Action learning has been used in healthcare settings to bring about changes to how services are delivered, to help individuals to develop their knowledge and skills, including leadership development, and to enable the development of collective abilities and communities of practice. It is evident that there are some positive elements in the healthcare environment that support the processes of action learning -- what we might call affinities between the environment and these processes. However, those who have practised action learning in these environments also know that difficulties and disablers can arise, to derail or block the processes -- what we might, perhaps optimistically, call challenges. This paper is based on the authors' experiences as facilitators of action learning in healthcare, and also social care. Each of the authors independently identified the main affinities they had experienced and the main challenges they had encountered in their work with action learning in different organisations in health and social care. They were collected together and themes were identified. The authors then reflected on the themes and, in some cases, built on them. The purpose of the paper is to share the learning from their experiences, and to encourage others who are using action learning in these environments to consider how best to use the affinities and how best to monitor for and, where necessary, tackle the challenges.