OET Writing Letter Format for Nurses: Step-by-Step with Sample Referral Letter

Your first paragraph should tell the reader the reason for the letter straight away.

A vague opening such as “I am writing about Mrs Smith” leaves the reader guessing. A stronger one names the patient and the request: “I am referring Mrs Smith for specialist review of her ongoing abdominal pain.”

Typical purposes include:

• Referring a patient for specialist assessment
• Asking for further tests
• Transferring care to another professional or facility
• Passing on discharge information
• Requesting ongoing management
• Reporting a change in the patient’s condition

Sorting the Case Notes

Do not copy the notes in their original sequence. Sort them by how useful each detail is to the reader. Four groups help:

1. Who the patient is. Name, age and any demographic detail that matters.
2. What is happening now. The main problem, symptoms, diagnosis, recent changes and key findings.
3. Relevant background. Past conditions and treatments, but only those that bear on the current problem.
4. Why you are writing. The specific action you need from the reader.

Take a patient with diabetes, high blood pressure and an infected wound. You do not need to report every historical detail. Keep what helps the reader grasp the present problem and decide on management.

A quick filter: Does this fact help the reader understand the patient’s situation or decide what to do next? If not, leave it out. Never add diagnoses, results, medications or plans that the notes do not contain.

A Four-Paragraph Structure That Works

1. Purpose: why you are writing.
2. Current problem: the presenting condition and the most important findings.
3. History and management: relevant background, treatment given and the response.
4. Request: what you want the recipient to do.

Skeleton:

Dear Dr [Surname],
Re: [Patient name, age]
[Purpose] → [Current condition] → [History and treatment] → [Request]
Yours sincerely,
[Your name]

Adjust the paragraphs as the case demands, as long as the order is logical and the purpose stays visible.

Worked Example: From Case Notes to Letter

This is an original practice example, not an official OET task.

Case notes

• Patient: Mary Thomas, 58
• Date: 5 October 2026
• History: type 2 diabetes for 8 years; hypertension
• Medication: metformin 500 mg twice daily; amlodipine 5 mg daily
• Current problem: right foot wound for 10 days; redness and swelling increasing; pain worse over the last 3 days; discharge present; temperature 38.1°C; blood glucose 12.4 mmol/L
• Treatment: wound cleaned and dressed; oral antibiotics started; little improvement after 3 days

Task: Write to the surgical team requesting further assessment.

Sample letter

5 October 2026

Surgical Team

Re: Mary Thomas, 58 years

Dear Surgical Team,

I am referring Ms Mary Thomas, a 58-year-old woman with type 2 diabetes, for urgent review of an infected wound on her right foot.

The wound has been present for 10 days. During the last 3 days her pain, redness and swelling have all increased, and the wound is now discharging. Her temperature today is 38.1°C and her blood glucose is 12.4 mmol/L.

Besides diabetes, Ms Thomas has hypertension. She takes metformin 500 mg twice daily and amlodipine 5 mg daily. We cleaned and dressed the wound and started oral antibiotics three days ago, but she has improved only slightly.

Because her symptoms are worsening despite treatment, I would be grateful if you could assess her and take over management of the wound.

Please contact me if you need further details.

Yours faithfully,

[Nurse’s Name]

Note: I used “Yours faithfully” because the letter is addressed to a team rather than a named person. Use “Yours sincerely” when you greet someone by name.

Raising Your Score, Criterion by Criterion

• Purpose: state the reason for writing in the first paragraph.
• Content: choose the facts the reader needs, and report them accurately.
• Conciseness and Clarity: cut anything that does not serve the reader.
• Genre and Style: use the register of one healthcare professional writing to another.
• Organisation and Layout: group related facts into focused paragraphs.
• Language: check grammar, vocabulary, spelling and punctuation.

After a practice letter, review it against each criterion on its own. You will quickly see whether your weak spot is selecting content, organising it, or the language itself.

Ten Practical Tips

1. Decide who the recipient is before anything else.
2. Write down the purpose before you draft the body.
3. Select only the case-note details that matter.
4. Keep symptoms, history and treatment grouped logically.
5. Write full sentences instead of note-style fragments.
6. Mention each fact once.
7. Use language suited to a colleague, not a layperson.
8. Keep the patient’s situation at the centre.
9. Leave time at the end for editing.
10. Practise under a 45-minute timer.

Common Mistakes

Final Checklist Before You Submit

• Purpose: Is it obvious why I am writing, and what I am asking for?
• Content: Have I included the key clinical facts, dropped the irrelevant ones, and stayed faithful to the notes?
• Organisation: Does each paragraph have one focus, in a sensible order?
• Language: Are grammar, spelling, punctuation and vocabulary correct?
• Style: Is the tone professional, and are any abbreviations appropriate for the recipient?

Because the criteria are scored separately, proofread for each one, not just for grammar.