Table 2

The Cultural Safety tree in table format

Translating Cultural Safety to the UK
The Cultural Safety tree
Roots from New Zealand
A Cultural Safety foundation, which holds strong, without which will not support the rest of the tree.
Trunk of transformation
Symbolic of the connection between roots and leaves which is a conduit to nourish from the ground through to the leaves.
Branches/leaves/flowers /fruit
Pre-existing UK discussions about improving healthcare that would translate into the Cultural Safety model.
These could blossom and bear fruit.
1. Person-centred experience of care (subjective)Nurturing principles
  • NHS patient experience framework.

  • Patient/user led initiatives to highlight structural blind spots.

  • Coproduction of initiatives.

  • Person-centred care.

  • Engaging and enabling voices of ethnic minorities.

  • Availability of interpreters.

  • Access to carers/health staff from a similar cultural background.

  • Continuity of care.

2. Staff self-reflexivityHealthcare human rights
  • Transformational learning.

  • Colonial history and inequality.

  • Impact of power and privilege.

  • Racism as a social determinant of health.

  • Intersectionality.

  • Mandatory Cultural Safety education of health and managerial staff.

  • Professional reflective practice.

  • Decolonising ideas of healing: respect for homeostatic/ecological principles of indigenous/traditional healing ideas.

3. Structural reflexivityInstitutional commitment to review structural knowledge, biases and assumptions
  • Allowing reverse innovation within structures.

  • Lay bare epistemic knowledge bias.

  • Improve training in diagnosis in darker skin tones, for example, cyanosis and skin conditions.

  • Finding a way to enable access to education and advancement to become healthcare professionals for minorities (and NZ/Australian First Peoples), ensuring zero racism policies and other aspects of ‘inclusion’ within education.

  • Address staff burnout that can lead to compassion deficit – respectful working conditions for staff.

  • NHS, National Health Service; NZ, New Zealand.