OET Writing: one letter in 45 minutes

10 March 2026

Dear Ms Holt,

Re: Mrs Joan Pritchard, born 14 June 1946

I am writing to refer Mrs Pritchard, a 79-year-old widow who is being discharged home today, for wound care and support with her anticoagulant injections.

Mrs Pritchard was admitted on 3 March after a fall at home, and the following day she underwent a left hip hemiarthroplasty for a fractured neck of femur. Her 12 cm wound is clean and dry, with clips in place, which are due to be removed on 14 March.

She has been prescribed enoxaparin 40 mg subcutaneously once daily for 28 days. Although she has been taught to inject herself, she remains anxious about doing so and would benefit from your supervision until she is confident.

In addition, a grade 1 pressure area on her sacrum is resolving and should continue to be monitored. Her type 2 diabetes is well controlled with metformin.

Mrs Pritchard lives alone in a ground-floor flat and walks with a frame. A neighbour checks on her daily.

I would be grateful if you could check her wound, remove the clips on 14 March and support her with her injections.

Please do not hesitate to contact me if you require any further information.

Yours sincerely,

Alex MorganCharge Nurse, Ward 7

5 October 2026

Dear Mr Deshpande,

Re: Mr Desmond Hartley, DOB: 22/08/1962

I am writing to refer Mr Hartley, a 64-year-old man, for urgent assessment under the suspected lower gastrointestinal cancer pathway, because of rectal bleeding, a change in bowel habit and weight loss.

Mr Hartley has had looser stools four or five times a week for three months, and for the past six weeks he has noticed intermittent bright red blood mixed with the stool. Over the same period he has lost about 6 kg without trying and feels increasingly tired. He has no abdominal pain and no family history of bowel cancer. Examination on 2 October found no abdominal mass, and rectal examination found no palpable mass.

Blood tests that day showed iron-deficiency anaemia, with haemoglobin 98 g/L, MCV 72 fL and ferritin 6 micrograms/L. I have started ferrous fumarate 210 mg twice daily.

He has hypertension, treated with ramipril, and no known drug allergies. He takes no anticoagulant or antiplatelet medication. He understands that the referral is to exclude cancer and is anxious to be seen quickly.

I would be grateful if you could see him urgently and arrange investigation, including colonoscopy, as you think appropriate.

Yours sincerely,

Dr Imogen RuddGeneral Practitioner, Calder Lane Surgery

3 March 2026

Dear Mr Nair,

Re: Miss Chloe Winters, DOB: 02/09/2009

I am referring Miss Winters, a 16-year-old patient, for assessment for surgical removal of an impacted lower left third molar, tooth 38, which has caused three episodes of pericoronitis over the past year.

The most recent episode, in February, presented with pain, trismus and facial swelling, and required a course of amoxicillin and metronidazole in addition to irrigation. Symptoms have now settled, but given the recurrent pattern, further conservative management is unlikely to prevent future episodes.

An OPG shows tooth 38 to be mesioangularly impacted and partially erupted, with food packing distal to 37. Root formation is approximately two-thirds complete, with the apex approaching the inferior alveolar canal, so there is a meaningful risk of altered sensation of the lip, chin or tongue following extraction; coronectomy may be worth considering if the apex is confirmed to abut the canal.

Miss Winters has well-controlled asthma and no known drug allergies. She and her mother are aware of the nerve-proximity risk, and Miss Winters is particularly keen to understand this, as she plays a wind instrument.

I would be grateful if you could assess her for surgical removal and discuss the risks and options in detail with her and her mother.

Yours sincerely,

Dentist

3 September 2026

Dear Dr Hargreaves,

Re: Mrs Patricia Duckworth, DOB: 03/04/1943

I am writing regarding Mrs Duckworth, a regular patient at this pharmacy for her repeat medication, following a drug interaction identified when she presented with a new prescription for clarithromycin.

Mrs Duckworth has taken simvastatin 40mg at night for hypercholesterolaemia since 2014, alongside amlodipine 5mg once daily. On 2 September she brought in a prescription for clarithromycin 500mg twice daily for seven days, issued out of hours for a chest infection. Clarithromycin markedly raises simvastatin plasma levels via CYP3A4 inhibition, increasing the risk of myopathy and rhabdomyolysis, so as an interim safety measure pending confirmation, I advised her to withhold simvastatin for the remainder of the course, and to report any muscle pain, weakness or dark urine immediately. I telephoned the practice the same afternoon and left a message with reception, having been unable to reach the duty doctor.

Mrs Duckworth has remained well throughout, with no muscle symptoms reported at follow-up. Her course finishes on 8 September, after which it should be appropriate for her to resume simvastatin straightaway.

I would be grateful if you could confirm this restart plan is appropriate, and consider an alternative to clarithromycin for any future infections given her ongoing statin therapy.

Yours sincerely,

Pharmacist

25 August 2026

Dear Mr Osei,

Re: Mr Callum Bryant, DOB: 11/06/1994

I am writing to update you on Mr Bryant’s rehabilitation following his right anterior cruciate ligament reconstruction with hamstring autograft and medial meniscal repair, performed on 2 October 2025, and to discharge him from physiotherapy.

Mr Bryant began physiotherapy two weeks post-operatively, with a mild effusion, restricted flexion to 90 degrees and a marked quadriceps lag. Range of movement was regained by six weeks, and closed-chain strengthening began once he was fully weight-bearing. By three months, quadriceps strength had reached 80% of the contralateral limb on isokinetic testing, allowing progression to balance and proprioceptive training.

A return-to-running programme started at five months, followed by agility and change-of-direction work from eight months, once single-hop-for-distance testing reached 88% limb symmetry. At his most recent review, all hop tests exceeded 90% limb symmetry index, and isokinetic quadriceps and hamstring strength were within 10% of the unaffected side. He has resumed full training with his five-a-side team for two weeks without swelling or instability, and reports no difficulty with the ladder work and manual handling his job requires.

I am therefore discharging Mr Bryant from physiotherapy with an independent gym-based maintenance programme, and would be grateful if you could review him for final sign-off.

Yours sincerely,

Physiotherapist

28 July 2026

Dear Dr Whitfield,

Re: Mrs Denise Okoro, DOB: 09/11/1969

I am writing regarding Mrs Okoro, whom you referred for MRI of the lumbar spine to investigate her worsening low back pain and leg symptoms. I regret to inform you that the scan could not be completed on either of two attempts due to significant claustrophobia.

At her first appointment, Mrs Okoro became acutely distressed shortly after entering the scanner and required immediate withdrawal. Following preparation with a coping leaflet, she returned for a second attempt and tolerated slightly longer in the bore before panic recurred, again preventing any sequences from being obtained.

Our unit has only a standard 60cm bore scanner, with no wide-bore or open MRI facility on site. The nearest wide-bore unit is approximately forty miles away, and we are unable to offer sedated MRI locally, as this would require an anaesthetist-led slot that is not currently part of our pathway.

Given that Mrs Okoro’s back pain and neurological symptoms remain uninvestigated, I would be grateful if you could review her imaging pathway, considering referral to a wide-bore or open MRI service, a sedation route, or an alternative imaging modality as appropriate.

Yours sincerely,

Diagnostic Radiographer