First Nations health

Recent reports have demonstrated that systemic and institutional racism remains embedded across Australian healthcare structures, policies and practices, contributing directly to inequitable access and outcomes.

Embedding cultural safety into everyday systems and process within health services will re-orient healthcare delivery to focus on models, practices and approaches that respect and prioritise First Nations ways of knowing, being and doing. It will also help contribute to the elimination of racism and the delivery of better health outcomes for First Nations people.
 

Cultural safety

Cultural safety for First Nations people is determined by First Nations individuals, families and communities.

In health care, culturally safe practise is the ongoing critical reflection of knowledge, skills, attitudes, practising behaviours and power differentials in delivering safe, accessible and responsive healthcare free of racism.

Essential features of cultural safety are individuals and organisations:

• acknowledging colonisation and systemic racism, social, cultural, behavioural and economic factors which impact individual and community health
• acknowledging and addressing individual racism, their own biases, assumptions, stereotypes and prejudices and providing care that is holistic, free of bias and racism
• recognising the importance of self-determined decision-making, partnership and collaboration in healthcare which is driven by the individual, family and community
• fostering a safe working environment through leadership to support the rights and dignity of Aboriginal and Torres Strait Islander people and colleagues.

Under the Priority reforms for the National Agreement on Closing the Gap signed in July 2020, all government organisations have committed to ‘embedding and practicing meaningful cultural safety’ as well as ‘delivering services in partnership with Aboriginal and Torres Strait Islander organisations, communities and people’.
 

The standards for First Nations Cultural Safety Review

The Commission's First Nations Health Team is leading the standards for First Nations Cultural Safety review. Through a co-design process, this work will identify options for strengthening cultural safety in hospital care. The first stage of the review focuses on building the evidence base and engaging with key stakeholders and is currently underway.

First Nations Health Team

The First Nations Health Team leads the standards for First Nations Cultural Safety Review. For more information about this work, please email the team.

Aboriginal and Torres Strait Islander Health Advisory Group

The Aboriginal and Torres Strait Islander Health Advisory Group is a key governance body for the Review. The Advisory Group provides strategic advice, guidance and monitoring to help shape the Review and its co-design processes.

The Advisory Group includes representatives from a broad range of sectors, including Aboriginal and Torres Strait Islander clinicians, consumers, community-controlled organisations and peak bodies.

Other work on cultural safety

• Cultural safety training: Analysis of national survey results and literature review
• National Survey on Cultural Safety Training
   

National safety and quality standards

Our National Safety and Quality Health Service (NSQHS) Standards are developed in collaboration with states, territories, clinical experts, patients and carers. The primary aim of the NSQHS Standards are to improve the quality of health service provision by providing nationally consistent statements about the level of care consumers can expect from health services.

Actions to meet the needs of First Nations peoples

The current NSQHS Standards include six actions that focus specifically on supporting improvements to health care delivery for First Nations people.

Implementation resources

We have developed guidance for health services to help take action to meet these requirements including:

• NSQHS Standards User guide for Aboriginal and Torres Strait Islander health
• Understanding leave events for Aboriginal and Torres Strait Islander peoples and other Australians from health service organisations: A Systematic Literature Review
• NSQHS Standards Identifying Aboriginal and Torres Strait Islander people 

Developing the Third Edition of the NSQHS Standards

We have started developing the third edition of the NSQHS Standards and are looking at how we can strengthen and improve a range of requirements including those to support cultural safety and improved outcomes for First Nations people. Visit the Third edition engagement hub to find out more.
 

Healthcare rights

The Australian Charter of Healthcare Rights describes what consumers, or someone they care for, can expect when receiving health care. These rights apply to all people in all places where health care is provided in Australia.

Your healthcare rights include the right to access, safety, respect, partnership, information, privacy and to give feedback without fear of it affecting care.

For First Nations people, delivering care aligned with the Charter means ensuring care is culturally safe and free from racism and discrimination.

My Healthcare Rights by Northern Sydney Local Health District

Northern Sydney Local Health District in New South Wales has developed a Charter Poster for First Nations people.