PPT49 How is palliative care delivered to adult brain tumour patients in the UK? Insights from a review of national health service neuro-oncology services by the Tessa Jowell brain cancer mission

<h3>Background</h3> Palliative care plays an essential role in oncology, particularly for tumour types with poor outcomes such as brain tumours. Yet, evidence suggests that service design and delivery vary for this patient group. To address this gap, we reviewed the organisation of palliative and supportive care within UK neuro-oncology centres. <h3>Methods</h3> As part of the 2024 Tessa Jowell Centre of Excellence process, 21 neuro-oncology centres (representing approximately 84% of UK services) self-reported details of their palliative and supportive care pathways. Information on referral processes, team composition, community integration, and bereavement support was thematically analysed and anonymised. <h3>Results</h3> Models of palliative care varied widely, from centres where care is led by a specialist palliative care team, to those where care is primarily led by neuro-oncology multidisciplinary team (MDT) or by community palliative care teams. Only 19% (4/21) of centres included palliative care specialists in their neuro-oncology MDT, contrary to national guidelines. Most centres (86%, 18/21) had access to specialist consultants and nurses, with additional input from social workers (33%), allied health professionals (19%), psychologists (10%), and non-clinical support (19%). Neuro-specialisation within palliative care teams was reported in only 38% (8/21) of centres. For patients with inoperable disease or those unfit for active treatment, 29% (6/21) had access to a best supportive care clinic, including one dedicated neuro-oncology service. Others relied on nurse-led follow-up (24%) or oncologist/surgeon consultation (62%). Community education by specialist neuro-oncology services was common but inconsistent: 48% (10/21) offered ongoing community training programmes, and 33% (7/21) invited community teams to in-house neuro-oncology training. Bereavement care was limited, with 29% (6/21) providing structured pre-bereavement support and 38% (8/21) hospital-funded provision. <h3>Conclusion</h3> This national review of palliative care in neuro-oncology highlights substantial variation in service design and delivery, reinforcing the need for coordinated national standards to ensure equitable, integrated care.