OET letter about safeguarding concerns: how to write to a social worker
When OET Nursing case notes raise a safeguarding concern, such as possible neglect, a carer who is not coping or unexplained injuries, write the concern as observed facts with dates, say who reported what, and avoid accusing anyone. State clearly what you are asking the social worker or other reader to do, such as assess the home situation or review care support, and include any immediate safety steps already taken.
When safeguarding comes up in OET case notes
Some Nursing case notes include worrying social details: an older patient arriving unwashed and underweight, a carer who seems overwhelmed, a child with injuries that do not match the explanation, or a patient who is afraid to go home. When the task asks you to write to a social worker, or when the concern affects the discharge plan, you need to pass this on clearly and fairly.
The key skill is the same as in all OET letters: select the relevant facts and present them so the reader can act. The difference is tone. Safeguarding letters must be factual, specific and non-judgemental. This matters for Genre and Style as well as content.
Real safeguarding procedures vary by workplace and country. This guide is about writing a test letter, not about how to raise a real concern; follow your employer's policy and local law in practice.
Questions to answer before you write
- What exactly was observed, and when?
- Who reported what (the patient, a relative, a neighbour, staff)?
- What is the patient's current condition and capacity, if the notes say?
- What has already been done (for example, a delayed discharge or a referral)?
- What does the patient want?
- What, specifically, do you want the reader to do?
Facts, not conclusions
| Judgemental | Factual |
|---|---|
| "Her son is neglecting her." | "On admission, she was dehydrated and her clothes were soiled. Her son, who is her main carer, said he was finding it difficult to cope." |
| "He is being abused at home." | "He had bruising on both forearms. He said he did not know how it happened." |
| "The house is filthy." | "The paramedics reported that the kitchen had no food and the heating was off." |
| "The mother is a bad parent." | "The child has missed two immunisation appointments and attended the emergency department twice in one month." |
Put the source next to the fact: "the paramedics reported", "her daughter said", "nursing staff observed". This helps the reader judge how reliable each piece of information is.
What to include and what to leave out
| Usually include | Usually leave out |
|---|---|
| The concern, stated early | Opinions about blame |
| Observations with dates | Every daily nursing entry |
| Who reported each fact | Rumours not in the notes as facts |
| Relevant medical condition and needs | Unrelated medical history |
| Current carer and home situation | Hobbies and past jobs, unless relevant |
| Patient's wishes and agreement | Your own feelings about the case |
| Actions already taken | Details already known to the reader |
| A clear, specific request | Vague "please help" |
Worked example (invented case)
Case summary (invented): Mrs Annika Moreau, 84, mild dementia, lives with son (main carer, works night shifts). Brought in by ambulance 2 November after neighbour found her on floor; on floor several hours. Dehydrated, pressure area on hip (red, skin intact), weight 6 kg lower than at GP check 6 months ago. Son says he is "exhausted" and cannot manage alone. Paramedics: little food in kitchen. Patient says she wants to go home but is frightened of being alone at night. Treated with IV fluids, pressure care; now eating with encouragement, walking with frame and one person. Discharge on hold pending social work assessment. Likes music. Task: write to the hospital social worker.
Selection decisions:
- In: concern stated as purpose, long lie and neighbour, dehydration, pressure area, weight loss, son's caring difficulties, food at home, patient's wishes and fear, current needs, discharge on hold.
- Out: music, details of IV fluids, son's job details beyond night shifts.
Sample letter body:
Dear Social Worker,
Re: Mrs Annika Moreau, aged 84
I am writing to request an assessment of Mrs Moreau's care and home situation before her discharge, as there are concerns about whether her needs can currently be met at home.
Mrs Moreau, who has mild dementia, was admitted on 2 November after a neighbour found her on the floor at home, where she had been lying for several hours. On arrival, she was dehydrated and had a red pressure area on her hip. She has also lost 6 kg in the last six months. The paramedics reported that there was little food in the kitchen.
She lives with her son, who is her main carer and works night shifts. He has said that he is exhausted and cannot manage her care alone. Mrs Moreau has said she would like to return home but is frightened of being alone at night.
She is now eating with encouragement and walks with a frame and the help of one person. Her discharge has been postponed until an assessment has been completed.
I would be grateful if you could assess her home situation and her son's ability to provide care, and consider what additional support may be needed. Please do not hesitate to contact me if you require any further information.
Yours sincerely,
No one is blamed. Each concern is an observation with its source, the patient's own wishes are included, and the request tells the social worker exactly what is needed. Because the reader is not clinical, the medical details are kept short and plain: see writing for a non-clinical reader.
Practise timed letters at /writing/, or check a letter you have written to see which case notes you included, missed or added unnecessarily.
Mistakes to avoid
- Hiding the concern. If it is the reason for writing, state it in the opening purpose sentence. See the Purpose criterion.
- Accusing someone. Report facts and sources, not blame.
- Leaving out the patient's voice. Include their wishes if the notes record them.
- Too much medical detail. A social worker needs the impact on care, not lab results.
- A vague request. Say what assessment or support you are asking for.
Related: social history in letters, dementia and delirium letters and sensitive information wording.
Sources
This guide is medEmu's writing advice, not official OET guidance, clinical advice or safeguarding guidance; all patients and situations are invented for practice. In real practice, follow your employer's safeguarding policy and local law. The network used for this run could not reach oet.com or regulators' sites, so no OET test facts are stated beyond the criterion names. For OET's official Writing information, see oet.com.