people cope and the resources available to them. Aims This study explored the lived experiences of financial insecurity during advanced illness across diverse UK settings to inform policy and practice at the end-of-life. Methods A qualitative design was used involving semi-structured interviews. Interview transcripts were analysed using the Framework Method (Gale et al., 2013), allowing comparison across regions and participant groups. Results Fifty-one participants (18 people with advanced illness and 33 family carers) were interviewed across rural North Wales (n = 18), rural/coastal/island Scotland (n = 20), and urban/coastal Southern England (n = 13). Five interrelated themes captured participants’ experiences: Housing: Difficulties maintaining, heating, or adapting homes; insecurity was compounded by high utility costs. Welfare Benefits: Essential but complex, bureaucratic, and stigmatised; eligibility gaps deepened hardship. Additional Costs: Transport, food, and care expenses intensified financial strain. Long-Term Financial Impact: Reduced employment and pension contributions created enduring insecurity. Perceptions of Support: Community help was inconsistent; stigma and isolation limited access to assistance. Conclusions Financial insecurity compounds the challenges of advanced illness, creating precarity shaped by geography, access to care, and community context. While people adopted resourceful coping strategies, systemic gaps heightened need. Hardship was often normalised but should not be accepted as inevitable. Impact Financial insecurity should be recognised as a core dimension that can heighten need in palliative and end-of-life care. Policy and practice should: Embed financial assessment and response within interdisciplinary care; Simplify welfare access for seriously ill people; Prioritise and secure funding for community-led and third sector initiatives (e.g. transport schemes, day care, peer networks) Reference Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Medical Research Methodology 2013;13:117. https://doi.org/10.1186/1471-2288-13-117