The task
Assume that today's date is 5 November 2026. Mr Currie has attended your outpatient clinic following cardiology review yesterday. This is original independent practice: the patient details, clinical findings and service decisions are fictional case facts. Allow 45 minutes: 5 minutes for reading and 40 minutes for writing.
You are a registered nurse in the cardiology outpatient clinic. Using the case notes, write to Ms Beatrix Bassett, Cardiac Rehabilitation Nurse, to reapply for Mr Currie's admission to the outpatient recovery programme. Explain how the barrier that led to the earlier refusal has changed and which access adjustment is still requested. Address your letter to Ms Beatrix Bassett, Cardiac Rehabilitation Nurse, Outpatient Recovery Programme, Level 2, 24 High Street, SW1V 2PB. 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?
Recovery after myocardial infarction: referral
You are a registered nurse in the cardiology outpatient clinic. Using the case notes, write to Ms Beatrix Bassett, Cardiac Rehabilitation Nurse, to reapply for Mr Currie's admission to the outpatient recovery programme. Explain how the barrier that led to the earlier refusal has changed and which access adjustment is still requested. Address your letter to Ms Beatrix Bassett, Cardiac Rehabilitation Nurse, Outpatient Recovery Programme, Level 2, 24 High Street, SW1V 2PB. 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.
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One-page worksheet. Answers and reasons are on the linked webpage, so you can practise before checking.
Case notes
Patient details
- Name: Mr Pratt Currie
- DOB: 09/03/1964 (62 yrs)
- Clinic review: 05/11/26
- Consents to repeat referral and sharing relevant clinical information
Social background
- Lives with wife; independent with personal care
- Daughter visits weekly; works during programme hours
- Retired mechanic; collects vintage bus tickets
- Privately criticised daughter's choice of partner
Medical history and earlier referral
- 02/10/26: myocardial infarction; coronary angioplasty with stent insertion
- Discharged home 06/10/26
- Initial cardiac rehabilitation referral sent 14/10/26 from cardiology outpatient clinic
- 16/10: service declined referral pending cardiologist assessment of exertional chest tightness
- Hypertension; reviewed regularly by GP
- Appendicectomy aged 19; uncomplicated recovery
- No known drug allergies
Assessment and progress
- 14/10: chest tightness on stairs reported at outpatient review during recovery at home
- No further chest discomfort since 20/10
- 04/11: cardiologist documented clinically stable; suitable for rehabilitation assessment; exercise prescription remains with rehabilitation team
- No current breathlessness, dizziness or syncope reported
- Walking around home independently; avoids longer walks through fear
- Secondary prevention medicines unchanged at review; reports taking as prescribed
- Anxious about another heart attack during activity; requests help rebuilding confidence
- Wants to resume gardening
- Complained that previous receptionist was unfriendly
Access and plan
- Original referral requested centre-based sessions
- Centre access remains difficult: no public transport; wife cannot drive
- Has tablet, reliable internet and private space; uses video calls independently
- Willing to attend remotely; daughter cannot provide regular transport
- Reapply for assessment; request supported home-based rehabilitation via video, if suitable
- Cardiologist's review enclosed with this letter; no promise of programme acceptance given
- GP follow-up booked 19/11
- Previously advised: new squeezing chest pain → call 999; do not drive to hospital
Who is reading, and what do they need?
Ms Bassett receives applications for the outpatient recovery programme; her service previously declined a referral for Mr Pratt Currie, born 9 March 1964. She needs the reason for renewed assessment, the cardiologist’s limited conclusion and the continuing access problem. Keep identification brief and prioritise evidence supporting reassessment and a feasible delivery format over a full medical or social history.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| 02/10/26: myocardial infarction; coronary angioplasty with stent insertion. | Establishes the cardiac event and intervention underlying the rehabilitation application. |
| 16/10 refusal pending cardiologist assessment of exertional chest tightness reported on 14/10. | Identifies the actual reason for refusal, allowing the reader to connect subsequent reassessment with the earlier decision. |
| 04/11: clinically stable; suitable for rehabilitation assessment; exercise prescription remains with the rehabilitation team. | Provides the essential basis for reconsideration while preserving the rehabilitation team’s responsibility for prescribing exercise. |
| No further chest discomfort since 20/10. | Supports the account of progress after the symptom that prompted refusal; useful alongside the cardiologist’s assessment. |
| No public transport; wife cannot drive; daughter cannot provide regular transport. | Explains why centre attendance remains difficult despite the completed cardiology review. |
| Tablet, reliable internet, private space; uses video calls independently. | Supports the practicality of the requested video format without establishing clinical suitability for that format. |
| Willing to attend remotely; reapply for assessment and supported home-based video rehabilitation, if suitable. | States the requested service decision and access adjustment while leaving acceptance and suitability to the programme. |
| Independent indoors; avoids longer walks through fear; anxious about another heart attack during activity. | Shows the functional and confidence concerns rehabilitation could address without attributing restricted walking to ongoing chest symptoms. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Retired mechanic; collects vintage bus tickets. | Occupation and collecting interests do not help the reader decide on reassessment or remote access. |
| Privately criticised daughter’s choice of partner. | This private family opinion has no demonstrated connection to rehabilitation needs or transport arrangements. |
| Appendicectomy aged 19; uncomplicated recovery. | The remote, resolved operation does not inform the present cardiac rehabilitation application. |
| Complained that previous receptionist was unfriendly. | The complaint does not explain the clinical refusal or establish a need for the requested delivery format. |
| Hypertension; reviewed regularly by GP. | Although clinically relevant background, this can be omitted or compressed because no hypertension-related rehabilitation decision is requested. |
| Discharged home 06/10/26. | The discharge date adds little once the infarction, refusal and subsequent cardiologist assessment establish the relevant sequence. |
A paragraph plan for this case
Open with the repeat referral, consent and conditional request for supported home-based video rehabilitation, keeping identifiers brief. In the clinical paragraph, connect the infarction and stent, initial referral on 14 October, refusal, subsequent symptom history and cardiology assessment; unchanged secondary prevention medicines with reported adherence and no current breathlessness, dizziness or syncope are optional supporting details. Close with transport limitations, video capability and activity-related anxiety; living with his wife, personal-care independence, his daughter’s weekly visits and programme-hours work, the gardening goal and no known drug allergies may be compressed or omitted.
Where candidates slip on this task
- Use 5 November 2026 as the letter date and identify 4 November as yesterday’s cardiology review; describe suitability for assessment without implying unrestricted exercise clearance or guaranteed programme acceptance.
- Keep the two barriers distinct: exertional chest tightness caused the earlier refusal; transport still limits the originally requested centre-based sessions, so home video rehabilitation remains conditional on suitability.
- Keep the focus on rehabilitation access: routine GP follow-up and previously recorded emergency advice are optional background, while the enclosed cardiology review supports reassessment without guaranteeing admission.
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 change since the earlier refusal be explained?
Connect the refusal pending cardiologist assessment with the 4 November findings. Preserve both limits: suitability concerns rehabilitation assessment, and exercise prescription remains with the rehabilitation team. The absence of chest discomfort since 20 October offers supporting context but does not establish unrestricted exercise clearance.
Which details best support the request for home-based video rehabilitation?
Prioritise the lack of public transport and the wife’s inability to drive. The daughter’s unavailable regular transport reinforces this explanation. Tablet access, reliable internet, private space, independent video use and willingness support feasibility; retain the qualification that the programme must assess suitability.
Sources
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