What Constitutes High-Quality Paediatric Palliative Care? A Qualitative Exploration of the Perspectives of Children, Young People, and Parents

Debbie Braybrook, Lucy Coombes, Hannah M. Scott, Daney Harðardóttir, Anna Roach, Jemimah Bariuan, Clare Ellis-Smith, Julia Downing, Fliss E. M. Murtagh, Myra Bluebond-Langner, Lorna K. Fraser, Richard Harding and Katherine Bristowe ()
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Debbie Braybrook: Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation
Lucy Coombes: Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation
Hannah M. Scott: Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation
Daney Harðardóttir: Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation
Anna Roach: Great Ormond Street Institute of Child Health
Jemimah Bariuan: King’s College London, GKT School of Medical Education
Clare Ellis-Smith: Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation
Julia Downing: Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation
Fliss E. M. Murtagh: University of Hull
Myra Bluebond-Langner: University College London
Lorna K. Fraser: Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation
Richard Harding: Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation
Katherine Bristowe: Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation

The Patient: Patient-Centered Outcomes Research, 2025, vol. 18, issue 5, No 11, 539-561

Abstract: Abstract Background Globally, over 21 million children need palliative care each year. Although guidelines exist to support paediatric palliative care delivery, they are not informed by the experiences of children themselves. Objective We aimed to determine what constitutes good quality palliative care from the perspectives of children with life-limiting or life-threatening conditions and their parents. Methods We analysed semi-structured qualitative interviews using reflexive thematic analysis informed by the European Association for Palliative Care charter of palliative care for children and young people, and Bronfenbrenner’s bioecological model. Participants included 26 children aged 5–17 years, and 40 parents of children aged 0–17 years, with a range of cancer and non-cancer diagnoses in nine UK paediatric palliative care services (hospitals and hospices). Results Quality paediatric palliative care can be both enacted or interrupted across the five domains of the bioecological model. Honest timely communication with the child and family (microsystem), and collaborative relationships between care teams and others in the child’s life (mesosystem), are vital. Care experiences are negatively affected by inequities in care provision (exosystems), and society’s reluctance to discuss mortality in childhood (macrosystem). Children need to enjoy what matters to them, and maintain social connections, and plan for the future, even if facing a shortened life (chronosystem). Conclusions Children and parents are experts in their condition and should be actively involved in care discussions, through communication tailored to the child’s pace and preferences, and support advocating for and coordinating care services. Fostering strong and collaborative relationships builds trust and helps children and families to feel safe, included and supported.

Date: 2025
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DOI: 10.1007/s40271-025-00744-8

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