Cultural Competency Statement

CNWL provides services within extremely diverse multi-cultural and multi-racial communities. As part of the Trust’s continued commitment to ensuring that all of its staff and services demonstrate multicultural sensitivity and responsiveness in accordance with Equalities and Diversity Legislation¹, this statement has been developed:

• to advise all staff of their cultural competency responsibilities
• to advise managers of the areas of cultural difference that the Trust expects staff to be competent to deal with

The following steps to cultural competence have been identified:

• Develop cultural awareness by reflecting on and examining your own values, beliefs and cultural identity
• Understand and challenge discrimination and racism in all its forms
• Raise awareness of similarities and differences, social disadvantage and healthcare inequalities
• Develop cultural understanding through fostering relationships with different cultural groups
• Recognise and continuously develop the skills, roles and functions needed to perform cultural assessments; to plan, implement and evaluate culturally sensitive care; and challenge discrimination and prejudice
• Arrange cultural encounters and opportunities for healthcare staff to observe culturally sensitive care in action where a model has been implemented successfully
• Develop an environment that recognises that managing diversity is a routine aspect of clinical work, not an exceptional event

Cultural competency is not simply a consideration of how people from the white community relate to people from the black community. It is much more complex than this and we need to reflect this in our understanding and in any training that is undertaken. Cultural Competency includes all the many permutations of interaction and relationship that can exist between people from different racial and ethnic groups.  We all need to understand the differences and similarities that are embedded within our cultural heritages, and which affect attitudes, expectations and values, and how we relate to each other.

It is as important for the White British staff member to understand the cultural needs of a Black and Minority Ethnic (BME)² colleague and service user as it is for a Black and Minority Ethnic staff member to understand White British culture. It is equally important that members of particular BME communities have a cultural understanding of members of other BME communities. For instance:

• a staff member from an Arab community will need to understand the particular culture of a Black African member of staff or service user, and vice versa
• a Polish staff member will need to understand the particular culture of a South East Asian member of staff or service user, and vice versa

The permutations are many, and whilst there are going to be cultural differences there will also be many similarities. The Trust wants to encourage dialogue between members of different cultures and communities in order to promote understanding, and this can take place within formal training sessions, team meetings, or informally in the workplace. We need to create and be part of a work environment that places a proactive emphasis on cultural learning and the benefits of diversity.

Our use of language is an important element in demonstrating cultural competence. This is not just a matter of being sensitive to our use of words, which might cause offence to others, it is also about the language that is spoken when on duty. The accepted language for staff to use in the ordinary course of their work is English. Unless it is for the specific purpose of delivery of Trust services, agreed with the service users, to speak another language in front of service users who speak English, is in breach of Trust policy. 

Being aware of religious and other beliefs is another important area of Cultural Competency.  The Trust employs people who have a range of religious backgrounds, along with people who have humanistic or other beliefs. Whilst most people who have a religious belief in the UK identify themselves as Christian, cultural competency in the context of religion and belief is not simply a matter of Christians learning about the beliefs of people from other faiths.  It is also important to understand that faiths themselves are not homogeneous. Cultural competency is concerned with people of all or no religious persuasion having an appreciation and understanding of what others believe. This can include a range of issues:

• values to live by
• death and dying
• gender relationships
• dress
• types and times of religious observance
• particular festivals
• diet

to name but a few. And it is not necessarily understanding differences in custom and belief between religions that is required. There can be significant differences between some denominations or groupings within a particular religion as well.

People’s gender should be respected and accepted. Cultural competency in this area will encourage understanding and acceptance of gender differences, needs and rights. It is important to understand gender-specific attitudes and views that are embedded within cultures, and which may also be informed by religious beliefs. These may be contrary to UK Equalities legislation, particularly with regard to attitudes towards women. Attitudes towards transgender people must also be considered.

Cultural competency must also embrace attitudes towards people who have a disability, or who identify themselves with a particular community, for instance the Deaf community. What are the different cultural beliefs and attitudes in relation to disability, and in particular mental illness? This may vary greatly within a given culture or religion depending on the nature of the disability. People may also have hidden disabilities that have a major impact on how they live their lives and how their care is organised. The rights of disabled people under UK law need to be respected and accepted.

People’s sexual orientation should be respected and accepted. Some cultures and religious beliefs do encourage negative attitudes towards people who are gay and lesbian which contravenes Equalities legislation. Encouraging understanding and acceptance of this area of diversity is another important component of cultural competency.

For many cultures and religious beliefs, the age of a person is a significant factor with regard to what is expected of them and how a person should be related to and be expected to relate to others. What are the cultural and religious differences in this area that need to be understood? Cultural competency must embrace an understanding of attitudes towards age and the different stages of life and should reflect UK age-related legislation.