The task
Assume that today's date is 6 November 2026. It is 10:20. Mr Moraa is awaiting urgent transfer from your acute hospital to the renal receiving unit. This is original independent practice material.
You are the doctor caring for Mr Mutisya Moraa in the acute assessment unit. Write a transfer letter to Dr Pearla Ellery, Renal Receiving Doctor, Renal Receiving Unit, 28 Station Road, AB10 1AA, United Kingdom. Explain the reason for transfer, accurately communicate the laboratory's formal correction of the potassium report, and hand over the consultant's recorded plan. 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: Transfer letter.
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Which case notes belong in this letter?
Hyperkalaemia in chronic kidney disease: transfer
You are the doctor caring for Mr Mutisya Moraa in the acute assessment unit. Write a transfer letter to Dr Pearla Ellery, Renal Receiving Doctor, Renal Receiving Unit, 28 Station Road, AB10 1AA, United Kingdom. Explain the reason for transfer, accurately communicate the laboratory's formal correction of the potassium report, and hand over the consultant's recorded plan. 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: Mr Mutisya Moraa
- DOB: 12/03/1957 (69 yrs)
- Acute assessment unit admission: today, 09:30
Social background
- Lives with wife; independent with daily activities
- Retired accountant; enjoys crosswords
- Wife privately described disagreement with son over inheritance
Medical history
- CKD stage 4; under renal outpatient care
- K+ 4.9 mmol/L at review 4/52 ago
- Hypertension
- Usual medication: ramipril daily
- Also takes amlodipine daily
- No known drug allergies
- Cataract surgery 2019; uncomplicated
Assessment today
- Poor oral intake 3 days; no vomiting/diarrhoea
- Alert; no chest pain, palpitations or breathlessness
- BP 138/76 mmHg; pulse 82/min
- Creatinine 410 micromol/L, ↑ from 290 at review 4/52 ago
- ECG: sinus rhythm; no hyperkalaemic changes
Laboratory report timeline
- 09:40 sample → initial report 10:10: K+ 6.8 mmol/L
- 10:11: urgent renal transfer requested
- 10:12: laboratory formally corrected K+ to 5.8 mmol/L; same 09:40 sample; supersedes initial report
- Laboratory confirmed transcription error; not a new sample
- No potassium-lowering treatment administered before correction or subsequently
Treatment and transfer plan
- 10:15: consultant Dr Milkah Muthiani reviewed corrected report
- Consultant decision: proceed urgently; while stable, no potassium-lowering medication before repeat testing
- Ramipril withheld by consultant
- Dr Pearla Ellery accepted transfer; monitored ambulance departure 10:25
- Agreed renal-team plan: repeat K+/renal function immediately on arrival; reassess treatment
- Continuous cardiac monitoring pending departure; deterioration → immediate senior review
- Original/corrected laboratory reports and ECG accompanying patient
- Patient complained breakfast arrived cold
Who is reading, and what do they need?
Dr Ellery is the accepting renal receiving doctor and needs a concise handover for immediate reassessment. Prior renal outpatient care does not establish access to today's results. Patient name and date of birth support identification; the main clinical detail concerns the creatinine rise, laboratory correction, treatment given or withheld, and consultant's transfer and arrival plan.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| Creatinine 410 micromol/L, up from 290 four weeks earlier; CKD stage 4. | The comparison establishes the renal deterioration requiring assessment; CKD provides useful context. |
| 09:40 sample: potassium initially reported as 6.8 mmol/L at 10:10. | The original value and timing establish what the laboratory subsequently corrected. |
| 10:12 formal correction: potassium 5.8 mmol/L; same 09:40 sample; supersedes initial report; transcription error. | This identifies the authoritative result and prevents interpretation as a repeat measurement or physiological change. |
| No potassium-lowering treatment administered before the correction or subsequently. | The receiving team needs an accurate treatment history when interpreting potassium and deciding further management. |
| Consultant: urgent transfer; while stable, no potassium-lowering medication before repeat testing; ramipril withheld. | This preserves the consultant's conditional treatment decision and communicates the relevant medication change. |
| Dr Ellery accepted transfer; monitored ambulance departure planned for 10:25. | Acceptance and planned transport establish the immediate handover arrangements without claiming departure has occurred. |
| Repeat potassium and renal function immediately on arrival; reassess treatment. | These are the receiving team's agreed next actions and their required timing. |
| Continuous cardiac monitoring pending departure; deterioration requires immediate senior review. | This clarifies supervision and escalation during the remaining pre-transfer period. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Retired accountant; enjoys crosswords. | Occupation and hobbies do not inform urgent renal assessment or transfer arrangements. |
| Wife privately described disagreement with son over inheritance. | This private family disclosure has no documented relevance to immediate renal care. |
| Uncomplicated cataract surgery in 2019. | Past eye surgery does not affect the documented renal problem or current management. |
| Patient complained breakfast arrived cold. | This complaint adds no useful information about the transfer indication or treatment. |
| Potassium 4.9 mmol/L four weeks earlier. | Despite apparent relevance, this historical result can distract from the essential same-sample correction; retain only if useful and space permits. |
| Lives with wife; independent with daily activities. | Baseline support and function may be compressed, but they do not determine the immediate renal-team actions. |
A paragraph plan for this case
Opening paragraph: urgent renal transfer requested at 10:11, today's 09:30 admission and creatinine rise, with stage 4 CKD and poor intake as concise context. Middle paragraph: initial and corrected potassium reports in sequence, their same-sample relationship and absence of potassium-lowering treatment; symptom negatives, observations and ECG may provide brief supporting context. Final paragraph: consultant decision, ramipril withholding, monitoring, planned departure and immediate arrival testing; hypertension, usual medicines, allergy status and accompanying laboratory reports and ECG can be compressed where useful.
Where candidates slip on this task
- Do not describe potassium as falling after treatment: 6.8 and 5.8 mmol/L belong to the same 09:40 sample, and the laboratory correction supersedes the initial report.
- At 10:20, the monitored ambulance departure at 10:25 remains planned. Preserve urgent transfer and immediate arrival testing; do not imply either departure or repeat sampling has already occurred.
- Attribute the stable-patient decision to consultant Dr Muthiani's 10:15 review; record ramipril withholding without implying amlodipine was stopped or that the absence of ECG changes removes risk.
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
How should the two potassium values be explained?
Treat 5.8 mmol/L as the formal replacement for 6.8 mmol/L from the same 09:40 sample. The laboratory identified a transcription error; the corrected report did not involve a new specimen. No potassium-lowering treatment was administered. This distinction supports accurate interpretation and treatment reassessment.
Which background findings can be shortened?
The symptom negatives, blood pressure, pulse and ECG can be summarised selectively as supporting context for the recorded stable-patient plan. Prior potassium, hypertension and usual amlodipine are optional background. Preserve the creatinine comparison, corrected-report sequence, absence of potassium-lowering treatment and immediate renal-team plan.
Sources
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