Equity of access: the referral process in palliative care – preliminary data from a scoping review

Background: Timely referral to Palliative Care remains a global challenge, often occurring late in the disease trajectory, which limits opportune intervention and the potential to improve quality of life for patients and their families. Although evidence supports the benefits of this integration, there is a lack of consensus on standardised criteria and validated screening tools, especially in non-oncological and community settings. This heterogeneity and fragmentation compromise equitable access and service organisation. Aim/Research question or hypothesis: map the available evidence on the Palliative Care referral process in adults, describing existing models, instruments, utilisation contexts, limitations, and best practices to inform clinical practice and future research. Methods: Scoping review using the Joanna Briggs Institute (JBI) methodology. Inclusion: Population (adults in Palliative Care), Concept (referral process and instruments), and Context (all levels/settings for Palliative Care). Databases: PubMed and CINAHL (August 2025). Screening and selection by two independent reviewers at Rayyan®. Data extraction was performed by one reviewer using a descriptive synthesis approach. Results: Initially, 5,198 studies were identified, of which 2,174 were duplicates, resulting in 4,139 articles being analyzed. Preliminary analysis of titles and abstracts confirms the identification of multiple referral instruments, studies in oncology populations, and in hospital settings. Discussion: The review is expected to systematically map the diversity of referral tools and processes, highlighting methodological inconsistencies and gaps in evidence, particularly outside of hospital-based cancer care. This work will provide foundational support for earlier and more equitable referral, identify research gaps, and guide the construction, adaptation, and validation of tools applicable in diverse Palliative Care contexts, thereby improving the quality and integration of care and informing health policies.