Consultations for people from minority groupsBMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a273 (Published 30 June 2008) Cite this as: BMJ 2008;337:a273
- Aziz Sheikh, professor of primary care research and development1,
- Rashid Gatrad, consultant paediatrician2,
- Sangeeta Dhami, locum general practitioner3
- 1Division of Community Health Sciences, GP Section, University of Edinburgh EH8 9DX
- 2Department of Paediatrics, Manor Hospital, Walsall WS2 2PS
- 3Edinburgh, EH17 8UE
- Correspondence to: A Sheikh
Most developed societies are ethnically, linguistically, and religiously diverse, and recent trends in migration mean that this diversity is set to increase. Irrespective of background, most people want (and most health professionals aim to provide) high quality care that is accessible and sensitively delivered. For many people in minority groups, the care sought and the professional knowledge base, skills, and competencies needed to deliver such care are no different from those needed for people from the majority population, but in some instances standard approaches may need to be modified to achieve comparable outcomes. Making the effort to do so is important for ethical and legal reasons, but also because it will be appreciated and remembered. Conversely, failures in communication often have a lasting negative effect on the doctor-patient relationship; in particular, such failures can erode trust, not only in the clinician, but also in the health service in general.
Challenges to delivering culturally competent and sensitive care
The NHS was created to serve the needs of a more homogeneous society than we have at present. Data on variations in quality of care, persistent health inequalities, and lower satisfaction with healthcare provision show that the NHS has difficulty in adapting to meet the needs of minority populations, particularly if these needs differ from those of mainstream society.1 This challenge is greatest when delivering care to older people who have recently migrated from parts of the world with very different societal structures; those who are not entitled to stay permanently; and those with limited English.
Most healthcare professionals will also have had little training in understanding the complex association between culture, health, and healthcare delivery, thereby increasing the risk of cultural misunderstandings and diminishing the potential for creatively exploring the development …