The task
This is original independent practice material. Assume that today's date is 6 November 2026. Mr Harte has attended the sleep clinic before his planned inpatient surgery. Allow 45 minutes: 5 minutes for reading and 40 minutes for writing.
You are a registered nurse in the sleep clinic. Using the case notes, write a transfer letter to Ms Yen Quach, Surgical Preassessment Nurse, to support coordination of Mr Hayden Harte's care before admission. Ms Quach already holds his surgical booking details and previous surgical history, but has not received his current sleep-clinic information. Explain the relevant findings and identify the arrangements requiring follow-up. Address the letter to Ms Yen Quach, Surgical Preassessment Nurse, Planned Inpatient Service, 48 Park Road, NW8 7RG. 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?
Obstructive sleep apnoea before surgery: transfer
You are a registered nurse in the sleep clinic. Using the case notes, write a transfer letter to Ms Yen Quach, Surgical Preassessment Nurse, to support coordination of Mr Hayden Harte's care before admission. Ms Quach already holds his surgical booking details and previous surgical history, but has not received his current sleep-clinic information. Explain the relevant findings and identify the arrangements requiring follow-up. Address the letter to Ms Yen Quach, Surgical Preassessment Nurse, Planned Inpatient Service, 48 Park Road, NW8 7RG. 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 Hayden Harte
- DOB: 14/03/1966 (60 yrs)
- Sleep-clinic review: 06/11/26; surgical preassessment booked 10/11/26
- Planned inpatient R total knee replacement: 20/11/26; osteoarthritis
Social background
- Lives with wife; independent with personal care and medicines
- Wife available to transport him and his CPAP equipment
- Retired accountant; prefers routine sleep-clinic appointment letters by post
- Complained receptionist was unfriendly when confirming appointment
Medical history
- OSA confirmed by sleep study in 2023
- Previous loud snoring and daytime tiredness → improved with CPAP
- Allergies: nil known
Current assessment
- Reports CPAP every night, at existing prescribed settings
- Nasal mask; applies and removes independently without assistance
- No recent mask leakage, skin irritation or machine faults
- No recent ↑ daytime sleepiness or other symptom deterioration
- Never smoked; no current cough or respiratory infection symptoms
- Appendicectomy aged 17; uncomplicated recovery
Treatment and progress
- Brought nasal mask and tubing today; machine and power lead left at home
- Sleep clinician today: continue prescribed nightly CPAP before admission
- No CPAP adjustment requested; prescription held by sleep clinic, not yet sent to preassessment; pressure values not included in these notes
- Earlier preassessment questionnaire: no sleeping tablets; today reports GP-prescribed zopiclone PRN, used twice in past month
- Patient asks whether to stop zopiclone before operation
Plan
- Surgical team note: anaesthetic review before admission; assess OSA and sedative use; document postoperative breathing monitoring and analgesia arrangements
- No medicine changes authorised; individual perioperative medicine instructions to come from anaesthetist
- Sleep clinician: bring CPAP machine, nasal mask, tubing and power lead on admission
- Preassessment nurse: coordinate anaesthetic review; confirm complete admission equipment; obtain existing CPAP prescription from sleep clinic; communicate agreed plan to receiving ward
- Postoperative monitoring and analgesia arrangements not yet finalised
- Patient understands review needed; agrees to share sleep-clinic information
- Brother criticised wife's spending during recent family argument
- Sleep clinic remains available for CPAP equipment difficulties
Who is reading, and what do they need?
Ms Quach already holds Mr Harte's surgical booking details and previous surgical history. She needs the current sleep-clinic findings and the updated sleeping-tablet history to coordinate anaesthetic review. Explain what must still be obtained or confirmed before admission, while keeping medicine, monitoring and analgesia decisions with the anaesthetic team.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| Nightly CPAP at existing prescribed settings; continuation advised; no setting adjustment requested. | Establishes current treatment. Combine these related details without inventing pressure values. |
| Earlier questionnaire recorded no sleeping tablets; today reports GP-prescribed PRN zopiclone twice in the past month and asks whether to stop. | Updates information the recipient may otherwise rely on and identifies a medicine question for the anaesthetist. |
| Preadmission anaesthetic review: OSA, sedative use, postoperative breathing monitoring and analgesia arrangements. | Conveys the surgical team's documented request without presenting outstanding decisions as settled. |
| No medicine changes authorised; individual perioperative medicine instructions to come from anaesthetist. | Makes clear who must answer the patient's question before any medicine is altered. |
| Bring CPAP machine, nasal mask, tubing and power lead on admission. | Identifies the complete equipment the recipient needs to confirm for admission. |
| Coordinate anaesthetic review, confirm complete equipment, obtain existing CPAP prescription from sleep clinic and communicate agreed plan to receiving ward. | Turns the outstanding arrangements into practical requests for Ms Quach. |
| Right total knee replacement for osteoarthritis: 20 November 2026; preassessment: 10 November. | Briefly orientates the transfer and gives a useful opportunity to confirm arrangements, although booking details are already held. |
| Manages nasal mask independently; brought mask and tubing today, leaving machine and power lead at home. | Optional practical context distinguishes current skills and today's clinic visit from the complete equipment needed on admission. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Retired accountant; prefers routine sleep-clinic appointment letters by post. | These details do not help arrange the current clinical handover or admission equipment. |
| Complaint about receptionist's manner when confirming appointment. | The service complaint has no documented consequence for surgical preparation or treatment coordination. |
| Appendicectomy aged 17 with uncomplicated recovery. | Ms Quach already holds his previous surgical history; repeating it adds no new information to this focused transfer. |
| Brother criticised wife's spending during a family argument. | The private dispute has no documented bearing on transport, equipment or perioperative care. |
| Previous loud snoring and daytime tiredness improved with CPAP. | Historical benefit may be compressed or omitted when current treatment and symptom stability already convey the useful information. |
| No leakage, irritation, faults, increased daytime sleepiness, deterioration, cough or respiratory infection symptoms; never smoked. | These optional findings can be consolidated; they do not resolve the outstanding anaesthetic arrangements. |
A paragraph plan for this case
Open with the transfer purpose and request for anaesthetic review before admission, using brief surgical context. Summarise current CPAP treatment and selected evidence of stability. Reconcile today's zopiclone history with the earlier questionnaire and identify the patient's unanswered question. Close with anaesthetic responsibility for medicine instructions, monitoring and analgesia planning, complete admission equipment, obtaining the existing prescription and communication to the receiving ward. Add practical support or clinic availability only if useful.
Where candidates slip on this task
- Keep the dates distinct: review on 6 November, preassessment on 10 November and surgery on 20 November 2026. The recipient already holds booking details and previous surgical history.
- Report newly disclosed PRN zopiclone use neutrally despite the earlier questionnaire. Do not advise cessation: no medicine changes are authorised, and individual instructions must come from the anaesthetist.
- Do not invent CPAP pressures or interpret equipment left at home today as lost or faulty. Confirm all admission components, obtain the existing prescription and distinguish pending monitoring and analgesia decisions from agreed instructions.
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 Nursing letter tasks
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- Transfer to a rehabilitation unit after knee replacement complicated by delirium transfer letter
- Below-knee amputation: transfer transfer letter
Your profession's guide: OET Nursing. Layout and structure: OET letter format.
Questions about this task
How much stable CPAP background belongs in this transfer?
Establish nightly use at the existing prescribed settings, then select a brief supporting detail such as stable symptoms or independent mask management. Historical improvement and multiple negative findings need not all be repeated. Numerical pressures are unavailable in the notes; request the existing prescription from the sleep clinic.
How should the changed sleeping-tablet history be handled?
Explain that the earlier questionnaire recorded no sleeping tablets, but Mr Harte now reports prescribed zopiclone twice in the past month. Convey his question about stopping it without answering it yourself. Request the documented anaesthetic review and individual instructions; monitoring and analgesia arrangements also remain unfinalised.
Sources
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