This week's sessions
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- Purpose, relevance and concisenessRead this week's lesson, then do the letter skills set below. For each question, say in one sentence why the best option helps the reader.
- Write a physiotherapy letterDo the writing task below. Spend 5 minutes marking each case note keep or cut, then write in 30 minutes. Compare your letter with the model and the checklist.
- Rewrite and cutUsing the structure in the referral letter guide, rewrite your letter from day 2. Move the request into the first paragraph if it isn't there, and cut any sentence the reader wouldn't miss.
- Linking ideas in lettersStudy the linking words for contrast, cause and result. Choose six (such as despite, as a result, in the meantime) and write one letter sentence with each.
- Reading Part A: a second set of textsDo Part A in 15 minutes. If you finish early, check spelling in the short-answer questions: answers must match the text.
This week's lesson: a letter the reader can act on
OET Writing is marked on purpose, content, conciseness and clarity, genre and style, organisation and layout, and language. At C+, the language is often fine. What holds letters back is usually that the purpose comes late, there's too much from the case notes, and the request is vague. A B-level letter is one the reader can act on after one quick read.
Start with the reader
Before you write, answer three questions in your 5 minutes of reading time:
- Who is the reader? A GP, a specialist, a community nurse, a physiotherapist?
- What do I want them to do? Review, investigate, visit, continue treatment?
- What do they need to know to do it? Everything else can go.
Put the purpose in the first sentence
C+: I am writing regarding Mrs Silva, who was admitted to our ward on 3 June after a fall at home, and who has a long history of various medical problems. B: I am writing to request daily home visits for Mrs Ana Silva, 81, who is being discharged tomorrow and requires dressings to a leg wound.
The second version tells the reader who, what and when, in one sentence.
Select, don't copy
Go through the case notes and mark each one keep or cut. Ask: would this reader miss it if it weren't there? Old operations, family details and hobbies usually go, unless they affect the request. A hobby the patient can no longer do may be worth one short phrase; a healed appendix scar almost never is.
Combine notes into clear sentences
Notes: BP 158/96 today. Last visit (Mar) 132/84. Started ibuprofen 3 wks ago for knee pain. Choppy: Today his blood pressure was 158/96. At his last visit it was 132/84. Three weeks ago he started ibuprofen. Concise: His blood pressure has risen to 158/96 from 132/84 in March, possibly related to ibuprofen he began three weeks ago for knee pain.
One sentence, and it shows the reader the link they need to see.
Make the request specific
"Anything you can do would be appreciated" makes the reader guess. "I would be grateful if you could arrange an ultrasound and consider referring him to an orthopaedic surgeon" doesn't. Repeat the key request near the end, briefly, so it can't be missed.
A simple order
- Purpose: who, what you want, and when.
- Relevant background: only what explains the request.
- Current situation: what has changed, and why you're concerned.
- Request and next steps: what you want the reader to do, and what happens meanwhile.
Length and the final check
Aim for 180 to 200 words in the body. Going over usually means you've copied too much; going well under may mean you've left out something the reader needs. In the last 5 minutes, check for note form, missing articles (a, the) and verb tenses: past for what happened, present perfect for changes up to now.
This week
Do the letter skills set, then write the physiotherapy letter. Mark each case note keep or cut before you start writing, and compare your choices with the model.
Practice for this week
Purpose, relevance and conciseness
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Write a physiotherapy letter
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Weekly check: Nursing referral letter
Write the nursing referral letter in 45 minutes (5 reading, 40 writing). Check: purpose in the first sentence, only relevant notes, a specific request, and 180–200 words.
When you finish, come back to your plan home: your dashboard updates with the new score.
Answers, explanations and transcripts
Finish the test first, then open each section to check your answers. Every answer has an explanation.
Purpose, relevance and conciseness
Answer key (6 answers)
| # | Question | Answer | Why |
|---|---|---|---|
| 1 | You are a ward nurse writing to a community nurse about a patient going home tomorrow who needs daily wound dressings. Which opening paragraph is best? | B. I am writing to request daily home visits for Mrs Ana Silva, 81, who is being discharged tomorrow and requires dressings to a leg wound. | B tells the reader in one sentence who the patient is, what is needed and when. The others delay the purpose, so the reader doesn't know why they're reading. |
| 2 | A physiotherapist is writing to an orthopaedic surgeon about a patient with a suspected rotator cuff tear. Which case note is LEAST relevant? | C. Had an appendicectomy at the age of 20 | An old, unrelated operation doesn't help the surgeon decide what to do. Weakness, night pain and the effect on work all support the request. |
| 3 | Which sentence presents these notes most concisely and clearly? Notes: 'BP 158/96 today. Last visit (Mar) 132/84. Started ibuprofen 3 wks ago for knee pain (self-purchased).' | B. His blood pressure has risen to 158/96 from 132/84 in March, possibly related to ibuprofen he began taking three weeks ago for knee pain. | B combines three notes into one clear sentence and shows the link the reader needs. A is choppy, C is still note form, and D is wordy and leaves out the numbers. |
| 4 | Which closing request is clearest for the reader? | B. I would be grateful if you could review his medications, in particular whether the ibuprofen should be stopped. | B tells the reader exactly what action is wanted. Vague requests (A, D) make the reader guess, and C isn't standard professional English. |
| 5 | You are writing a discharge letter to a GP. The patient's warfarin dose was changed in hospital. Where should this information go? | C. Early in the letter, stated clearly with the new dose and the follow-up needed. | A medication change the GP must act on is key information. Put it where the reader can't miss it, and say what follow-up is needed. |
| 6 | Which sentence is most appropriate for a letter to a specialist? | B. He reports increasing shortness of breath on exertion over the past two months. | B is professional, precise (on exertion, over two months) and in full sentences. A and D are too informal or emotional; C is note form. |
Write a physiotherapy letter
Model answer: Writing task (physiotherapy): 5 minutes reading, 40 minutes writing
Using the case notes, write a letter to the patient's GP, Dr Helen O'Brien, Bayside Family Practice, 22 Harbour Road, Bayside, explaining your concerns and requesting further investigation. Expand the relevant notes into complete sentences; do not use note form. The body of the letter should be approximately 180–200 words.
Dear Dr O'Brien,
Re: Mr Rajesh Kumar, aged 58
I am writing to request an ultrasound of Mr Kumar's right shoulder, as his limited progress with physiotherapy suggests a possible rotator cuff tear.
As you know, Mr Kumar injured his shoulder seven weeks ago while lifting a heavy cable reel at work. At his first assessment, he reported pain of 7/10 when reaching overhead and night pain that prevented him from lying on his right side. Active abduction was limited to 80 degrees, with marked weakness when lifting his arm to the side.
Despite six sessions of exercises, activity modification and taping, his pain has improved only slightly, to 6/10, and abduction to 85 degrees. Of most concern, his weakness is unchanged and he is still waking two to three times a night. As a self-employed electrician, he is unable to work overhead, has turned down several jobs and is worried about his finances.
I would be grateful if you could arrange an ultrasound and consider referring him to an orthopaedic surgeon. In the meantime, he will continue gentle exercises, and I will review him in two weeks.
Please do not hesitate to contact me if you require further information.
Yours sincerely,
Physiotherapist
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