The task
Original independent practice. All patient details, observations and individual care arrangements are fictional. Assume that today's date is 3 November 2026. Ms Shannon remains under staff supervision while awaiting the ambulance already arranged for immediate transfer. Allow 45 minutes: 5 minutes reading and 40 minutes writing.
You are the general practitioner assessing Ms Bristol Shannon. Using the case notes, write a transfer letter to Dr Renae Osinski, Receiving Doctor, Emergency Mental Health Service, 40 Church Road, N1 8XX, United Kingdom. Hand over her suspected postpartum psychosis, immediate risks, current mother-and-baby safeguarding arrangements and supervised transfer for emergency assessment. 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.
Free · no sign-up · medicine
Which case notes belong in this letter?
Suspected postpartum psychosis: transfer
You are the general practitioner assessing Ms Bristol Shannon. Using the case notes, write a transfer letter to Dr Renae Osinski, Receiving Doctor, Emergency Mental Health Service, 40 Church Road, N1 8XX, United Kingdom. Hand over her suspected postpartum psychosis, immediate risks, current mother-and-baby safeguarding arrangements and supervised transfer for emergency assessment. 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 Bristol Shannon
- DOB: 18/08/1995 (31 yrs)
- 03/11/26: urgent GP consultation; partner provided collateral history
- 25/10: first baby; uncomplicated vaginal birth; nine days postpartum
Social background
- Lives with partner; breastfeeding
- Partner available to care for baby during assessment
- Complained about reception parking charges
Medical history
- No previous psychiatric diagnosis or admission
- No regular medication; no known drug allergies
- Antenatal mood screening negative; no mental health treatment
- Remote ankle sprain; recovered fully
Earlier observations
- 30/10 midwife review: tired but coherent; appropriate infant care
- 01/11 onwards: almost no sleep despite opportunities to rest
- Partner reports ↑ agitation, rapid speech and restless activity
Current assessment — 03/11/26
- Today: believes baby replaced; hears voice telling her to take baby away
- Attempted to leave consultation with baby
- Denies suicidal intent; cannot establish safety of mother or baby
- Limited insight; does not believe she needs assessment
- Afebrile; no headache, focal neurological signs or physical complaints
- No psychotropic medication administered today
- GP impression: suspected postpartum psychosis; emergency assessment required
Immediate safeguarding and transfer plan
- Continuous staff observation of mother; no unsupervised infant contact
- Baby safe with partner and staff member in separate room
- Dr Renae Osinski accepted immediate transfer by telephone
- Ambulance arranged directly to emergency mental health service; clinical escort
- Receiving team: continue safeguarding; assess admission need, including mother and baby unit
- Partner informed of urgent plan; agrees to remain with baby
- Patient currently accepting ambulance transfer; staff supervision maintained
Who is reading, and what do they need?
Dr Osinski has accepted immediate transfer by telephone and needs a concise account for emergency assessment. Prioritise the postpartum timing, psychotic experiences, behavioural risk and inability to establish safety. Describe exactly where mother and baby are and who supervises them. Breastfeeding, relevant history and treatment status can support assessment after the immediate transfer and safeguarding information.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| First baby born 25/10; uncomplicated vaginal birth; nine days postpartum | Provides the essential temporal relationship between childbirth and the emergency presentation. |
| Believes baby replaced; hears a voice telling her to take baby away | Communicates the actual psychotic experiences and their direct relevance to infant safety. |
| Denies suicidal intent; safety of mother or baby cannot be established | Preserves the risk assessment without treating denial of suicidal intent as evidence of safety. |
| Suspected postpartum psychosis; emergency assessment required | States the working impression and immediate purpose while retaining diagnostic uncertainty. |
| Continuous staff observation of mother; no unsupervised infant contact | Hands over the active maternal supervision and contact restriction that must remain clear during transfer. |
| Baby safe with partner and staff member in a separate room | Defines the infant's current location and supervision rather than leaving safeguarding arrangements implicit. |
| Ambulance arranged directly to emergency mental health service with clinical escort | Specifies the organised transport, destination and supervision for the emergency transfer. |
| Almost no sleep; agitation, rapid speech, restlessness; attempted departure with baby | Adds the recent clinical course and observed behaviour supporting the risk handover; individual supporting details may be omitted. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Complaint about reception parking charges | Does not inform the emergency assessment or safeguarding arrangements. |
| Remote ankle sprain with full recovery | Has no stated relevance to current mental state or transfer. |
| Negative antenatal mood screening and no antenatal mental health treatment | This historical screening does not resolve the current emergency and need not occupy the acute handover. |
| 30/10 midwife review: tired but coherent, with appropriate infant care | Optional baseline context that may be compressed; it must not displace today's symptoms and safeguarding requirements. |
A paragraph plan for this case
Open with the emergency transfer purpose, patient identifiers, suspected diagnosis and nine-day postpartum timing, then describe the psychotic experiences, relevant collateral history and current risk. Set out continuous maternal observation, restricted infant contact, the baby's separate supervision and the arranged ambulance with clinical escort; distinguish the patient's current acceptance from her limited insight and include the partner's agreement if useful. Close with the request to continue safeguarding and assess admission, including a mother and baby unit, adding concise breastfeeding, psychiatric history, medication, allergy and physical-assessment information only where it assists receiving care.
Where candidates slip on this task
- The birth on 25 October makes this nine days postpartum on 3 November; retain suspected postpartum psychosis rather than converting the GP impression into a confirmed diagnosis.
- Denial of suicidal intent does not establish safety for either mother or baby; current acceptance of ambulance transfer also does not demonstrate insight or sustained agreement.
- Keep mother and baby arrangements distinct: continuous maternal observation and no unsupervised infant contact, with the baby separately supervised; ambulance transport includes a clinical escort.
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
More Medicine letter tasks
- Transfer to orthopaedics: hip fracture in a patient on warfarin transfer letter
- Transfer to a residential aged care facility after delirium transfer letter
- Suspected ectopic pregnancy: transfer transfer letter
Your profession's guide: OET Medicine. Layout and structure: OET letter format.
Questions about this task
Does her denial of suicidal intent reduce the need for emergency transfer?
The notes explicitly state that safety of mother or baby cannot be established. Include that assessment alongside the denial, and relate it to the reported voice, belief about the baby and attempted departure. Do not infer safety from a single negative answer or current cooperation.
How much detail is needed about safeguarding and transport?
Enough to make the current arrangements unambiguous: continuous staff observation of the mother, no unsupervised infant contact, the baby with the partner and a staff member separately, and direct ambulance transfer with a clinical escort. The receiving team is asked to continue safeguarding and assess admission needs.
Sources
Last checked 22 Oct 2026. Rules and prices change: confirm on the official page before you book or apply.
OETAce is an independent practice site. OET is a registered trademark of Cambridge Boxhill Language Assessment (CBLA); we are not affiliated with or endorsed by CBLA. All practice material here is original.