The task
This is original independent practice material. Assume that today's date is 6 November 2026. Mr Kort has been reviewed at his supported accommodation today. Allow 45 minutes: five minutes for reading and 40 minutes for writing.
You are a registered nurse providing outreach care to adults in supported accommodation. Using the case notes, write a referral letter to Ms Mary Kruns, Community Learning-Disability Nurse, requesting accessible appointment support for Mr Christof Kort while respecting his consent preferences and involvement in decisions. Address the letter to Ms Mary Kruns, Community Learning-Disability Nurse, Community Learning Disability Service, 24 High Street, SW1P 2AA, 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: Referral letter.
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Which case notes belong in this letter?
Adult with epilepsy and missed appointments: referral
You are a registered nurse providing outreach care to adults in supported accommodation. Using the case notes, write a referral letter to Ms Mary Kruns, Community Learning-Disability Nurse, requesting accessible appointment support for Mr Christof Kort while respecting his consent preferences and involvement in decisions. Address the letter to Ms Mary Kruns, Community Learning-Disability Nurse, Community Learning Disability Service, 24 High Street, SW1P 2AA, 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: Mr Christof Kort
- DOB: 12/03/1991 (35 yrs)
- Address: Flat 2, 8 Park Road, SW1P 2AA, UK
- Outreach nursing review at home: 06/11/26
Social background
- Supported accommodation; own flat, support staff available daily
- Independent washing/dressing; charity-shop work twice weekly
- Enjoys model trains; recently bought a railway magazine
- Sister privately complained staff were 'useless at organising anything'
Medical history
- Mild learning disability diagnosed in childhood
- Epilepsy since adolescence; prescribed antiseizure treatment unchanged
- No seizures reported for 9/12; no current illness
- Staff supervise regular medication; no missed doses recorded
- Tonsillectomy aged 7; uncomplicated recovery
Assessment/visit notes
- Missed neurology reviews: 14/08/26 and 23/10/26; wants to attend
- Standard letters difficult: confused appointment date with letter date
- No reminder or transport booked for either missed appointment
- Understands short spoken explanations + pictures; needs extra processing time
- Explained referral purpose/options back accurately; chose support himself
- No concerns about capacity for this referral decision at today's review
- Prefers direct telephone contact; answers own mobile
Consent and contact preferences
- Consents to referral and sharing relevant health information with receiving nurse
- Permits staff to receive date/time/location only, for reminders and transport
- No clinical details to staff; no information to family; seek permission before wider sharing
- Own mobile for contact: 07700 900123
Plan
- Request agreed home visit: assess appointment-support needs; develop accessible reminders
- Liaise with neurology alongside patient: rebook review; request longer appointment
- Wants chosen staff member to accompany him; consultation initially private
- Practise checking appointment date/time together; use pictorial reminder
- GP/neurology retain epilepsy treatment decisions; no medication changes requested
- Confirm agreed support arrangements to referring nurse after initial visit
Other recorded comments
- Complained clinic waiting-room chairs were an 'awful colour'
- Previous review: enjoyed charity-shop summer outing
Who is reading, and what do they need?
Ms Kruns, the community learning-disability nurse, needs an actionable appointment-support referral for Mr Kort, who has a mild learning disability and lives in his own supported flat with daily staff availability. Prioritise communication adjustments, consent boundaries and shared decisions. Direct telephone contact is preferred; he answers his own mobile, 07700 900123, so staff should not automatically become the main contact.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| Missed neurology reviews on 14/08/26 and 23/10/26; confused appointment date with letter date. | Explain the attendance problem and specific communication barrier so Ms Kruns can target support appropriately. |
| Understands short spoken explanations and pictures; needs extra processing time. | Specify how Ms Kruns can make assessment, reminders and appointment discussions accessible. |
| Consents to referral and relevant health-information sharing with the receiving nurse. | Establish the permission supporting this referral without suggesting unrestricted disclosure. |
| Staff may receive date, time and location only, for reminders and transport. | Define the practical information staff can use to organise attendance within his permission. |
| No clinical details to staff; no information to family; permission before wider sharing. | Make all disclosure restrictions explicit so appointment coordination respects his stated boundaries. |
| Agreed home visit to assess appointment-support needs and develop accessible reminders. | Give Ms Kruns the principal requested action and its intended scope. |
| Liaise with neurology alongside him; rebook review and request a longer appointment. | Translate the referral into coordinated follow-up while preserving his participation. |
| Wants a chosen staff companion; consultation initially private. | Distinguish his chosen practical support from permission for staff to participate throughout the consultation. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Enjoys model trains; recently bought a railway magazine. | These interests do not establish an appointment barrier or a requested adjustment. |
| Sister privately described staff as useless at organising anything. | This complaint may appear to explain missed appointments, but adds blame rather than actionable evidence and does not authorise family involvement. |
| Uncomplicated tonsillectomy aged seven. | Remote, resolved surgery has no stated bearing on appointment access or consent. |
| Disliked the clinic waiting-room chair colour. | The notes do not connect this preference to attendance or identify an adjustment arising from it. |
| Enjoyed the charity-shop summer outing at the previous review. | This past social event does not help Ms Kruns arrange the requested support. |
| Independent washing and dressing; charity-shop work twice weekly. | Compress or omit this functional background unless it helps contextualise support; it does not determine capacity for the referral decision. |
A paragraph plan for this case
Keep Mr Christof Kort’s name, DOB 12/03/1991, address at Flat 2, 8 Park Road, SW1P 2AA, and home-review date of 6 November 2026 brief, then open with the agreed home-visit request. Next, group the missed reviews and communication adjustments with his accurate explanation of referral options, self-chosen support and absence of capacity concerns for this referral at today’s review. Finish with neurology coordination, accompaniment and initial privacy, making consent boundaries and direct contact preferences explicit alongside the requested arrangements.
Where candidates slip on this task
- Keep epilepsy context proportionate: unchanged antiseizure treatment, nine months without reported seizures and supervised medication without recorded omissions do not establish attendance reliability; GP/neurology retain treatment decisions.
- Distinguish access barriers from unwillingness: he wants to attend, neither missed review had reminders or transport booked, and practising date/time checks with a pictorial reminder addresses the documented difficulty.
- Keep the requested follow-up limited to confirming agreed support arrangements after the initial visit; family exclusion and staff access restricted to date, time and location remain explicit consent boundaries.
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 Nursing. Layout and structure: OET letter format.
Questions about this task
How much epilepsy history belongs in this appointment-support referral?
A brief epilepsy reference can explain why neurology follow-up matters. The unchanged treatment, nine months without reported seizures and supervised medication are useful context, but each may be omitted if the support request remains clear. Avoid turning the referral into a medication review.
How should consent and decision-making be handled?
Separate permission for relevant health-information sharing with Ms Kruns from staff permission for date, time and location only. Retain the restrictions on clinical disclosure to staff, all family disclosure and wider sharing without permission. His accurate explanation of options supports involvement; the capacity observation concerns this referral decision.
Sources
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