Good communication within the multi-disciplinary team and with patients and their relatives is essential to the efficient running of an intensive care unit. In 2015–2016, the NHS received over 198,000 written complaints; just over 10% were related to communication. In the intensive care unit, the patient's outcome relies upon good communication within the intensive care multi-disciplinary team, the referring specialty team and other departments within the hospital. The majority of this communication will involve junior members of the clinical team. Effective communication is dependent to a large extent upon mutual respect and trust. It is essential to acknowledge everyone's role within the multi-disciplinary team, and to recognise that patient outcomes depend upon all aspects of care delivery, not just the doctor's role. Ideally, the most senior clinical available should lead conversations about withdrawing and withholding treatment, preferably in the daytime when there is plenty of support for patients and their relatives are immediately available.