OET update letter: how to inform a doctor or nurse about a patient's progress
An update letter tells a health professional who already knows the patient what has changed since they last saw them, so start by naming the patient and the change, then give only the new information (condition, results, treatment changes) and finish with what you want the reader to do, even if that is only to note the update or review at the next appointment. Do not retell the history the reader already has; one sentence of background is usually enough.
When a letter is an update
Not every OET Nursing task is a referral or a discharge. Some tasks ask you to write to someone who already knows the patient (the GP who referred them, a specialist nurse, a clinic) to inform them of progress, a deterioration, a result or a change of plan. The same criteria apply, but one thing changes sharply: the reader already has the background. Retelling it is a Conciseness & Clarity problem, and it can hide the update itself, which weakens Purpose.
What changes compared with a referral
| Referral to a new reader | Update to a reader who knows the patient | |
|---|---|---|
| Opening | Who the patient is and what you are asking | Who the patient is, how the reader knows them, and what has changed |
| Background | Enough for a stranger to take over | One sentence, or none |
| Main body | Full relevant history, findings, medications | Only new findings, new or changed treatment, new concerns |
| Medications | Current list of relevant drugs | Only changes since the reader's last contact |
| Closing | Request for assessment or care | Request to note, continue, review or respond |
Use the reader test from case-notes selection: if the reader wrote the original referral, they do not need you to repeat it.
A paragraph plan
- Purpose and change: "I am writing to update you on…, as…"
- What has happened: the new findings or events, in time order.
- What has been done: treatment changes, new referrals, education given.
- What happens next and the request: the plan, and what you want the reader to do.
Short notes may combine paragraphs 2 and 3. See Organisation & Layout for more on paragraph order.
Opening sentences for update letters
- "I am writing to update you on Mr Garcia, whom you referred to our heart failure clinic on 5 March, as his breathlessness has increased over the past fortnight."
- "I am writing to inform you of the progress of Ms Abebe, who attended our diabetes education programme following your referral."
- "Further to my letter of 12 April, I am writing to let you know that Mrs Brennan's wound swab has grown Staphylococcus aureus."
Each sentence links to the reader's previous involvement and names the change in the same sentence. More patterns are in opening sentence examples.
Worked example (invented case)
Case summary (invented): Mrs Helen Chen, 72, referred by her GP, Dr Faisal Rahman, to the community nursing service in March for a venous leg ulcer, right ankle. Background in notes: hypertension, osteoarthritis, lives with husband. Weekly dressings since March; ulcer reducing until last week. 3 July: ulcer larger (4 cm to 5.5 cm), more exudate, surrounding redness, pain 6/10 (previously 2/10). Temperature 37.9 °C. Swab taken 3 July. Compression bandaging paused. Dressings increased to three times weekly. Task: write to Dr Rahman updating him and requesting review for possible antibiotics.
Selection: hypertension, osteoarthritis and the home situation are already known to the GP and do not change the request, so they are cut. The March-to-June healing is reduced to one clause.
Sample letter body:
Dear Dr Rahman,
Re: Mrs Helen Chen, aged 72
I am writing to update you on Mrs Chen, whom you referred to our service in March for a venous leg ulcer on her right ankle, as the ulcer has shown signs of infection over the past week, and to request your review.
The ulcer had been reducing in size with weekly dressings until last week. However, on 3 July it had increased from 4 cm to 5.5 cm, with more exudate and redness of the surrounding skin. Her pain has risen from 2/10 to 6/10, and her temperature was 37.9 °C. A wound swab was taken on the same day, and the result is awaited.
We have paused her compression bandaging and increased her dressings to three times a week.
I would be grateful if you could review Mrs Chen this week and consider whether antibiotics are required. We will forward the swab result as soon as it is available.
Yours sincerely,
Notice the comparisons ("from 4 cm to 5.5 cm", "from 2/10 to 6/10"): in an update, the change is the content, so give the before and after.
Common mistakes in update letters
- Retelling the whole history the reader wrote in their own referral.
- Hiding the change in the second or third paragraph.
- No request. "For your information" alone often misses what the notes imply.
- Listing unchanged medications. Give only what has started, stopped or changed; see medications in your letter.
- Tense confusion. Present perfect for changes up to now, past simple with a date; see the Language criterion guide.
Practise and check
Write an update version of any case on the practice page by imagining the reader already received a referral, or paste your own update letter and its case notes into the letter checker. medEmu checks referral, discharge and transfer letters and other letter tasks such as updates, and its grade is an estimate for practice, not an official OET result.
Sources
This guide is medEmu's writing advice, not official OET guidance; the patient and case notes are invented. The network used for this run could not reach oet.com, so no OET test facts (such as the list of letter types) are stated here as official. For the official Writing test format and assessment criteria, see oet.com.