Gugurr yan.guwan dhadhadya: Keep on walking strong

Improve cultural safety: ask a simple question

James Gerrard

Section Editor

James is a podiatry graduate who has worked in public and private settings in Victoria, New South Wales and Tasmania, and he now lectures at La Trobe University within the discipline of podiatry. James is also a current University of Newcastle PhD candidate, involved in research giving First Nations voice to foot health education, and the developing, delivering, and evaluating of cultural safety education for undergraduate podiatry students.

Providing culturally safe podiatry care is a professional capability, let’s look at where it starts. Here are some questions to self-reflect on first of all.

Are you aware whether the patients you work with are Aboriginal and/or Torres Strait Islander? If not, why not? And if not, how can you deliver culturally safe care for First Nations Peoples without accounting for cultural differences?

Now start with this question

A starting point in delivering culturally safe podiatry care is to simply ask clients: ‘Are you of Aboriginal and/or Torres Strait Islander origin?’

This may be asked as an individual podiatrist or by the organisation or business within which you work.

Why is asking this question so important?

One reason is, as the National Safety and Quality Health Service Standards (NSQHS) states, it initiates a culturally safe process where, ‘People who identify as being of Aboriginal and/or Torres Strait Islander origin are provided with tailored and culturally appropriate comprehensive care’.

In fact, ‘Action 5.08’ of the NSQHS requires that, ‘The health service organisation has processes to routinely ask patients if they identify as being of Aboriginal and/or Torres Strait Islander origin, and to record this information in administrative and clinical information systems.’

Added to this advice, the below is taken directly from page 36 of the National Safety and Quality Primary and Community Healthcare Standards (NSQPCHS).

On the following page of this document (‘Action 3.22’), the National Safety and Quality Primary and Community Healthcare Standards requires healthcare services to have processes that:

Routinely ask if a patient is of Aboriginal and/or Torres Strait Islander origin
Record this information in the patient’s healthcare record
Use this information to optimise the planning and delivery of health care

So, asking this question is important not just because it respects the patient and wider communities, but also because it reflects government guidelines that all healthcare providers should be aware of, and follow.

In the next issue of STRIDE, we will follow up with further cultural safety considerations to bear in mind when asking patients or clients if they are of Aboriginal and/or Torres Strait Islander origin.

In the meantime, the following resources may aid your own improvements when it comes to clinical governance and cultural safety: 

Australian Institute of Health and Welfare brochure  for staff and fact sheet for patients
Australian Institute of Health and Welfare 2010. National best practice guidelines for collecting Indigenous status in health data sets. Cat. no. IHW 29. Canberra: AIHW. Accessed here 
The Royal Australian College of General Practitioners (2010) Identification of Aboriginal and Torres Strait Islander people in Australian general practice accessed here 
The User Guide for Aboriginal and Torres Strait Islander Health accessed  here .

How does the NSQHS fit into the bigger podiatry picture?

Here’s a run down of the structures that surround it.

First of all, the Podiatry Accreditation Committee is responsible for developing professional and accreditation standards for approval by the Podiatry Board of Australia, and for maintaining such standards. Both the Committee and the Board comply with legal, regulatory, and professional requirements, responsibilities, and guidelines, including the Australian Commission on Safety and Quality in Health Care (ACSQHC).
Second, the ACSQHC is a government agency that leads and coordinates national improvements in safety and quality in health care across Australia. Their aim is to support healthcare professionals, organisations, and policy makers.
Third, the ACSQHC oversees the National Safety and Quality Health Service (NSQHS) Standards and the National Safety and Quality Primary and Community Healthcare Standards which drive the implementation of safety and quality systems and improve the quality of health care in Australia. Importantly, the National Safety and Quality Primary and Community Healthcare Standards (released in 2021) mirror the National Safety and Quality Health Service Standards. They are available here.

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