Background It has been established that clinical empathy, or empathy shown in clinical settings in medicine, has considerable impact on the Healthcare professional (HCP)-patient dynamic. Patients’ perceptions of clinical empathy have a key role within the HCP-patient relationship, particularly for those patients with long term conditions or severe illness. Accurately capturing and understanding the patient perspective of clinical communication is vital for informing measurement and implementation. Research objectives The objective of this study was to gather interview data on the perception and use of clinical empathy in different health care specialties from the patients’ perspective. Aims The aim of this study was to establish a rich understanding of clinical empathy in practice within the specialties of rheumatology, obstetric & gynaecology, renal care and intensive/coronary care to inform future intervention development. Methods Semi-structured interviews with 14 Patients with in-patient experience of one of the 4 investigated specialties. Transcribed audio data was thematically analysed utilising both inductive and deductive approaches. Findings Six overarching themes were identified across the understanding and perceptive appearance of clinical empathy, its impact and the general patient experience influencing these perceptions. The impact of Covid-19 on these perceptions and consequent interpretation and appreciation of healthcare interactions was also uncovered. Within this, confusion surrounding clinical empathy and the juxtaposition between patient expectation and reality were also explored. Discussion These Findings: provided a consistent behavioral picture of what patients expected ‘clinical empathy’ to look like. This, however, bled into confusion surrounding other communicative constructs. Interestingly, data also revealed the impact of accumulative experience and the key role empathy plays within this, including in impaired states. Patients also report a confliction between desire for increased empathy and ability to implement training in HCPs. These Findings: help to elucidate the construct’s role contextually.