The task
Original independent practice material. Assume that today's date is 6 November 2026. Ms Fikayomi Adisa has attended a general practice review today.
You are a registered nurse working in general practice. Using the case notes, write a referral letter to Ms Subomi Ayoola, Perinatal Mental Health Nurse, Community Perinatal Mental Health Team, 24 Station Road, NSW 2000. Request assessment and psychological treatment coordination for Ms Fikayomi Adisa. Clarify maternal mental-health follow-up, the separate infant-care arrangements and the authorised information sharing with the child-health nurse. 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?
Postnatal depression: referral
You are a registered nurse working in general practice. Using the case notes, write a referral letter to Ms Subomi Ayoola, Perinatal Mental Health Nurse, Community Perinatal Mental Health Team, 24 Station Road, NSW 2000. Request assessment and psychological treatment coordination for Ms Fikayomi Adisa. Clarify maternal mental-health follow-up, the separate infant-care arrangements and the authorised information sharing with the child-health nurse. 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 Fikayomi Adisa
- DOB: 14/02/1997; 29 yrs
- Address: 18 Park Road, NSW 2000
- General practice review today: 06/11/26
- First baby born 11/09/26; 8/52 old; uncomplicated delivery
Social background
- Lives with partner; he assists with baby care overnight
- Sister providing weekday practical help for next 2/52
- Previously attended sewing group monthly
- Aunt privately criticised partner's choice of job to receptionist
Medical history
- No previous mental-health diagnosis or treatment reported
- Appendicectomy aged 12
- No known drug allergies
Assessment today
- GP assessment: postnatal depression diagnosed today
- Low mood, guilt, loss of enjoyment for 4/52
- Poor sleep even when partner cares for baby; concentration ↓
- Denies suicidal thoughts/self-harm thoughts/thoughts of harming baby; no psychotic symptoms elicited
- Accepts help; feeding/changing baby safely with prompts from family
- Baby breastfeeding; gaining weight at child-health reviews
Treatment and preferences
- GP discussed psychological therapy and antidepressants; prefers psychological treatment initially
- No antidepressant prescribed
- GP retains medical review; appointment 10/11
- GP requested specialist referral; patient consents
- Prefers morning telephone contact while sister cares for baby
Agreed referral and liaison plan
- Perinatal team requested: contact by 09/11, assess mood/risk, coordinate psychological treatment; advise GP of ongoing plan
- Ms Omodunni Ninalowo, Child Health Nurse: retains infant feeding/growth reviews; home visit booked 09/11
- Routine sharing with child-health nurse authorised: maternal diagnosis + contact/attendance arrangements only; therapy-session details excluded
- Perinatal team requested to lead ongoing maternal mental-health follow-up; child-health nurse reports maternal deterioration to GP same day
- Safety advice explained: rapid mental deterioration → same-day urgent GP assessment; immediate danger to mother/baby → emergency services
- Complained about music playing in clinic waiting room
- Baby's next immunisation appointment: 13/11
Who is reading, and what do they need?
Ms Subomi Ayoola is the receiving perinatal mental-health nurse; previous involvement is not documented. She needs clinical context for assessment, psychological treatment coordination and follow-up ownership. Psychiatric history and allergy status can be brief or omitted if unnecessary. Family-supported infant care and breastfeeding/growth findings provide context. Distinguish retained GP review, child-health responsibilities and authorised routine liaison.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| Postnatal depression diagnosed today; four-week low mood, guilt, anhedonia; psychological treatment preferred; no antidepressant prescribed. | Provides a concise clinical rationale and treatment starting point; supporting details can be selected according to space and assessment needs. |
| Denies suicidal, self-harm and baby-harm thoughts; no psychotic symptoms elicited. | Establishes the documented assessment baseline while preserving the need for the receiving team to reassess risk. |
| Contact by 09/11; assess mood/risk; coordinate psychological treatment; advise GP of ongoing plan. | Defines the requested response, its timing and the communication needed to coordinate continuing care. |
| Child-health nurse Omodunni Ninalowo retains infant feeding/growth reviews; home visit booked 09/11. | Identifies the separate infant-care provider and existing appointment, preventing confusion about responsibility for the baby's reviews. |
| Authorised child-health sharing: maternal diagnosis and contact/attendance arrangements only; therapy-session details excluded. | Sets the explicit boundary for routine liaison so coordination does not imply permission to disclose therapy content. |
| Requested perinatal-led maternal follow-up; child-health nurse reports maternal deterioration to GP same day. | Clarifies requested maternal follow-up ownership and the child-health nurse's reporting route without presenting the specialist handover as already accepted. |
| Rapid mental deterioration: same-day urgent GP assessment; immediate danger to mother/baby: emergency services. | Transfers the agreed escalation arrangements; both levels belong together, with 000 made explicit for immediate danger. |
| GP review retained, 10/11; morning telephone contact preferred while sister cares for baby. | Supports continuity during referral and offers a practical contact arrangement; these useful details can be compressed if space is limited. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Previously attended sewing group monthly. | Past attendance does not establish current withdrawal or a treatment goal; the documented symptoms already provide more direct assessment context. |
| Aunt privately criticised partner's job choice to receptionist. | Third-party criticism does not establish a clinical relationship problem and would introduce unsupported interpretation into the referral. |
| Appendicectomy aged 12. | Remote surgery has no documented bearing on the requested mental-health assessment or care coordination. |
| Complaint about waiting-room music. | A service complaint does not help the specialist assess or coordinate the documented condition; avoid interpreting it as a psychiatric symptom. |
| Baby's next immunisation appointment: 13/11. | Although it resembles relevant follow-up, immunisation scheduling does not clarify this specialist referral; the feeding/growth reviews and home visit do. |
A paragraph plan for this case
Opening paragraph: referral purpose, selected patient identifiers, today's diagnosis and concise symptom context; first-baby status, eight-week postpartum timing, uncomplicated delivery, sleep/concentration findings and referral consent can be added selectively. Middle paragraph: documented risk findings, treatment preference and medication status, retained GP review, and useful functioning/support details such as safe feeding/changing with family prompts, partner assistance overnight and the sister's next fortnight of practical help. Closing paragraph: requested contact and assessment/treatment coordination, preferred telephone timing, requested maternal follow-up ownership, separate infant-care arrangements, restricted routine sharing and the complete agreed escalation advice.
Where candidates slip on this task
- Keep the requested 9 November contact and child-health home visit distinct from the GP's 10 November review; the perinatal team's ongoing role is requested, not confirmed.
- Retain all three denied thought categories and the absence of elicited psychotic symptoms; these findings do not establish absence of risk or justify removing the reassessment request.
- Limit routine child-health sharing to diagnosis and contact/attendance arrangements; exclude therapy-session details, preserve same-day deterioration reporting to the GP, and avoid implying unrestricted consent.
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 should the three clinicians' responsibilities be distinguished?
Organise the handover around separate functions: requested perinatal-team leadership of ongoing maternal mental-health follow-up and psychological treatment coordination; retained GP medical review on 10 November; and Ms Ninalowo's infant feeding/growth reviews, including the 9 November home visit. Preserve the request for the perinatal team to advise the GP of its ongoing plan.
How should the escalation advice be handled without overstating what was explained?
Keep both documented routes together: rapid mental deterioration requires same-day urgent GP assessment; immediate danger to mother or baby requires 000. Lifeline 13 11 14 offers crisis support, not a substitute for emergency services. Do not claim this additional number was discussed. See Australian crisis guidance.
Sources
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