What is culturally safe GP care? New research from Aboriginal and Torres Strait Islander consumers
A new paper, “Towards assessment of culturally safe general practitioners: co-designing with Aboriginal and Torres Strait Islander peoples’ perspectives, the Calgary–Cambridge guide and clinical yarning”, published in the Australian Journal of Primary Health on 25 May 2026, puts Aboriginal and Torres Strait Islander consumer voices at the centre of the conversation about cultural safety in general practice.
The research was carried out in Queensland across four sites, including three Aboriginal Medical Services and one mainstream general practice, spanning regional, rural and very remote communities. A total of 131 Aboriginal and Torres Strait Islander people took part through surveys, interviews and group processes. The work was guided by an Aboriginal Community Reference Group to ensure the findings reflected community perspectives.
This research matters because cultural safety is often discussed in policy or training settings, but less often defined by consumers themselves.
What Aboriginal and Torres Strait Islander consumers said matters most
Participants were clear about what they expect from a GP consultation. The priorities people identified were not theoretical; they were grounded in what really helps people feel respected, understood and confident about their care.
The most important attributes were:
- knowing how to diagnose and treat disease properly
- explaining things clearly, using basic words
- greeting people respectfully
- not stereotyping Aboriginal people
- listening carefully
Other highly ranked elements included recognising what matters to the patient, not interrupting, being polite and respectful, creating a welcoming environment, and providing enough time for the appointment.
These findings show that culturally safe care is not something separate from everyday practice but is built through how care is delivered and whether people feel heard and taken seriously.
What does culturally safe care look like in a GP appointment?
Consumers said they want GPs who get clinical care right, use plain language, listen without interrupting, speak respectfully and as an equal, and avoid assumptions.
Participants also described the importance of privacy, comfort, and having enough time in appointments. Cultural safety also sits in the environment, including how welcoming the service feels, whether privacy is maintained, and whether people feel comfortable in the space.
What consumers want to see change
Consumers are asking for consistent, high-quality clinical care, clear communication, genuine listening, respectful interactions, freedom from stereotyping, and adequate time, privacy and follow-up.
There was also a strong message about consent. Participants wanted control over who is involved in their care and how information is shared, including during consultations, procedures and examinations.
Participants also valued continuity of care. Seeing the same GP over time, not having to repeat their story, and having follow-up on results and referrals all contributed to feeling safe and supported.
Important findings about culture and identity
Participants had mixed views about being asked about Country, Mob or cultural identity. For some, this was helpful. For others, it was intrusive or distressing, particularly where identity had been questioned or where people were disconnected from family or community. The paper recommends allowing these conversations to develop over time, rather than making them a standard opening question.
The research also goes further in challenging routine identification processes in general practice. It highlights that asking people to identify as Aboriginal or Torres Strait Islander in a standard administrative way can create fear of stereotyping, mistrust and disengagement. It points to the need for safer systems, where identity can emerge over time through relationships and where access to supports does not depend on a process that can cause harm.
What this means for general practice
The authors recommend strengthening existing GP consultation approaches by embedding relational practices such as respectful greeting, listening and clear communication, and integrating elements of social yarning into standard practice.
The paper also challenges commonly taught approaches. It shows that practices such as asking about Country, using silence, or trying to find common ground should not be assumed to be culturally safe for everyone. These approaches need to be used carefully and in response to the individual.
Where to next
Suggested future work includes testing the proposed consultation model in real settings and developing tools to assess cultural safety from a consumer perspective. This research was conducted in specific Queensland communities, and further work is needed across different regions and communities.
Why this matters in Western Australia
This paper provides clear direction based on what Aboriginal and Torres Strait Islander consumers have said themselves.
The key message is straightforward, people want care that is clinically sound, clearly explained, respectful, and free from judgement or stereotyping.
For services, this means reviewing how care is delivered and making practical changes that reflect these expectations.
Further reading & reference
Training for healthcare professionals
The insights in this article reflect what Aboriginal and Torres Strait Islander consumers have shared with HCCWA over many years. They also inform the content of our Aboriginal Patient Advocacy Training, where we work with community workers, advocates and health professionals to turn these insights into practical skills. Visit our training and events page to register for our next training session, or contact us to find out more.
Further reading
Brumpton K, Evans R, Sen Gupta T, Ward R (2026) Towards assessment of culturally safe general practitioners: co-designing with Aboriginal and Torres Strait Islander peoples’ perspectives, the Calgary–Cambridge guide and clinical yarning. Australian Journal of Primary Health, 32, PY25245. doi:10.1071/PY25245
ABSTRACT
Background. Cultural safety is a key component of quality general practice for Aboriginal and Torres Strait Islander peoples; however, few tools exist to assess this from the patient’s perspective. This study aimed to explore the qualities of a general practitioner (GP) that support culturally safe consultations, as described by Aboriginal and Torres Strait Islander peoples, and to examine how these align with two consultation models: the Calgary–Cambridge Guide and clinical yarning. Methods. A mixed methods approach was used, including a survey, qualitative interviews and a modified nominal group technique (mNGT). Participants were Aboriginal and Torres Strait Islander peoples who had previously engaged with general practice care. Data were both described and analysed thematically. Results. In total, 131 Aboriginal and Torres Strait Islander peoples participated (70 in the survey and interview; 43 in mNGT to validate the findings; and 18 in three separate mNGTs to rate desirable attributes of a GP). Participants identified several qualities underpinning a safe GP consultation. Within the top five attributes in the mNGT were universal skills – clinical competence, avoidance of jargon and attentive listening – alongside welcoming patients with a greeting and avoiding stereotyping. Although there was strong emphasis on respectful, individualised care, preferences varied significantly, highlighting the limitations of a generic approach to consultation skills. Some findings challenged core assumptions regarding clinical yarning and elements of cultural safety training. Conclusion. We propose a refined, integrated consultation model that enhances the Calgary– Cambridge Guide with relational elements of the social yarn, particularly during initiation of the consultation. This integrated model, grounded in Aboriginal and Torres Strait Islander peoples’ perspectives yet familiar to GPs and academics, offers a promising foundation for culturally safe practice and assessment, with potential applicability across other diverse populations.
Keywords: Aboriginal and Torres Strait Islander health, Australia, Calgary–Cambridge guide, clinical yarning, cultural safety, equity, general practice, Indigenous health care.
