The task
Assume that today's date is 5 November 2026. Mrs Dumlao is being transferred from the community assessment clinic to the acute receiving service today. Her medication history and body map have already been sent securely to Ms Abalos. This is original independent practice material.
You are a registered nurse at the community assessment clinic. Using the case notes, write a transfer letter to Ms Aileen Abalos, Hospital Safeguarding Nurse, Hospital Safeguarding Service, Acute Receiving Service, 24 Hospital Road, SE5 9RS, United Kingdom. Briefly summarise the safeguarding concerns and request a private assessment, safe confidential follow-up and discharge planning alongside the accepted medical 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.
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Which case notes belong in this letter?
Older adult with unexplained injuries: transfer
You are a registered nurse at the community assessment clinic. Using the case notes, write a transfer letter to Ms Aileen Abalos, Hospital Safeguarding Nurse, Hospital Safeguarding Service, Acute Receiving Service, 24 Hospital Road, SE5 9RS, United Kingdom. Briefly summarise the safeguarding concerns and request a private assessment, safe confidential follow-up and discharge planning alongside the accepted medical 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: Mrs Adoracion Dumlao
- DOB: 19/01/1947 (79 yrs)
- Seen: community assessment clinic, 05/11/26; transfer today
Social background
- Lives with adult son; walks with stick; son helps with bathing/shopping
- Usually manages own medicines
- Retired seamstress; enjoys knitting
- Shared telephone at home; son usually answers; no personal mobile available
- Prefers tea without milk
Medical history
- Knee osteoarthritis
- No anticoagulant or antiplatelet medicines; medication history already sent to Ms Abalos
- Appendicectomy 1972; uncomplicated
- Allergies: nil known; included in medication handover
Assessment today
- Today: attended with son for L rib pain
- Observed: bruising across both upper arms
- L lower rib tenderness; skin intact
- Alert; breathing comfortably; observations stable during assessment
- Pt privately: tripped over doorway on 03/11; struck L side
- Pt unable to explain upper-arm bruises
- Neighbour telephoned: alleges son caused injuries; did not witness incident
- Injury cause unconfirmed; body map completed with consent
- Son waited outside during private discussion
Private discussion
- Pt privately: 'Please do not discuss this with my son'
- Pt understands proposed review; agrees to private discussion
- Consents to safeguarding review and treating/safeguarding team sharing; no family disclosure agreed; confidentiality limits explained
Agreed transfer plan
- Receiving registrar accepts transfer today for medical assessment of injuries
- Safeguarding nurse: private review today → assess safety/wishes + coordinate safe discharge plan
- Pt requests no home calls, texts or letters; establish safe follow-up contact directly
- Medication history/body map already sent securely to Ms Abalos
- Discharge destination undecided
- Son complained about clinic waiting time
- Neighbour also criticised son's housekeeping
- Pt reassured; transport arranged with nursing escort
Who is reading, and what do they need?
Ms Aileen Abalos is the hospital safeguarding nurse receiving Mrs Dumlao alongside an already accepted medical assessment. She needs a brief account of the safeguarding concern, the patient's consent boundaries and practical requests for private review, safe contact and discharge planning. Her medication history and body map have already been sent; select only a little additional clinical or support context.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| Registrar's acceptance of today's transfer for medical assessment of injuries | Establishes the medical pathway alongside the safeguarding request. |
| Observed bruising across both upper arms; patient unable to explain it | Describes the finding without assigning a cause; her inability to explain it is useful supporting detail. |
| Patient's private account: tripped over doorway on 03/11; struck left side | Identifies her explanation as a reported account. |
| Neighbour's allegation that son caused injuries; neighbour did not witness incident | Communicates the concern without presenting the allegation as established fact. |
| Consent to safeguarding review and treating/safeguarding team sharing; no family disclosure agreed; confidentiality limits explained | Tells the receiving nurse what has been agreed about review and information sharing. |
| Private review today: safety, wishes and coordinated safe discharge planning | Makes the requested safeguarding actions clear. |
| No home calls, texts or letters; establish safe follow-up contact directly | Provides clear contact restrictions and a practical next step. |
| Discharge destination undecided | Useful optional context for discussing safe options privately; the request for safe discharge planning can convey the necessary action. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Retired seamstress; enjoys knitting | Occupational history and this hobby do not help the receiving nurse assess the immediate concern. |
| Preference for tea without milk | A refreshment preference does not affect the requested assessment or confidential follow-up. |
| Uncomplicated appendicectomy in 1972 | Remote resolved surgery does not explain the current injuries or alter the safeguarding request. |
| Son's complaint about clinic waiting time | Dissatisfaction with waiting does not establish injury causation or mistreatment. |
| Neighbour's criticism of son's housekeeping | This criticism adds no specific evidence about the injuries. |
| Medication negatives, allergy status and confirmation that the medication history/body map were sent | Ms Abalos already has this information; repeating it does not advance the safeguarding request. |
A paragraph plan for this case
Open with the accepted medical transfer and request for today's private safeguarding review. Briefly describe the observed bruising, the patient's fall account and the neighbour's unwitnessed allegation. Add a little useful context, such as rib symptoms or help from her son. Close with consent boundaries, the home-contact restrictions and requests for directly agreed safe follow-up and private discharge planning. The medication history and body map are already supplied.
Where candidates slip on this task
- Attribute the fall account to Mrs Dumlao and the unwitnessed allegation to the neighbour. Observed bruising does not establish who caused the injuries.
- State consent to review and team sharing, and the absence of agreed family disclosure. Reporting that confidentiality limits were explained is sufficient; do not promise absolute secrecy or infer a formal capacity assessment.
- Keep the contact restrictions together: no home calls, texts or letters. Ask the receiving nurse to agree a safe contact method directly with Mrs Dumlao.
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
- Transfer to residential aged care after a stroke: dysphagia and pressure injury transfer letter
- 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
Should the letter identify the son as responsible for the injuries?
Responsibility remains unconfirmed. Attribute the fall explanation to Mrs Dumlao and the allegation to the neighbour, stating that the neighbour did not witness the incident. Describe the bruising as an observed finding.
How should confidentiality and follow-up be selected?
State her consent to safeguarding review and treating/safeguarding team sharing, the absence of agreed family disclosure and that confidentiality limits were explained. Include all home-contact restrictions and ask for a safe contact method to be agreed directly. Detailed medication information and the body map have already been supplied.
Sources
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