Often the mere mention of the importance of communication causes less than positive reactions in healthcare professionals. The assumption is that communication is a fundamental skill that everyone knows about and practises well. However, reality shows a very different picture and communication has been found to be at the heart of many of the tragedies and disasters that have taken place within health, social care and the wider environment in recent times. This article explores communication by discussing the importance of self-awareness, communication style, the use of technology and assumptions made by individuals and their potential relationship on effective service delivery. It argues that effective leaders and managers need to take the time to reflect upon the communication styles, systems and processes in operation within and across their teams and organisations and consider how they can be enhanced to improve the delivery of care.