Ensure that the environment is conducive to discussion and that the patient’s privacy is respected, particularly when discussing sensitive, personal issues.


Maximise patient participation in communication by, for example:

  • maintaining eye contact with the patient (if culturally appropriate)
  • positioning yourself at the same level as the patient
  • ensuring that the patient is appropriately covered (if applicable).

Ask the patient how they wish to be addressed and ensure that their choice is respected and used.


Establish the most effective way of communicating with each patient and explore ways to improve communication. Examples include using pictures, symbols, large print, Braille, different languages, sign language or communications aids, or involving an interpreter, a patient advocate or family members.


Ensure that the accent, use of idiom and dialect of both the patient and the healthcare professionals are taken into account when considering communication needs.


Avoid using jargon. Use words the patient will understand, define unfamiliar words and confirm understanding by asking questions.


Use open-ended questions to encourage discussion.


Summarise information at the end of a consultation and check that the patient has understood the most important information.

Relative values of different outcomesThe GDG considered that good communication was an essential aspect of good patient care. Other important aspects of good patient experience will be undermined if communication is not appropriate.
Trade off between clinical benefits and harmsThe GDG considered no harms were likely.
Economic considerationsThe replacement of poor communication with better communication was not considered to have additional costs. Any additional cost required by extra time or use of interpreters was considered likely to be offset by better patient understanding and the need for fewer repeated consultations.
Quality of evidenceThe GDG used evidence reviews from Medicines Adherence guideline and findings of NHS surveys to inform the recommendations.
Other considerationsThe GDG used their own professional and personal experiences to inform these recommendations. They considered that good communication is an area that all involved in healthcare need to consider. This includes hospital porters, cleaning staff, reception, clerical or administrative staff all of whom interact with patients. Some skills are more important in clinical consultations e.g. summarising information, but not using jargon, using appropriate eye contact, asking the patient how they wish to be addressed for example, are relevant in all settings and for all personnel. There is a requirement under equality and diversity considerations to ensure that patients who need help with communication receive that help.

From: 10, Enabling patients to actively participate in their care

Cover of Patient Experience in Adult NHS Services: Improving the Experience of Care for People Using Adult NHS Services
Patient Experience in Adult NHS Services: Improving the Experience of Care for People Using Adult NHS Services: Patient Experience in Generic Terms.
NICE Clinical Guidelines, No. 138.
National Clinical Guideline Centre (UK).
Copyright © 2012, National Clinical Guideline Centre.

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