Inclusion criteria  > 18 years of age Inpatient at RCHT know to the palliative care team Able to consent Able to speak and understand the English language Able to use the virtual reality system Able to complete ESAS-r Questionnaire  Exclusion criteria  <18 years of age Patient unable to consent Patient unable to speak English Unable to use the virtual reality system (e.g. visually impaired) Known Epilepsy or seizures or suspected predisposition to seizures (e.g. Brain metastasis)