Background COVID-19 has resulted in greater attention on health inequities associated with culture and ethnicity in palliative and end of life care. Patients from minority ethnic groups are less likely to access palliative care services or rate the quality of their care as excellent. Understanding why this is the case remains limited. In trying to address health inequities, concepts like cultural competence, cultural humility and cultural congruence have been used to frame approaches. Within the UK context, these terms have been used to develop particular outcomes, for example, staff training courses on unconscious bias, as opposed to an ongoing reflective process. Cultural safety on the other hand is where healthcare providers, at both systemic and individual levels, use reflective practice to identify differences in experience between themselves and their patients, their families and caregivers and recognise how these differences may influence power in the patient-professional relationship (Curtis et al; 2019. Int J Equity Health.18: 1). Cultural safety is used more extensively in countries such as New Zealand and Australia. We aim to explore the current conceptualisation of cultural safety, within palliative and end of life care in the UK, as well as barriers and facilitators to its implementation; to understand what cultural safety means and how culturally safe practice can be applied across palliative care settings in the UK.
Methods A systematic review has been designed using the PRISMA-P framework. The data will be extracted, analysed by five reviewers, and assessed for the strength of evidence given.
Results These will be presented using an appropriate framework.
Discussion Given the significant discrepancies between the provision of palliative care for different ethnic minority backgrounds, we need to understand what good palliative care looks like. Patient – professional relationships, as well as ‘competence’ are key considerations which is why cultural safety is an important starting point. This systematic review will critically examine this in the UK context specifically.
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