Having difficult conversations with a healthcare professional

People often develop close relationships with their healthcare team. But some conversations can be difficult.

There may be:

  • something you want to feedback or complain about
  • a decision about your healthcare that you disagree with
  • a problem with how your healthcare team treats and communicates with you.

Starting a conversation about this may feel like a lot to cope with when you are already coping with cancer. You may feel that you are not being listened to, or that your concerns are not being taken seriously. 

If you need to have a difficult conversation with a healthcare professional, the tips on this page might help.

Our Easy Read publication 7 steps to equal health care can be useful for people with a learning disability. It uses simple language and pictures to explain how to advocate for good healthcare.

Worried about having a conversation?

People often worry about having a difficult conversation with their healthcare professional. You might worry about the following:

My healthcare team will start to treat me differently, or they will think I am a difficult person to deal with. 

It might help to remember that you are talking to your healthcare professional to improve things. Talking about a problem is often the first part of solving it. If it goes well, you should feel more satisfied with the situation. Your healthcare team should have a better understanding and will work with you to deal with your concerns. Raising a concern will not affect your care or the treatments you have.

I cannot challenge my healthcare professional because they are a specialist.

Your healthcare professional has specialist training and knowledge, but you are the expert about you. We have more information about shared decision-making. The NHS aims to provide care that is right for each person. If your healthcare team has not correctly understood what your needs are, it is okay to tell them what is important to you.

The person I talk to already has ideas about me that will affect the way they talk to me or treat me. 

We all make assumptions about other people based on what we think we know about them. These ideas or biases can stop us from hearing what the other person really thinks or wants.

For example, a healthcare professional may assume you want to be treated in a certain way based on what they think your religion is. They may have incorrect ideas in general about people from your cultural background. They may assume you will or will not want a certain cancer treatment because of factors such as your age, sex, gender, sexual orientation, disability or social situation.

These assumptions are often unspoken and difficult to identify. The people involved may not be aware of them. They may believe they are treating you in a fair and unbiased way.
If you think a person’s attitudes might be affecting a conversation, the following tips might help:

  • The person you are talking to is a professional and may welcome feedback so they can learn and offer better care. If you know an attitude is causing problems, you may be able to say something that helps them correct it.
  • Healthcare professionals are there to help you. Their job is to get it right and make things better for the people they care for. Try to be positive as you talk to them. Assume they want the best for you and want to understand you well.
  • Think about your own attitudes. Are you assuming the conversation is going to be difficult or that the person will not listen? Will this affect how the conversation goes?

If your healthcare team is treating you less well than someone else, this is called discrimination. We have more information about coping with discrimination below.

Coping with discrimination

Your healthcare team must not treat you less favourably because of your:

  • age
  • disability
  • sex
  • sexual orientation
  • gender reassignment
  • marriage or civil partnership
  • pregnancy
  • race
  • religion or belief.

This is called discrimination and is against the law. If you are being treated unfairly, there are things you can do:

Talk to your healthcare team

Talk to someone from your healthcare team, if it feels safe and comfortable to do so. Sometimes they may not realise that there is a problem. Giving feedback about this may help your healthcare team make things right.

Get support

Explain what is happening to someone you trust. If you do not feel safe or comfortable talking to your healthcare team, this might be the first and most important thing you do.

You may get support from someone close to you or a healthcare professional you know well. Or you may want to talk to people in a cancer support group or our Online Community. Sometimes it is helpful to talk to people who understand or are in a similar situation.

There may be a local or national organisation that can offer information and support. Here are examples of some larger, national organisations that support specific communities:

  • Age UK provides support, companionship and advice for older people.
  • Disability Rights UK provides information about rights of disabled people.
  • Switchboard, the LGBT+ helpline, and the LGBT Foundation offer safe spaces for LGBTQ+ people to talk by phone or online.
  • Galop offers support to LGBT+ people who have experienced hate crime, domestic abuse or sexual violence.

Some organisations offer support and advice to people who are facing discrimination:

Give feedback or make a complaint

If you do not want to be identified, you can give feedback and complaints anonymously. The process is different depending on where you live. We have more information about making a complaint (see 'Making a complaint' below).

Before a difficult conversation

Think about what you want to talk about. What are the issues or problems? What do you want to achieve from the conversation. Do you have questions you want answered?

You might find it helpful to write this down. Or you could talk through what you want to say with someone close to you. This may help you work out exactly what you want to say. It can also help you practise and feel more confident.

Is there information you should take to the appointment or anything you should research before you go? Try to be as prepared as you can.

Is there anything that will help you communicate or make you more confident?

If English is not your first language, you can ask for an interpreter to attend appointments with you.

Do you want a someone else to be involved? This could be a friend, family member or carer. Or you may have a support person or advocate who helps you get your views and wishes heard. If someone comes with you, tell them what you want them to do. Do you want them to listen and take notes? Do you want them to speak on your behalf or ask questions?

During the conversation

Appointments with health professionals are usually time-limited. This can put pressure on you and on the person you are talking to. It is important not to rush. At the start of the conversation, pause and think about what you want to say first.

Remember that the person you are talking to is there to help you. Your reason for talking to them may be difficult, but it is important.

If you do not understand something, or the conversation is not going how you expect, stop and tell the person. You could say ‘I’m not sure I understand what you said there’ or ‘Can I check what you just said?’

Make notes, or ask the person with you to do this. If everyone gives permission, you can record the conversation to listen to again later.

At the end of the conversation, repeat what you think are the main points. This can help you and the other person correct any misunderstandings and work out what should happen next.

If you feel you have not had long enough, ask for a follow-up appointment or telephone call.

After the conversation

Think about the conversation. Did it achieve what you wanted? 

If you are able, follow up the conversation with an email or letter to the healthcare professional or team involved. This can be a useful way of showing you understand what was decided and confirming any next steps.

You may not be happy with how the conversation went, perhaps because:

  • you do not feel the person listened or heard you
  • your questions have not been answered
  • your issue was not taken seriously
  • the person you spoke to did not communicate effectively, or even politely.

It is not always easy to know what to do next. Sometimes it is helpful to talk to someone close to you. If you have strong or difficult feelings about the conversation, you may find it helpful to give yourself time to think. 

If you are still unhappy, you could try one of the following options:

  • Ask the healthcare professional, or someone else in your healthcare team, if there is another way to communicate with them. For example, could you email your questions to someone in the healthcare team?
  • Write to your healthcare professional or healthcare team explaining why you are unhappy with the conversation you had. Sometimes writing the problem down makes it clearer and helps the person you talked to understand how you feel. 
  • Make a complaint or give feedback to the healthcare service involved. 

Making a complaint about healthcare

Many people are happy with the treatment and care they get from healthcare professionals. But sometimes mistakes happen, or things go wrong. If you are unhappy about the treatment you have received, you have the right to complain.

Getting feedback and complaints is important for health services. It lets health services and professionals understand what is working well and what the problems are. This helps services improve the care they give.

For people who use health services, making a complaint can also be a positive way of dealing with an upsetting situation. Getting an apology or an explanation of what went wrong sometimes helps people understand and cope with what happened. It may also be reassuring to know what is being done to make sure the situation will not happen again.

How to complain

Sometimes the problem can be sorted out by talking to the people involved. It is a good idea to try this before making a formal complaint.

To begin with, it is usually best to speak to the healthcare professional involved. If you are worried about how to start a conversation about your care, we have more information about challenging conversations with healthcare professionals (see 'Having difficult conversations with a healthcare professional' at the top of the page).

If you do not feel comfortable or able to do this, you could speak to someone else in the healthcare team. This might be the person’s manager. 

If you decide to make a formal complaint, find out about the complaints procedure. You can ask your healthcare provider for a copy of the process. Or you can usually find information online. 

For information about making a complaint about NHS healthcare in:

For more information about making a complaint about private healthcare, contact your healthcare provider.

Getting support

Making a complaint can feel like a lot to cope with when you are already coping with cancer. You might find it helpful to get support from someone close to you. Talking about the problem may help you work out what you want to say in your complaint. Or they may be able to help you by filling in forms or being in meetings with you.

You can ask someone to complain on your behalf. You usually need to give them your permission in writing to do this.

Some organisations also provide information and support to patients making a complaint. We have contact details for these organisations in ‘Help with your complaint’ (see below).


You should make the complaint as soon as you reasonably can. This means it can be investigated while the people involved are still available and can remember what happened.

Complaints about the NHS should be made within 12 months of when the event happened, or from when you were first aware of it. The time limit can sometimes be extended if there are reasons why you could not make the complaint within this period. For example, you may have longer to make your complaint if you were grieving at the time.

What to include

It is best to make a complaint in writing, but it can be made in person or by phone.

You should give as much information as possible so your complaint can be fully investigated. Focus on the main issues and leave out anything that is not relevant. Try to keep your explanations as clear as possible.

Try to include:

  • dates of when and where the incident took place
  • names and positions of the people involved 
  • details of any other discussions about your complaint that have already taken place – include dates and the names of the healthcare professionals you spoke to 
  • questions you would like answered and a list of the things you are not happy about
  • what you would like to happen as a result of your complaint
  • your name, address, phone number and email address.

You can send a written complaint by letter or email. Keep a copy of everything you send, and a note of when you sent it. If you make a complaint in person, a member of staff should record it in writing. Some hospitals, GP surgeries and clinics have websites that allow you to submit a complaint online.

Who to make your complaint to

Many hospitals and GP practices will have a complaints manager or team. You may be able to find their contact details by looking at the hospital or practice website, or checking their complaints procedure. If you are not sure who to send your complaint to, the following may help:

  • If your complaint is about a GP, contact the surgery’s practice manager or complaints manager.
  • If your complaint is about an NHS hospital, contact the hospital trust’s chief executive or the hospital complaints manager.
  • If your complaint is about a private consultant or hospital, contact the hospital manager or hospital complaints manager.

Asking for your medical records

When you use a health service, the service saves information about you. This is called your medical or health record. It includes information about your care and details of any treatment you have. It helps your team give you the care you need now and in the future.

Different services may keep separate records. For example, the records your GP keeps are separate from your hospital records.

Before you make a complaint, you may find it helpful to read your medical records. In England, if you have an NHS account, you can view your GP health record using the NHS app.

Reading your medical records may help you understand more about the situation. You can also check details of dates or people involved. If you are making a clinical negligence claim, you will need a copy of your medical records and possibly copies of scans and x-rays. You do not have to explain why you want them.

If you do not want to request your records yourself, you can usually give permission for someone else to do it for you. You can find out more about asking for your health records (or someone else’s records) in:

The complaints process

You can get details of the complaints process from the NHS in your country, or from the private healthcare provider you are complaining to. The process will explain when you should expect a response to your complaint. It will also explain when and how you will be told the outcome of your complaint.

Make a note of the date that you expect a response. If you do not get the response on time, you can write or phone to ask what is happening.

Local resolution

Most complaints about healthcare are sorted out by the healthcare service involved. This is called local resolution. You should receive information about what has happened because of your complaint.

For example:

  • if there was an investigation, what this found
  • an appropriate apology
  • an explanation of what has been learned and any changes that will be made.

If you are not satisfied, you can ask more questions or for more information.

Appealing to an ombudsman

If you do not believe your complaint has been properly investigated, or if you are unhappy with the response, you can complain to an ombudsman. This is an independent official who investigates complaints against businesses or organisations. There are different ombudsmen for:

You should contact the ombudsman within 12 months of when the event took place, or from when you were first aware of it. You will need to fill in a form to explain why you are not satisfied with the way your complaint has been dealt with. The ombudsman will decide whether or not to investigate your complaint further.

Taking legal action

If a healthcare provider has done something wrong when treating you, you may decide to take legal action. A clinical negligence claim is legal action to try and get compensation if you have been injured because of something your healthcare provider did wrong. Compensation usually means a payment of money.

You can get advice about taking legal action at any time. But if you take legal action during the complaints process, the NHS may stop investigating your complaint. Taking legal action may also affect whether you can complain to an ombudsman. An ombudsman will not usually investigate a complaint that is being considered in court, or has been to court.

Complaints and clinical negligence claims should both give you information about what went wrong. They may both lead to a formal apology or changes in practice to stop the event from happening again. But a complaint will not give you any money or compensation.

You can find more information about getting legal advice and taking legal action:

Making a complaint for someone else

You can make a complaint for someone else. For example, you can complain on behalf of any of the following people:

  • Your child.
  • Another person, if you have their permission. Usually you need their permission in writing. Or you may have a legal authority that allows you to make health and care decisions on their behalf, such as a power of attorney (POA).
  • A person who cannot complain for themselves because they do not have capacity.
  • A person who has died. You will need to explain your relationship to the person.

There are laws about how health professionals and services share a patient’s information. Sometimes this can make complaining for someone else complicated. A health professional should always respond reasonably to your complaint, but they may also have to maintain patient confidentiality.

Your feelings about making a complaint

Making a complaint can be difficult and upsetting. It may be painful to remember or talk about what happened. If you still need medical care, you may find it hard to trust your healthcare team.

Making a complaint should not have a negative effect on your treatment or care in any way. But people often worry about this. It may help to talk to your healthcare team, so they understand your worries.

Each person has their own way of coping with difficult situations. You may find it helpful to talk to family, friends or someone outside of your situation, such as a counsellor. Other people prefer to keep their feelings to themselves. There is no right or wrong way to cope.

Our Online Community is a place where you can share experiences with people who know what you are going through. You might also find our information on coping with your emotions helpful.

The list of organisations below may be able to offer you advice and support. You may also find it helpful to talk to a counsellor who can listen and help you deal with your emotions. Call us on 0808 808 00 00 to talk to our cancer support specialists, who can give you advice about finding a counsellor in your area.

Help with your complaint

The following organisations can help you make your complaint or give you information and support.

  • UK-wide organisations

    Action against Medical Accidents (AvMA) gives advice and information about making a complaint. If you cannot find the information you need on their website, you can call their helpline on 0345 123 2352. The Patients Association has information online about how to make a complaint. You can also call their helpline free on  0800 345 7115.

  • England
    • Most hospitals in England have a Patient Advice and Liaison Service (PALS). PALS aims to help patients, relatives, carers and friends find answers and resolve healthcare problems as quickly as possible. They can give you information and support about making a complaint. You can find a PALS office on the NHS website, by asking your GP or hospital, or by phoning NHS 111.
    • If you need help or support to make a complaint, an advocate may be able to help. An advocate is a person who can help you get your views and wishes heard. They can help at any stage of the complaints process. In England, local authorities fund advocacy services in their area. To find an advocacy service, contact your local council or check its website.
    • Healthwatch has tips and more detail about making a complaint about health and social care in England.
  • Scotland
    • The Patient Advice and Support Service can help you make a complaint about NHS healthcare in Scotland. Call 0800 917 2127, email them through their website, or visit your local Citizens Advice Bureau.
    • If you need help or support to make a complaint, an advocate may be able to help. An advocate is a person who can help you get your views and wishes heard. They can help at any stage of the complaints process. You can find out more about advocacy services in Scotland on mygov.scot.
  • Wales
    • There may be a Patient Advice and Liaison Service (PALS) at your hospital. PALS aims to help patients, relatives, carers and friends find answers and resolve healthcare problems as quickly as possible. They can give you information and support about making a complaint. To find a PALS office, check the website of your local health board or ask at the hospital.
    • If you need help or support to make a complaint, an advocate may be able to help. An advocate is a person who can help you get your views and wishes heard. They can help at any stage of the complaints process. Patient advocacy services in Wales are available for free through Community Health Councils (CHC). You can find your local CHC on www.wales.nhs.uk.
  • Northern Ireland

    The Patient and Client Council gives information and support about making a complaint about NHS services. They also provide advocacy support. An advocate is a person who can help you get your views and wishes heard. They can help at any stage of the complaints process.

About our information

  • This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been approved by members of Macmillan’s Centre of Clinical Expertise.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

  • use plain English
  • explain medical words
  • use short sentences
  • use illustrations to explain text
  • structure the information clearly
  • make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

You can read more about how we produce our information here.

Date reviewed

Reviewed: 01 July 2023
Next review: 01 July 2026
Trusted Information Creator - Patient Information Forum
Trusted Information Creator - Patient Information Forum

Our cancer information meets the PIF TICK quality mark.

This means it is easy to use, up-to-date and based on the latest evidence. Learn more about how we produce our information.