Resource update: cultural competency

  • Read our guide to a new e-learning tool which helps health professionals understand the issues around culture and health.

Essential facts 

Cultural competency is about respecting and understanding the cultural context in which patients live their lives, and the effect this can have on the way they access healthcare and accept treatment.

Health Education England has published an e-learning tool for professionals to help them
understand the relationship between culture and health.

Health Education England (HEE) has published an e-learning tool for professionals to help them understand the issues around culture and health. It has two modules for health professionals – which take about 30 minutes to complete – and a third module for midwives. 

The UK population is becoming increasingly diverse, with growing numbers of people identifying themselves as belonging to a black and minority ethnic (BME) group. Some individuals described as white European may also perceive themselves as belonging to a minority group, such as people from eastern Europe or Romany/travellers.

Being culturally competent is not only about respecting and appreciating the cultural contexts of patients’ lives, but about understanding the way health care is delivered to respond to the needs of a diverse population. Being aware of issues relating to culture can help reduce disparities in healthcare outcomes, according to HEE.

Disparity in access to care, choice and care provision, along with increased poverty and poorer socioeconomic status among BME groups, contributes to unjustified variation in clinical outcomes and inequalities in health and life expectancy, and has a negative impact on patient satisfaction.

The modules say that whether a patient feels comfortable and culturally safe is dependent on whether the health professional is culturally competent. This means being able to develop trust with their patient, being aware of power imbalances, having clear, open and respectful communication and understanding how racism and discrimination have resulted in inequalities. 

Nurses should also appreciate how their own culture, gender, religion, values and beliefs may impact the health encounter or experience for the patient.

Implications for nurses

Offer culturally competent care by asking the patient and family open-ended questions to gain more information about their expectations or understanding of their health condition, illness or treatment.

Ensure your language and behaviour convey a non-judgemental attitude towards people whose culture differs from their own, and demonstrate a willingness to meet their needs.

Pay close attention to body language, lack of response or expressions of anxiety that may signal discomfort for either the patient or their family.

HEE module author Katie De Freitas says cultural competence is largely about respect and communication. 

With cultural information, remember that although it can be useful, avoid making assumptions or broad generalisations and remember to tailor care to individual needs and preferences. 

Expert comment

Katie De Freitas, HEE module author, midwife and quality improvement lead at Great Ormond Street Hospital for Children NHS Foundation Trust

‘Cultural competence is about healthcare staff working with their local communities to understand their needs, expectations and preferences and how we can deliver more appropriate health services. We know that BAME groups historically have poorer outcomes and poorer experiences of care. 

‘Sometimes it is because services haven’t been able to adapt or understand how to meet their needs, or because we haven’t provided communication or information in a way that is accessible to all groups. 

‘Professionals have told me they don’t want to stereotype, make assumptions or be prejudiced, but I think we have in some cases, whether knowingly or not. 

‘The most important thing is not to have knowledge of everyone’s culture but to have honest discussions and not be afraid to ask questions if you are not sure. 

‘I recognise that we can be afraid of offending people but this is a matter of quality and safety and generally people say they are happy to be asked and welcome these discussions as long as you are respectful and seeking to provide better care.’

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