Communicating with Patients
Candour conversations tend to work best when they are clear, humane, and paced. The aim is to reduce fear, maintain respect, and leave space for questions during a stressful time. [4][5]
Structure and tone
Many clinicians open by thanking the patient for their time, stating plainly what happened, and offering an apology. Jargon and passive voice can be replaced with concrete words and short, well-linked sentences. For example, "the OCT machine faulted and the image was unclear" is easier to follow than "technical issues were encountered." Pauses allow reactions, followed by checks for understanding and preferences around detail and updates. [2][4]
Anticipating and supporting emotion
Anger, fear, or disappointment are common. Rather than debating feelings, acknowledgement and a return to practical steps often help. Some patients value a chaperone or supporter. Accessibility needs - such as large print, an interpreter, or email follow-ups - are worth checking. For example, giving a short written summary can help a patient who struggles with English process the key points later. [4][1][2]
- Conversation scaffold: acknowledgement and apology; plain description of the event; immediate safety actions; investigation plan with timelines; practical supports; contact details for questions. [1][2]
- Helpful phrases: "I'm sorry this happened," "Here is what we know and what we are checking," "We will update you by [date], even if there is no new information." [2][6]
Handling uncertainty and questions
If facts are unclear, saying so and committing to a timeline for answers can maintain trust. [2][7]
Shifting blame to colleagues, systems, or patients tends to undermine clarity. Where multiple factors contributed, a simple chain of events with the change each factor prompts is usually easier to follow. For example, "the test image was blurred, so we are repeating the scan and updating our maintenance checks." [4][5]
Reliability and follow-up
Choices about next steps - such as second opinions, contact routes, or appointment times - can be offered where appropriate. Recording what matters most to the person (for example, safe return to driving or getting back to work) helps align fixes with priorities. Follow-ups that arrive on time, or are updated before a promised date if they slip, reinforce reliability. A named contact supports continuity and timely replies. [7][3]
References (numbered in text)
- The professional duty of candour; General Optical Council Find (opens in a new tab)
- Openness and honesty when things go wrong: The professional duty of candour; General Medical Council Find (opens in a new tab)
- Regulation 20: Duty of candour; Care Quality Commission Find (opens in a new tab)
- Being open: communicating patient safety incidents with patients, their families and carers; National Patient Safety Agency (Being Open framework, 2009) Find (opens in a new tab)
- Disclosure of patient safety incidents: a comprehensive review; Elaine O'Connor, Hilary M Coates, Iain E Yardley, Albert W Wu; Int J Qual Health Care Find (opens in a new tab)
- More than words: patients' views on apology and disclosure when things go wrong in cancer care; Kathleen M Mazor et al.; Patient Education and Counseling Find (opens in a new tab)
- Patient safety incident response standards (engagement and involvement / timelines / named contact); NHS England Find (opens in a new tab)
References are included to demonstrate that all the content in this course is rigorously evidence-based, and has been prepared using trusted and authoritative sources.
They also serve as starting points for further reading and deeper exploration at your own pace.
Ask Dr. Aiden
Rate this page
Sign up now for a free account
Course tools & details
