In OET Writing, discharge and transfer letters are not simply exercises in formal English. They are examples of professional healthcare communication, where the reader needs clear and relevant information to continue caring for a patient.
Maintaining the right tone means being formal, objective, concise, reader-focused, and appropriately direct. However, formal does not mean complicated. The most effective OET letters communicate clinical information clearly without unnecessary vocabulary, excessive politeness, or long sentences.
This is particularly important in discharge and transfer letters, where the information priorities are slightly different.
Understanding the Purpose of the Letter
OET Writing commonly includes referral, transfer, and discharge letters. The purpose of the letter should be immediately clear to the reader.
Before writing, identify:
- Who is receiving the letter?
- Why are you writing to them?
- What information do they need?
- What action, if any, is expected from them?
The purpose should then guide the information and tone throughout the letter.
For example, a discharge letter may need to explain the patient’s hospital stay, treatment, current condition, and follow-up requirements. A transfer letter, on the other hand, should help the receiving healthcare team understand the patient’s current condition, treatment, risks, and immediate care needs.
This reader-focused approach is important because OET does not expect candidates to include every detail from the case notes.
The Right Tone for Discharge Letters
A discharge letter communicates information about a patient’s completed hospital care and what needs to happen next. Therefore, the tone should be formal, clinical, informative, and objective.
The letter should generally distinguish between three areas:
- What happened during the patient’s hospital stay
- The patient’s current condition
- What follow-up or ongoing management is required
For example, rather than listing treatment details without context, connect them to the patient’s progress and current needs.
Instead of writing:
The patient was admitted with pneumonia. Antibiotics were given. Oxygen was administered. Temperature improved.
A more professional approach would be:
The patient was admitted with pneumonia and treated with antibiotics and supplemental oxygen, following which their temperature improved.
The second version transforms the notes into connected professional communication rather than reproducing them mechanically.
Keep the Focus on Continuity of Care
The receiving healthcare professional needs enough information to continue managing the patient safely.
Therefore, the discharge letter should make follow-up requirements clear. Depending on the case, this may include:
- medication continuation
- monitoring
- further investigations
- clinical review
- referral
- follow-up appointments
The tone should remain factual rather than emotional or speculative.
Avoid statements such as:
Fortunately, the patient responded very well to treatment and should be completely fine now.
Instead, report the clinical facts:
The patient’s symptoms improved following treatment, and their condition was stable at discharge.
The second version is more appropriate because it reports the patient’s condition without making an unsupported prediction.
The Right Tone for Transfer Letters
A transfer letter has a different information priority. Its purpose is to support the safe transfer of responsibility from one healthcare professional or team to another.
Therefore, the tone should be professional, direct, and cooperative.
The receiving team may need information about:
- the patient’s current condition
- treatment already provided
- relevant risks
- current needs
- important clinical findings
- actions required from the receiving team
The focus should be on what the receiving team needs to know now.
For example:
Mr Smith was admitted three days ago with worsening shortness of breath. He has received intravenous antibiotics and oxygen therapy. His oxygen saturation is currently stable on 2 L/min of oxygen. Please continue to monitor his oxygen saturation and respiratory status.
This is more effective than providing extensive background information that does not affect the patient’s current transfer.
Avoid Unnecessary Background Information
If the receiving professional already has relevant knowledge of the patient, avoid repeating information that does not contribute to the purpose of the transfer.
Ask yourself:
“Does the receiving team need this information to continue the patient’s care?”
If the answer is no, it may not belong in the letter.
This is one reason why copying case notes into a letter is not an effective strategy. OET expects candidates to select and organise information according to the reader’s needs and the purpose of the letter.
Formal Does Not Mean Overly Complicated
One common mistake is assuming that a professional tone requires advanced or complicated vocabulary.
It does not.
OET assesses Genre & Style as part of its Writing criteria, but appropriate professional communication is not the same as unnecessarily difficult English. The goal is to communicate accurately and efficiently.
For example:
Too conversational:
She’s doing much better now, so hopefully everything will be fine.
Too complicated:
In view of the considerable improvement demonstrated in the patient’s overall clinical presentation, it is anticipated that her condition will continue to progress favourably.
Appropriate:
Her condition has improved, and further monitoring is recommended.
The final version is formal, clear, and clinically appropriate without sounding unnatural.
Use Professional Language Without Becoming Impersonal
Professional tone does not mean removing all politeness.
When requesting an action, use language that is polite but direct.
For example:
- Please continue to monitor his blood pressure.
- Please arrange a follow-up review within one week.
- I would appreciate your continued monitoring of her symptoms.
Avoid vague requests such as:
It would be great if you could keep an eye on the patient.
This sounds conversational and does not clearly communicate the required action.
At the same time, avoid excessive politeness that makes a simple clinical request unnecessarily long.
Avoid Informal Language and Contractions
OET recommends formal writing to another healthcare professional. Informal expressions and contractions should therefore be avoided.
| Informal | More appropriate |
| He’s doing better. | He is recovering well. |
| She’s been feeling rough. | She has reported feeling unwell. |
| Please keep an eye on him. | Please continue to monitor him. |
| Things are looking good. | His condition has improved. |
| He can’t manage the medication. | He is unable to manage his medication independently. |
The aim is not to replace every simple word with a more complicated one. Instead, choose language that sounds natural in professional healthcare communication.
Prioritise Facts Over Judgements
OET guidance emphasises objective clinical reporting.
This means separating what the notes establish from what you personally assume or believe.
Avoid:
The patient was clearly careless with his medication.
Prefer:
The patient reported missing several doses of his medication.
The second statement is based on documented information rather than personal judgement.
Similarly, avoid unsupported conclusions such as:
She will definitely recover soon.
Instead:
Her symptoms have improved, and continued follow-up is recommended.
This distinction is particularly important in discharge and transfer letters because the receiving professional needs reliable clinical information, not the writer’s personal interpretation.
Structure Supports the Right Tone
Tone is also influenced by how information is organised.
There is no compulsory OET template, but the letter should be clearly laid out and appropriate for its purpose. A well-structured letter will typically contain three to five paragraphs, including an introduction and the required recommendations or action.
A useful structure is:
Paragraph 1: Purpose
State why you are writing and identify the patient.
Paragraph 2: Key Clinical Information
Present the most relevant information supporting the purpose of the letter.
Paragraph 3: Current Status and Management
Explain the patient’s current condition and relevant treatment or management.
Paragraph 4: Follow-up or Required Action
Clearly state what the receiving professional needs to do.
Not every letter will require exactly four paragraphs. The structure should depend on the case notes and the purpose of the letter.
Within each paragraph, place the most important sentence first, followed by supporting details. This makes the letter easier for a busy healthcare professional to scan.
Discharge vs Transfer: Where Should You Place the Focus?
Although both letters require a formal and objective tone, their priorities differ.
| Discharge letter | Transfer letter |
| Focuses on completed hospital care | Focuses on ongoing care after transfer |
| Summarises treatment and response | Highlights treatment already provided |
| Describes current condition at discharge | Highlights current condition and immediate needs |
| Emphasises follow-up and continuing management | Emphasises safe handover and receiving-team responsibilities |
| Provides information needed for ongoing care | Provides information needed to assume responsibility |
The tone itself does not need to become more or less formal depending on the letter type. What changes is the information you prioritise.
A Simple Final Check for Tone
Before submitting your OET Writing task, ask yourself:
Purpose: Is the reason for writing immediately clear?
Reader: Have I included information that this particular healthcare professional needs?
Tone: Does the letter sound like professional communication between healthcare professionals?
Objectivity: Have I reported facts rather than personal opinions or assumptions?
Clarity: Are my sentences clear without being unnecessarily complicated?
Action: If the reader needs to do something, have I stated it clearly?
Language: Have I avoided contractions, informal expressions, and inappropriate abbreviations?
Organisation: Can the reader quickly identify the most important information?
Final Takeaway
Maintaining the right tone in OET discharge and transfer letters is not about trying to sound overly sophisticated. It is about communicating accurately, professionally, and efficiently.
A strong discharge letter focuses on the patient’s hospital course, current condition, and continuing care. A strong transfer letter focuses on the information the receiving team needs to safely take over the patient’s care.
In both cases, the key principles remain the same: be formal, objective, concise, reader-focused, and clear about any required action.
When you stop treating the task as an exercise in “formal English” and start treating it as a real clinical handover, the appropriate tone becomes much easier to maintain.
