Three complete OET referral letter samples with detailed annotations explaining why each section works. Includes the official scoring rubric and a free writing checklist to help you achieve Grade B or above.
Download Free OET Writing Checklist →The Occupational English Test (OET) Writing sub-test for nurses requires you to write a letter (typically a referral, discharge, or transfer letter) based on provided case notes. You have 45 minutes to complete the task, including 5 minutes of reading time to review the case notes.
Your letter must be between 180-220 words and demonstrate that you can communicate effectively in a healthcare context. The task assesses six criteria: Purpose, Content, Conciseness & Clarity, Genre & Style, Organisation & Layout, and Language.
The letter type varies by task but common formats include:
A well-structured OET letter follows a consistent format. Here is the recommended structure that examiners expect to see.
Scenario: Post-operative patient discharge • Estimated Grade: A
| The Letter | Why It Works |
|
Dr James Mitchell Oakwood General Practice 14 High Street, Manchester M1 4AB 18 March 2025 Re: Mrs Margaret Chen, DOB 15/06/1956 Dear Dr Mitchell, |
PROPER ADDRESSING Full recipient address demonstrates attention to detail. Date format is clear. Subject line includes patient name and DOB for easy identification. |
| I am writing to inform you of the discharge of your patient, Mrs Chen, who was admitted to Oakwood Hospital on 14 March 2025 for a right total knee replacement. |
CLEAR PURPOSE Opening sentence immediately states the purpose (discharge), identifies the patient, and provides key context (admission date and reason). No unnecessary detail. |
| The procedure was performed without complications on 14 March. Mrs Chen has a history of type 2 diabetes mellitus and hypertension, both of which were well-managed perioperatively. Her blood glucose levels remained stable throughout her admission, and her antihypertensive medication was continued. |
RELEVANT COMORBIDITIES Mentions PMH because it is relevant to ongoing care. Shows understanding of what the GP needs to know. Past tense for completed events. |
| Post-operatively, Mrs Chen commenced physiotherapy on day one and has made good progress. At discharge, she was mobilising independently with a walking frame. Her wound is healing well with no signs of infection. |
RELEVANT DETAIL Includes post-op progress relevant to discharge. Specifies mobility aid (frame) so GP knows current status. Wound status included as it requires follow-up. |
| Please arrange for community physiotherapy to continue her rehabilitation. Additionally, her wound will require review in seven days. Her medications have been adjusted as follows:... |
CLEAR REQUESTS Specific, actionable requests for the GP. Timeframe given (7 days). Uses polite "Please arrange" which is appropriate for inter-professional communication. |
|
If you require any further information, please do not hesitate to contact me. Yours sincerely, Sarah Williams Registered Nurse |
APPROPRIATE CLOSE Standard professional closing. "Yours sincerely" used because recipient is named. Professional title included. Offer of further contact is courteous. |
Scenario: Wound infection referral to tissue viability nurse • Estimated Grade: A
| The Letter | Why It Works |
|
Ms Rachel Thompson Tissue Viability Service Oakwood Hospital, Manchester M13 9WL 17 March 2025 Re: Mr David Okafor, DOB 22/08/1970 Urgent referral: infected diabetic foot ulcer Dear Ms Thompson, |
URGENCY INDICATED Subject line includes "Urgent referral" which immediately signals priority. This helps the recipient triage appropriately. Specific clinical detail in subject line adds clarity. |
| I am writing to refer Mr Okafor, who was admitted to our ward on 10 March 2025 with an infected diabetic foot ulcer on his left heel. He has type 2 diabetes mellitus and the ulcer has failed to heal despite six weeks of community nursing care. |
CONCISE CONTEXT Two sentences provide the essential context: admission details, diagnosis, PMH, and crucially that this is a non-healing ulcer (justifying specialist referral). Community care failure is key information. |
| On examination, the ulcer measured 3cm x 2cm with surrounding erythema and purulent discharge. A wound swab taken on admission confirmed MRSA. Intravenous vancomycin was commenced on 11 March and his systemic signs of infection are now resolving. |
CLINICAL PRECISION Specific measurements demonstrate clinical accuracy. MRSA status is critical for the tissue viability nurse. Treatment response included to show current status. Relevant, no fluff. |
| Given the MRSA-positive status, the non-healing nature of this ulcer, and the risk of further complications, I would appreciate your specialist assessment for ongoing wound management and advice regarding pressure offloading strategies. |
JUSTIFIED REQUEST "Given..." structure clearly links the request to clinical rationale. Specific asks: specialist assessment, ongoing wound management, and pressure offloading advice. Professional phrasing "I would appreciate." |
|
Mr Okafor will be discharged on 18 March 2025. Please could you arrange to review him within the community setting at your earliest convenience? Yours sincerely, Emily Carter Registered Nurse |
CLEAR FOLLOW-UP Discharge date provided for planning. "Community setting" clarifies where review should happen. "Earliest convenience" politely conveys urgency. Complete and professional. |
Scenario: Elderly patient transfer to nursing home • Estimated Grade: A
| The Letter | Why It Works |
|
The Manager Rosehill Nursing Home 42 Rosehill Drive, Manchester M20 3TX 16 March 2025 Re: Mrs Eileen Fraser, DOB 03/01/1943 Transfer for ongoing rehabilitation and residential care Dear Sir/Madam, |
CORRECT SALUTATION "The Manager" with "Dear Sir/Madam" is appropriate when the specific recipient's name is unknown. Subject line clearly states reason for transfer so care home understands immediately. |
| I am writing regarding Mrs Fraser, who is being transferred to your facility on 17 March 2025 following a period of acute hospital care. She was admitted on 5 March after a fall at home and underwent a left hemiarthroplasty for a fractured neck of femur on 6 March. |
RELEVANT SURGICAL HISTORY Surgical procedure and date clearly documented. Left side specified (important for mobility care). "Following a period of acute hospital care" frames the transfer context. |
| Mrs Fraser has moderate dementia and her post-operative period was complicated by episodes of confusion, which have now resolved. She also has osteoporosis and atrial fibrillation for which she takes warfarin. Her INR has been stable at 2.3-2.8. |
ESSENTIAL PMH Dementia is crucial as it affects care needs. Warfarin with recent INR range is vital for medication management. Osteoporosis relevant to fall risk. Confusion history noted but resolved status included. |
| Medically, Mrs Fraser is now stable. She is mobilising with the assistance of two nurses and is weight-bearing as tolerated. Her wound is clean and dry. However, her family are unable to provide the level of care required at home, and she would benefit from 24-hour nursing care and continued physiotherapy. |
RATIONALE FOR TRANSFER Current status (stable, mobilising, wound status) then clear reason for transfer: family unable to cope + need for 24-hour care + ongoing physio. "However" signals the transition to the reason for writing. |
|
Please could you ensure that Mrs Fraser continues with her physiotherapy programme and that her warfarin is monitored regularly. Her daughter, Mrs Patricia Hughes, can be contacted on 07700 900123 for any non-clinical matters. Yours faithfully, Lucy Brennan Registered Nurse |
SPECIFIC CARE NEEDS Two clear requests: continue physio, monitor warfarin. Family contact included for practical matters. "Yours faithfully" correctly used as recipient not named. Complete and well-organised. |
Your OET writing is assessed across six criteria, each scored from 0-7. Understand what examiners look for at each band.
| Criterion | Band A (500+) | Band B (400-499) | Band C (300-399) | Band D (200-299) | Key Requirements |
|---|---|---|---|---|---|
| Purpose | Clear & immediately apparent | Adequately clear | Somewhat unclear | Unclear or missing | Must state why you are writing in the opening lines. Recipient should understand the letter's purpose without reading further. |
| Content | All relevant, no omissions | Mostly relevant, minor omissions | Some relevant content, notable omissions | Many omissions or much irrelevance | Include everything the recipient needs to know. Omit anything irrelevant to the specific recipient and purpose. |
| Conciseness & Clarity | Highly concise, no redundancy | Reasonably concise | Some wordiness or lack of clarity | Very wordy or unclear | Use efficient expression. One sentence should convey one idea. Avoid unnecessary words or repetition. |
| Genre & Style | Highly appropriate throughout | Generally appropriate | Sometimes inappropriate | Frequently inappropriate | Use formal professional language. Appropriate register for recipient. Polite but not overly familiar. |
| Organisation & Layout | Excellent structure | Good structure, minor issues | Adequate but inconsistent | Poorly organised | Logical paragraphing. Correct letter format. Clear connections between ideas. Appropriate use of connectives. |
| Language | Accurate, natural expression | Minor errors, meaning clear | Errors occasionally obscure meaning | Errors frequently obscure meaning | Correct grammar, spelling, punctuation. Appropriate vocabulary. Sentence variety without sacrificing clarity. |
Most nursing regulatory bodies require a minimum of Grade B (350+) in Writing, though some accept Grade C+ (300+). Always check with your specific regulator (NMC, AHPRA, etc.) for current requirements. We recommend aiming for Grade B or above to ensure compliance.
Understanding common errors can help you avoid losing valuable marks. Here are the most frequent mistakes candidates make in the OET Writing sub-test:
Using appropriate healthcare vocabulary demonstrates professional competence. Here are key terms organised by category.
admitted with / presented with / referred from
complaining of / reporting / experiencing
acute onset / gradual onset / sudden onset
history of / background of / known diagnosis of
incident / episode / event / occurrence
stable / deteriorating / improving / unchanged
hypotensive / hypertensive / tachycardic / febrile
alert and oriented / confused / drowsy / unconscious
in good spirits / anxious / distressed / comfortable
afebrile / normotensive / saturating well on room air
commenced on / initiated / prescribed / administered
responding well to / not tolerating / allergic to
intravenous / oral / subcutaneous / topical
dosage adjusted / increased / reduced / withheld
continued / discontinued / changed to / weaned off
healing well / clean and dry / granulating
serous / purulent / haemoserous discharge
erythema / oedema / induration / dehiscence
mobilising independently / with assistance / with aid
weight-bearing as tolerated / non-weight-bearing
I would appreciate your assessment of...
Please arrange for... / Kindly organise...
It would be appreciated if you could...
Please review / monitor / follow up...
Do not hesitate to contact me if...
In addition / Furthermore / Moreover
However / Nevertheless / Despite this
Therefore / Consequently / As a result
Currently / At present / Post-operatively
Given that / In view of / Considering
During the reading time, identify the letter type, recipient, and purpose. Underline or mentally note which case notes are relevant. This planning time is crucial for a well-organised letter.
Start your letter with a clear purpose statement. This ensures the examiner immediately sees you have addressed the Purpose criterion, which carries significant weight.
Never copy phrases directly from the case notes. Transform bullet points into connected sentences. "T2DM, 10 yrs" becomes "She has had type 2 diabetes mellitus for ten years."
Keep your letter between 180-220 words. Under 180 may lack necessary content; over 220 may be penalised for lack of conciseness. Practice writing to this length repeatedly.
Always write the full term first, then add the abbreviation in brackets: "atrial fibrillation (AF)". Subsequent uses can use the abbreviation alone.
Write formally but clearly. "Please could you arrange" is better than "Can you sort out" or "I would be most grateful if you would kindly consider." Be professional, not overly elaborate.
Get a comprehensive OET Writing Checklist covering all six assessment criteria, common error patterns, and a step-by-step framework for transforming case notes into Band B+ letters.
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