Communicating with Patients in the UK

This communication skills course for international healthcare professionals helps doctors, nurses, midwives, pharmacists, dental professionals, allied health professionals and other patient-facing staff who trained or worked outside the UK to communicate confidently with UK patients, families and colleagues. It is not an English language test or a grammar course. It is about the conventions, expectations and techniques that make a consultation safe and leave the patient feeling heard.

Most complaints in UK healthcare come not from clinical error but from communication: feeling unheard, not being kept informed, perceived rudeness, or not understanding a decision. For professionals new to the UK the gaps are often subtle. British patients soften what they say, apologise when they mean "please repeat that", and use understatement that hides real pain or worry. They also expect to be told the truth, to be offered choices and to have the final say. The course works through these expectations with phrase tables, worked examples and short cases.

It takes approximately 2 hours, including reading, reflection points, a written reflective account and a 15-question assessment, and it is self-paced. You buy and take it on our course portal; see the course catalogue for related titles. Healthcare Practise UK is an independent provider. We are not affiliated with any UK regulator or the NHS, and no regulator has reviewed this course.

Communication is a professional standard for every UK regulator, not a personal style. The course draws on:

• the GMC's Good medical practice (2024), which describes patients as partners, and its Decision making and consent guidance;
• the NMC Code, which asks registrants to listen to people and respond to their preferences and concerns;
• the HCPC Standards of conduct, performance and ethics, which require registrants to communicate appropriately and effectively;
• the standards of the GDC, GPhC, GOC, GOsC and GCC, which set similar expectations;
• Montgomery v Lanarkshire Health Board (2015), because you cannot know what is material to a patient unless you ask;
• the Accessible Information Standard in England (revised 2025), the accessible communication standards in Wales, Welsh language duties and the British Sign Language Act 2022;
• section 2 of the Compensation Act 2006 and the Apologies (Scotland) Act 2016 on apologies.

It uses two widely taught frameworks: the Calgary-Cambridge guide for structuring consultations and SPIKES for breaking bad news. For a broader course on communication, consent and complaints that is not aimed specifically at newcomers, see our communication skills course.

Module 1, what UK patients expect. Partnership, information and choice; British conversational conventions; and health literacy. A phrase table decodes what patients may mean by "I don't want to bother you, but...", "it's a bit uncomfortable", "I'm sure you know best" and "with respect...". The module notes research suggesting more than four in ten working-age adults in England find typical health information hard to understand when it uses words alone.

Module 2, structuring the consultation. The Calgary-Cambridge stages, opening with an open question and asking "is there anything else?" early, exploring ideas, concerns and expectations (ICE), and closing with specific safety-netting rather than "come back if it gets worse". It covers telephone and video consultations, including checking that the patient can speak freely; one case shows a video review that led to a disclosure of domestic abuse.

Module 3, language, plain English and checking understanding. Everyday terms patients use, from "waterworks" and "the runs" to "chesty", "knackered" and the Scottish "peely-wally", and how to clarify them. It explains why to say "died" rather than "passed away", how to ask directly about suicidal thoughts when a patient says "I just want it all to stop", how to explain risk with natural frequencies instead of "halves the risk", and how to use teach-back and "chunk and check". It also covers writing to patients in plain English and writing every record as if the patient will read it.

Module 4, cultural humility and diverse communities. Moving from cultural competence to cultural humility, bias in assessing pain and symptoms, why pulse oximeters may overestimate oxygen levels in people with darker skin, faith and fasting, gender preferences, inclusive language, and reasonable adjustments for people with learning disabilities, autistic people and inclusion health groups.

Module 5, difficult conversations. Breaking bad news with SPIKES, step by step, and what to do when a family asks you not to tell the patient. Handling requests you cannot meet, such as antibiotics for a viral illness, without sounding dismissive. De-escalating anger, the NHS complaints routes and ombudsmen in each nation, and why a sincere apology is not an admission of liability.

Module 6, interpreters, accessible information and language rights. Why relatives and children should not interpret, how to brief a professional interpreter, speaking to the patient in the first person, and when to choose face-to-face over telephone interpreting. It explains the five steps of the Accessible Information Standard (identify, record, flag, share, meet), the active offer of Welsh-language services, and the rights of Deaf British Sign Language users, with a case of a Deaf patient who left an appointment without understanding her treatment.

Module 7, communicating with colleagues and in writing. Structured handover and SBAR, read-back on the telephone, graded assertiveness and the CUS words ("I am concerned, I am uncomfortable, this is a safety issue"), and striking the right tone between too indirect and too blunt. A table rewrites stigmatising record entries such as "non-compliant", "difficult patient" and "pt c/o SOB" into clear, respectful language.

Each module ends with key points and practical "apply it" tasks: rewrite one piece of information you give often in no more than three key messages; ask one ICE question each in your next few consultations; use teach-back with at least three patients this week; review three of your recent record entries for tone. A quick-reference guide covers opening, listening, ICE, explaining, checking, closing, bad news, interpreters, accessibility and colleagues.

Your reflective account answers three prompts: which aspect of communicating with UK patients has been most different and how you are adapting; a consultation where language, culture or understanding was a challenge and what you would do differently; and which two techniques you will practise over the next month and how you will get feedback.

The 15-question scenario-based assessment has a pass mark of 12 (80%), with a chance to revisit sections and retry. You then receive a certificate of completion from Healthcare Practise UK. Record the time you actually spend as CPD; each regulator sets its own CPD rules, and nurses and midwives should note that self-directed online learning usually counts as individual learning for NMC revalidation.

Individuals get most from it by pairing the course with real practice: ask a colleague or supervisor to observe a consultation, or record and review one with consent where appropriate, then add that feedback to your reflection.

Teams that recruit internationally use it as a common language for induction, so phrases such as ICE, teach-back and CUS mean the same thing to everyone. Organisations can buy team credits; see for organisations.

Where a complaint or concern about communication has been raised, the course can support reflection on how you communicate, but take advice from your defence organisation or union first; a course alone does not resolve a concern. It supports awareness and does not replace your employer's mandatory training, so check local requirements.

This course belongs to our international and returning professionals collection. It pairs well with:

• Working in the NHS: UK Practice for International Doctors;
• UK Professional Practice for Internationally Educated Nurses and Midwives;
• UK Healthcare Law Essentials for International Professionals, which covers the law behind consent, confidentiality and candour.

The which course do I need tool can suggest a starting point.