While referral letters are the most common OET writing task, discharge letters appear regularly — and many nurses lose marks because they treat them the same as referrals. A discharge letter has a different purpose, a different reader, and requires different content selection. This guide explains exactly how to write a discharge letter that scores Grade B.
Referral vs Discharge: The Key Difference
A referral letter asks someone to take action — assess, investigate, or manage a patient. A discharge letter informs someone that a patient has left your care and hands over responsibility. The reader needs to know what happened during the admission, what the patient's current status is, what medications they are on, and what follow-up is needed.
Discharge Letter Structure
1. Recipient and Reference Line
Address the letter to the person named in the prompt (usually a GP or community team). Include 'Re:' with the patient's name, DOB, and the reason for admission.
2. Opening Paragraph
State that the patient is being discharged and give the headline: 'I am writing to inform you of the discharge of Mr. Patel following a five-day admission for community-acquired pneumonia. He was admitted on 18 May and discharged on 23 May 2026.'
🎯 Don't go in blind — 5,000+ candidates have used our AI-graded mocks
Most users discover at least one section they were under-prepared for before they paid for the real exam.
✅ Try a free 5-min demo → — No card, no signup hassle.
💪 See full-length mock packs → — AI scores in 30 seconds.
Notice the structure: who, what happened, when admitted, when discharged — all in two sentences.
3. Body: Admission Summary
Cover three areas in one or two paragraphs:
- What brought the patient in: Presenting complaint and key findings on admission (e.g., 'Mr. Patel presented with a three-day history of productive cough, fever of 38.8°C, and right-sided chest pain. Chest X-ray confirmed right lower lobe consolidation.')
- What was done: Key treatments provided during the admission (e.g., 'He was commenced on intravenous amoxicillin-clavulanate, which was stepped down to oral antibiotics on Day 3 after clinical improvement.')
- Current status: The patient's condition at discharge (e.g., 'At discharge, Mr. Patel was afebrile, oxygen saturations were 97% on room air, and his appetite had returned to normal.')
4. Discharge Medications
List current medications clearly. If medications were changed during the admission, note what was added, adjusted, or stopped. For example: 'Discharge medications include amoxicillin-clavulanate 625mg three times daily for a further five days and paracetamol 1g as required for pain.'
5. Closing: Follow-Up Plan
State the specific follow-up actions needed: 'Please arrange a repeat chest X-ray in six weeks to confirm resolution. A follow-up appointment with the respiratory team has been booked for 20 June 2026.' End with an offer of further information and sign off.
Sample Discharge Letter Opening
Dear Dr. Williams, Re: Mr. Raj Patel, DOB 04/09/1965 — Discharge Summary Following Admission for Community-Acquired Pneumonia. I am writing to inform you of the discharge of Mr. Patel on 23 May 2026, following a five-day admission to the respiratory ward for treatment of community-acquired pneumonia.
Common Mistakes
⚡ Ready to find out if you're at exam-pass level?
Our 100% AI-graded mocks match the real exam format — same timing, same question types, same scoring scale. Over 5,000 nurses and doctors have used them to pass on their first attempt.
👉 Free demo · 💎 Buy a mock pack — start with one, upgrade if you like it.
Trusted by candidates in 30+ countries · 4.6★ user rating · Same-day score reports.
- Including irrelevant history: The GP does not need to know about the patient's appendectomy 10 years ago unless it affected this admission. Select only information relevant to the discharge and ongoing care.
- Omitting discharge medications: This is critical. The GP needs to know exactly what the patient is taking now, including any changes made during the admission.
- Forgetting follow-up actions: A discharge letter without clear follow-up instructions leaves the GP guessing about what to do next.
- Writing it like a referral: Discharge letters inform and hand over — they do not request action in the same way referrals do. The closing should specify follow-up plans, not ask the GP to assess or investigate.
Practise discharge letters alongside referral letters. Many candidates only prepare referrals and are caught off guard when a discharge letter appears on test day. Two or three practice discharge letters are enough to learn the format and content selection differences.