Background and aims

Diversity within UK healthcare has increased significantly in recent years, bringing new challenges for clinicians and institutions. Cultural competency is the ability to deliver effective care across diverse cultural contexts. Currently, UK cultural competency education relies heavily on the hidden curriculum and e-learning, whereas many US institutions mandate more structured training.

This review aims to evaluate whether current UK cultural competency training is adequate and explores how educational reform could improve patient outcomes.

Materials and methods

A critical narrative review was conducted using PubMed and MEDLINE, supplemented by UK and US government reports and professional guidance. Thirty sources informed the review, including systematic reviews and original studies. The review was primarily drawn from literature published between 2016 and 2026 and was supplemented by earlier studies.

Results

The evidence consistently identified three related themes: communication and linguistic barriers to practice, clinician capability and institutional support. Cultural and linguistic barriers were a major contributor to lower engagement in preventive healthcare, with vaccination uptake in UK ethnic minority groups ranging from 66% to 75% compared to 94% among the white British population. Similar patterns were seen for adherence to breast and cervical cancer screening. In contrast, studies from the US showed improved clinician capability and patient trust and as a result, greater engagement with preventative behaviours from patients. Institutional support was a key differentiator for this disparity with structured training characterising US programmes whereas the UK curriculum remained inconsistent.

Conclusions

The reviewed evidence indicates that cultural competency training is associated with improving patient outcomes, however the current UK training may not prepare clinicians adequately for a diverse population. These findings support the development of a standardised module-based approach to cultural competency education, replacing e-learning activities with active mandatory case-based scenarios and incorporating formal assessment.