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Introduction: The current study investigated the mediating role of perceived risk in the relationship between customer trust and brand loyalty in the UK healthcare sector. Marketing communication in healthcare had traditionally relied on one-way, low-risk messages that used fear appeals. However, such approaches have often proven ineffective. This study explored the potential of value-based marketing in the healthcare sector by focusing on personalised digital strategies and solution-oriented communication. It sought to assess the mediating role of perceived risk between trust and loyalty, compare traditional versus digital marketing effectiveness, and offer actionable recommendations for healthcare communication improvement. Methods: A quantitative survey was conducted among 200 UK healthcare professionals, with 151 valid responses analysed using a structured 5-point Likert scale questionnaire. Statistical analysis through SPSS, including correlation and regression, was used to interpret the data. Results: Results indicated that perceived risk is a stronger predictor of brand loyalty than trust (β = .536, p < .001) and that marketing strategy plays a critical role in influencing consumer decisions (β = .370, p < .001). While trust in endorsements from institutions like the NHS and MHRA is relatively high, consumers remain cautious about unfamiliar digital healthcare services. Digital strategies, especially personalised messaging, enhance engagement when they address risk-related concerns. Together, perceived risk and marketing strategy explains over 70% of the variance in brand loyalty (R² = .706). Trust in healthcare brands alone did not significantly predict brand loyalty when other factors were controlled (β = -.008, p = .903). Mediation analysis revealed that perceived risk fully mediated the relationship between trust in healthcare brands and brand loyalty (indirect effect: β = 0.56, 95% CI [0.42, 0.71]; direct effect: β = 0.08, p = .325), indicating that trust impacts loyalty only through perceived risk. In contrast, perceived risk partially mediated the relationship between marketing strategy and brand loyalty (indirect effect: β = 0.41, 95% CI [0.30, 0.53]; direct effect: β = 0.40, p < .001), suggesting that marketing strategies influence loyalty both directly and indirectly via perceived risk. Discussion: Trust alone did not ensure brand loyalty; instead, it had to be complemented by transparent, strategic communication and risk mitigation. Public endorsements and patient-centred messaging were vital to building and sustaining consumer relationships. The study was limited by its cross-sectional design, small sample size, and lack of differentiation between types of perceived risks. Future research should adopt longitudinal approaches and broader demographic sampling to deepen the understanding of consumer behaviour in healthcare marketing.
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