Toolkit for doctors new to the UK

Communicating with patients and autonomy

Location: UK International
Audience: International doctors All doctors
Updated: Monday 6 June 2022
Topics: International doctors

We give some tips on how to speak with your patients. The patient-doctor relationship here might be different to what it is at home.

Patients have overall autonomy, and can make choices, about their care in the UK. Healthcare decisions are a two-way conversation and your seniority as a doctor may not always be upheld.


How to address patients

  • Do speak clearly to patients. Your voice should be at a volume which is neither too loud nor too quiet.
  • Do speak fluidly. It is better to speak at a normal pace with some errors rather than trying to speak in perfect English very slowly.
  • Do ensure that your patients have understood what you have said to them. Ask them if everything is clear or if they would like anything explained to them again.
  • Do work in partnership with your patients and involve them in decisions to about their healthcare.
  • Do make sure that your voice is pitched at a tone that is appropriate to the situation that you are in. Raising or lowering your tone half-way through your sentence could change its meaning.

Get more information from our guidance on good communication.


Get to know British culture

  • Do watch TV. This will give you a good insight into the lifestyles and attitudes of those you work with and your patients. Behaviour that would be considered taboo in your country may not be considered so in the UK. It is also a good opportunity to hear different accents and try these out in the comfort of your own home. Coronation Street and Eastenders are good programmes to start with.
  • Do watch Prime Ministers Questions or Question Time on BBC One to help with negotiation skills. It’s a good way to pick up tips on how to give your point effectively without coming across as confrontational.

Tips on British culture and behaviours

The following tips are not the case for all British people in all circumstances, but do give a good indication of British culture and behaviours.

  • Modesty: British people do not like showing off about their possessions and achievements, it can be seen to be crass.
  • Politeness: the British are very polite and will say 'sorry' (even if something's not their fault) and 'please' and 'thank you' multiple times in a conversation.
  • Queueing: queueing or lining up is taken very seriously, you should never push in front of a queue.
  • Humour: the British sense of humour is very dry and sarcastic.
  • Terms of endearment: it's normal to be called 'love' or 'duck', especially in the north.

Try these books for more of an insight:


Remember that your patients' first language may not be English either, and they may have trouble understanding English. You could use an interpreter if needed. You should check that they understand the information and advice that you have given them.

If you are moving to Wales, Welsh is spoken as a first language for some and you may notice that leaflets  are written in Welsh. However, most Welsh-speakers will speak English too.


Patient autonomy