The task
Original independent practice. Assume that today's date is 6 November 2026. Ms Celena Hilll has returned home following discharge and telephoned about contradictory instruction sheets. Patient-specific findings and treating-team decisions in this fictional case are invented for practice.
You are the hospital medical officer responsible for Ms Celena Hilll's discharge. Using the case notes, write to her general practitioner, Dr Giang Chau, explaining her recovery, identifying the formally superseded instruction sheet and communicating the valid plan. Clarify your responsibility for explaining the correction and the GP's role in confirming her understanding and reviewing recovery. Address the letter to Dr Giang Chau, General Practice, 24 High Street, SW1A 1AA, United Kingdom. In your answer: expand the relevant notes into complete sentences; do not use note form; use letter format. The body of the letter should be approximately 180-200 words.
Length: the body of the letter should be about 180-200 words. You have 45 minutes in the test: 5 minutes to read, 40 to write. Letter type: Discharge letter.
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Which case notes belong in this letter?
Diverticulitis after inpatient care: discharge
You are the hospital medical officer responsible for Ms Celena Hilll's discharge. Using the case notes, write to her general practitioner, Dr Giang Chau, explaining her recovery, identifying the formally superseded instruction sheet and communicating the valid plan. Clarify your responsibility for explaining the correction and the GP's role in confirming her understanding and reviewing recovery. Address the letter to Dr Giang Chau, General Practice, 24 High Street, SW1A 1AA, United Kingdom. In your answer: expand the relevant notes into complete sentences; do not use note form; use letter format. The body of the letter should be approximately 180-200 words.
Mark every line: Include keeps the specific detail; Compress keeps the relevant gist in fewer words; Omit leaves it out. Then compare your choices with our reviewed analysis. Some choices are optional.
Download practice checklist (PDF)
One-page worksheet. Answers and reasons are on the linked webpage, so you can practise before checking.
Case notes
Patient details
- Name: Ms Celena Hilll
- DOB: 12/03/1964 (62 yrs)
- Admitted 01/11/26; discharged home 06/11/26
- GP holds established medical history
Social background
- Lives alone; independent with meals/medicines
- Daughter visiting this weekend
- Enjoys gardening
- Complained that ward staff were unfriendly
Medical history
- Hypertension; usual amlodipine unchanged
- Appendicectomy 1984
- NKDA
- No previous diverticulitis
Admission
- Admission: LLQ pain, fever, reduced intake
- CT: sigmoid diverticulitis; no abscess/perforation
- Inflammatory markers ↓ during admission
- Treated with IV fluids and antibiotics during admission
Treatment/Progress
- Today: afebrile; observations stable
- Minimal residual LLQ tenderness; no guarding
- Tolerating food/fluids; passing stools; without nausea or vomiting
- Consultant stopped antibiotics today; none prescribed for home
Contradictory discharge instructions
- After discharge: pt phoned, confused by two instruction sheets; no new symptoms; wants written clarification sent to GP
- Sheet A, dated 03/11: clear fluids only; await hospital dietary review
- Consultant formally superseded A today; signed sheet B (06/11) sole valid plan
- B: balanced diet; gradually ↑ fibre; adequate fluids
- B: GP review 09/11
- A withdrawn electronically; pt still has both paper copies
Plan
- Discharging doctor to telephone today: explain correction, check understanding by teach-back, document response
- GP on 09/11: assess recovery/intake; reconfirm B and understanding
- B safety advice: urgent assessment for worsening pain, fever or inability to retain fluids
- B: emergency attendance for severe pain with vomiting, abdominal distension or inability to pass stool/flatus
- No hospital dietary review arranged or required under B
- Discharge prescriptions otherwise unchanged
Who is reading, and what do they need?
Dr Giang Chau already holds Ms Hilll’s established medical history and needs an actionable correction after discharge. Prioritise which sheet governs care, the hospital doctor’s immediate explanation duties, and the GP’s review responsibilities. Living alone while independently managing meals and medicines is optional context; the clinical summary should establish recovery without reproducing every admission detail.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| Post-discharge call: confused by two sheets; no new symptoms; requests written clarification to GP. | Establishes the immediate communication problem and the patient’s requested destination for clarification. |
| Consultant formally superseded A (03/11); signed B (06/11) is the sole valid plan. | Resolves the contradiction through the treating consultant’s documented decision. |
| Balanced diet; gradually increase fibre; adequate fluids. | Provides all three components of the current dietary advice the GP must reinforce. |
| CT: sigmoid diverticulitis, no abscess/perforation; afebrile, stable; minimal tenderness; tolerating food/fluids; passing stools. | Selected findings can establish the diagnosis and recovery sufficiently for continuing care; every supporting detail is not compulsory. |
| Discharging doctor to telephone today: explain correction, check understanding by teach-back, document response. | Keeps immediate correction and verification with the responsible hospital doctor. |
| GP review 09/11: assess recovery/intake; reconfirm B and understanding. | Defines the review date and the GP’s separate clinical and communication responsibilities. |
| Urgent assessment: worsening pain, fever or inability to retain fluids. | Preserves every listed trigger for urgent reassessment under the valid plan. |
| Emergency attendance: severe pain with vomiting, abdominal distension or inability to pass stool/flatus. | Preserves the emergency escalation instructions and all listed criteria. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Daughter visiting this weekend; enjoys gardening. | Neither detail changes the instruction correction or the scheduled recovery review. |
| Complained that ward staff were unfriendly. | The complaint does not explain which instructions are valid or help the GP continue treatment. |
| Appendicectomy in 1984. | Remote surgery contributes little to this documented recovery and dietary clarification. |
| Hypertension; usual amlodipine unchanged. | Although medication history looks relevant at discharge, the GP already knows this unchanged treatment. |
| No previous diverticulitis. | First-episode status is optional context and does not determine the documented correction or review responsibilities. |
| NKDA. | Allergy status adds limited value here because no home antibiotics are prescribed and the GP holds established history. |
A paragraph plan for this case
Open with Ms Celena Hilll’s identification, optionally using DOB 12/03/1964 and admission/discharge dates 01/11/26–06/11/26, then identify the telephone query and superseded sheet. Follow with a brief recovery paragraph, selecting admission LLQ pain, fever and reduced intake, IV fluids and antibiotics, falling inflammatory markers or current findings as useful; clarify that the consultant stopped antibiotics and none were prescribed for home, with other prescriptions unchanged if mentioned. Finish with B’s diet, the hospital doctor’s same-day explanation and teach-back, the GP’s 09/11 recovery/intake review and reconfirmation, and both safety escalation levels together.
Where candidates slip on this task
- Identify A dated 3 November, containing clear-fluids-only advice pending hospital dietary review, as superseded; electronic withdrawal leaves paper copies in her possession, and B requires no hospital dietary review.
- If discussing antibiotics, distinguish inpatient treatment from the consultant’s decision to stop them on 6 November; do not imply a home course or an invented duration.
- Do not transfer the hospital doctor’s same-day correction call to the GP or postpone clarification until 9 November; preserve teach-back, documentation, and the GP’s subsequent review responsibilities.
No model letter is published here. Write for the named reader from the case notes in the timed editor, then get it marked.
Write it in the timed editor and get marked on the 6 criteria
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Your profession's guide: OET Medicine. Layout and structure: OET letter format.
Questions about this task
Who is responsible for explaining the correction?
The discharging doctor must telephone on 6 November, explain the correction, check understanding through teach-back and document the response. At the 9 November review, the GP assesses recovery and intake and reconfirms B and understanding. The GP review does not replace the hospital’s immediate responsibility.
Which safety advice needs to remain together?
Keep both levels together: urgent assessment for worsening pain, fever or inability to retain fluids; emergency attendance for severe pain with vomiting, abdominal distension or inability to pass stool/flatus. Preserve every listed trigger and avoid strengthening the documented recovery findings.
Sources
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