This week's sessions
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- Layout, tone and a physiotherapy letterRead this week's lesson, then do the set below: five quick questions, then the full letter (5 minutes reading, 40 minutes writing; finish it tomorrow if you need to). Mark it with the checklist before you read the model.
- Polite requests for lettersStudy polite requests on this page. Then write five requests to a colleague, starting with 'I would be grateful if you could…', 'Could you please…' or 'It would be helpful if…'.
- Fix the tone of your last letterTake the letter you wrote for last week's check. Remove every contraction, idiom and vague word, split it into clear paragraphs, and check the layout against this week's lesson.
- Reading Part B: workplace extractsDo Part B on the reading practice test. For each question, find the sentence that gives the answer, and check whether the options repeat words but change the meaning.
- Role-play: explain in small chunksRead the useful phrases on the role-play guide. Then record yourself explaining one condition to a patient in three short chunks, checking understanding after each one.
This week's lesson: layout and a professional tone
Last week you chose the right case notes and put the purpose first. This week is about how the letter looks and sounds. Layout and tone are some of the easiest marks to gain at grade C, because they depend on a few fixed habits, not on advanced English.
The layout
Use the same frame for every letter:
- Recipient's name and address, and the date, as given in the task.
- Salutation: Dear Dr Collins, using the title and surname from the task. If no name is given, Dear Sir/Madam,.
- Re: line: Re: Mr Tomasz Nowak, aged 67. Use the full name and age (or date of birth).
- Opening paragraph: the purpose and the request.
- Two or three body paragraphs: one topic each, such as background, progress, current concerns.
- Request paragraph: what you'd like the reader to do.
- Closing: Yours sincerely, (when you used a name) or Yours faithfully, (after Dear Sir/Madam), then your role.
Leave a blank line between paragraphs. A reader should see the structure before reading a word.
One paragraph, one job
At grade C, letters often have one long paragraph that mixes history, medicines and social details. Instead, give each paragraph a clear topic and start it with a sentence that shows the topic:
Over the past eight weeks, Mr Nowak has attended eight sessions… (progress) However, his symptoms have worsened… (current concerns)
Linking words such as however, in addition and of particular concern help the reader follow your reasoning.
A professional tone
The reader is a colleague. Your tone should be polite, clear and factual.
| Avoid | Use |
|---|---|
| His knee's been playing up. | His knee pain has worsened over the past two weeks. |
| You need to send him for an X-ray. | I would be grateful if you could consider imaging. |
| He's really fed up. | He is finding the pain increasingly difficult to manage. |
| Thanks heaps! | Thank you for your ongoing care of this patient. |
Three rules cover most problems:
- No contractions in letters: he has, not he's.
- No slang or idioms, and no vague words like really or a lot. Give the fact: pain 8/10, five minutes.
- Requests, not commands. I would be grateful if you could…, Could you please…, It would be helpful if…. The clinical decision belongs to the reader.
Show change clearly
When a patient has improved or worsened, a short before-and-after comparison is clearer than a list of numbers:
His pain on stairs has increased from 7/10 to 8/10, and he can now walk for only five minutes, compared with ten minutes at the start.
Check your length
Aim for 180–200 words in the body. Much shorter usually means something important is missing; much longer usually means you've copied case notes the reader doesn't need.
This week
Do the layout and tone questions, then write the full physiotherapy letter. Before you check the model, use the checklist to mark your own letter. Then compare paragraph by paragraph.
Practice for this week
Layout, tone and a physiotherapy letter
Loading questions…
Weekly check: A discharge letter to a GP
Write the discharge letter in 45 minutes (5 reading, 40 writing). Check the layout, paragraph topics and tone with this week's lesson, then compare with the model.
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.
Layout, tone and a physiotherapy letter
Model answer: Writing task (physiotherapy): 5 minutes reading, 40 minutes writing
You are the physiotherapist. Using the case notes, write a letter to the patient's GP, Dr Sarah Collins, Hillview Medical Centre, explaining his progress and asking for a review. The body of the letter should be approximately 180–200 words.
Dear Dr Collins,
Re: Mr Tomasz Nowak, aged 67
I am writing to update you on Mr Nowak, whom you referred for physiotherapy for right knee osteoarthritis, and to request a review, as his symptoms have worsened despite treatment.
Over the past eight weeks, Mr Nowak has attended eight sessions, including strengthening exercises, a walking program and advice on weight loss. He has lost 2 kg and now weighs 102 kg.
However, his knee pain on stairs has increased from 7/10 to 8/10, and he can now walk for only five minutes, compared with ten minutes at the start. His knee has become more swollen, and he has developed night pain, which wakes him three to four times a week. Of particular concern, his knee has given way twice in the past fortnight, including one near fall on the stairs at home. I have supplied a walking stick, which he has started using.
I would be grateful if you could review his pain management, which currently consists of paracetamol 1 g three times daily and ibuprofen gel, and consider imaging and referral to an orthopaedic surgeon. I will continue to see him weekly.
Yours sincerely,
Physiotherapist
Answer key (5 answers)
| # | Question | Answer | Why |
|---|---|---|---|
| 1 | Which is the correct layout for the start of the letter body? | Dear Dr Collins, / Re: Mr Tomasz Nowak, aged 67 / I am writing to… | Use the title and surname from the task, then a 'Re:' line with the patient's full name and age, then your opening sentence. |
| 2 | Which sentence has the most appropriate tone for a request to a GP? | I would be grateful if you could review his pain management and consider imaging. | 'I would be grateful if you could…' is polite and professional, and it leaves the clinical decision with the doctor. Commands like A and D can sound rude to a colleague. |
| 3 | Which sentence avoids informal language? | His knee pain has worsened over the past two weeks. | Avoid contractions (knee's, he's), idioms (playing up, fed up) and vague intensifiers (really bad). Give precise information instead. |
| 4 | Which paragraph order suits a referral letter? | Purpose and request → relevant history and current situation → what you'd like the reader to do → closing | Purpose first, then the background the reader needs, then a clear request and a short closing. You don't have to follow the order of the case notes. |
| 5 | You started the letter 'Dear Dr Collins'. Which closing is correct? | Yours sincerely, | Use 'Yours sincerely' when you know the reader's name. 'Yours faithfully' is for 'Dear Sir/Madam'. Informal closings don't fit a professional letter. |
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