NMC Code Section 7: Communicate Clearly

Section 7 is the communication standard.

“Communicate clearly.”

Sub-clauses:

• 7.1 Use terms that people in your care, colleagues and the public can understand.
• 7.2 Take reasonable steps to meet people’s language and communication needs, providing, wherever possible, assistance to those who need help to communicate their own or other people’s needs.
• 7.3 Use a range of verbal and non-verbal communication methods, and consider cultural sensitivities, to better understand and respond to people’s personal and health needs.
• 7.4 Check people’s understanding from time to time to keep misunderstanding or mistakes to the smallest level possible.
• 7.5 Be able to communicate clearly and effectively in English.

Communication failures appear in nearly every serious incident review. Section 7 is the Code’s response to that pattern.

What it means in practice

Plain language (7.1) is the foundational skill. Medical terminology used with patients without translation creates distance and risk. “Hypertension” becomes “high blood pressure”. “Dyspnoea” becomes “breathlessness”. The translation isn’t dumbing down; it’s the standard of care.

Communication adaptation (7.2, 7.3) covers patients with:

• Hearing impairment: written information, BSL interpreters where needed.
• Vision impairment: large print, verbal description, navigation support.
• Cognitive impairment: shorter sentences, repetition, visual aids.
• Language barriers: professional interpreters, not family members.
• Mental health distress: slower pace, fewer choices at once, validation.
• Children: age-appropriate explanation, often involving play.

The teach-back method (7.4) is the practical safety net. After explaining anything important, ask the patient to tell you back what they understand. The pattern most easily corrected: “So just so I know I’ve explained that clearly, can you tell me when you’d take the new medication?”

Common breaches

Section 7 breaches that surface in fitness-to-practise cases:

• Inadequate handover: missing information that contributed to a subsequent error.
• Documentation errors: entries that misrepresented what actually happened.
• Disrespectful communication: tone, language, dismissiveness that affected patient experience.
• Failure to use interpreters when needed, particularly in emergency or consent contexts.
• Inadequate written communication: discharge letters or care plans that the next professional couldn’t act on.

Handover failures are the most common Section 7 issue in serious incident reports. SBAR was adopted across the NHS specifically to reduce these.

CPD that maps to Section 7

• SBAR training (often combined with deteriorating patient training).
• Difficult conversations training, for breaking bad news and conflict de-escalation.
• Sensory impairment awareness (Royal National Institute of Blind People and similar).
• Makaton or BSL awareness at introductory level.
• Plain English in healthcare, short courses widely available.
• Interpreter use: formal training in working with telephone or video interpreting services.
• Documentation standards: record keeping training (also relevant to Section 10).

Common reflective account themes

Strong Section 7 accounts describe:

• A handover where SBAR transformed a previously confused conversation into a clear one.
• An interaction with a patient who had communication needs you had to adapt for.
• A teach-back moment that caught a misunderstanding you’d have otherwise missed.
• An escalation conversation where the framing of your concern got the right response.

The most common Section 7 reflection is the medication or care error caught by clearer communication: a near-miss that prompted a structural change in how the team handovers.

Where Section 7 connects to other sections

• Section 2 (listen and respond): listening is half of communication.
• Section 10 (clear and accurate records): written communication.
• Section 14 (duty of candour): being open requires clear communication.
• Section 16 (act on safety concerns): escalation depends on Section 7 skills.

The next chapter covers Code Section 8: working cooperatively with colleagues.