The difference between a discharge letter and a transfer letter in OET can be answered with a single query: To whom are you sending the patient, and what is the next step that you need to take? A discharge letter sends a stable patient back to the community or home, so it is constructed based on aftercare. On the other hand, a transfer letter transfers an unstable patient to a different unit within the hospital, which means it should be written based on the “chief complaint and current condition.”
Get that single idea right and half of your Writing problems disappear.
The Writing subtest is where most nurses and doctors get stuck. Reading and Listening have answers you can mark right or wrong. Writing does not. It judges your clinical thinking, your choice of information, and your ability to write to one named person who has a very specific job to do.
The usual failure looks like this. The clock starts, and the candidate sees three pages of case notes, panics, and copies them in date order from the first line to the last. Every observation goes in. Every routine reading goes in. Forty five minutes later, there is a letter that reads like a diary instead of a handover. Under the OET assessment criteria, that letter drops marks under Purpose, Content, and Conciseness & Clarity all at the same time.
This guide covers what each letter is for, who reads it, what stays in, what gets cut, and how to lay both of them out.
Your Reader Decides Everything in the Writing Sub-Test
Your reader decides what goes into the letter, what stays out, and how formal your tone should be. Nothing else does.
Most candidates read the case notes first and the task last. Flip that. The OET writing sub-test strategies that actually work start with the five minutes of reading time, and the first thing you should do with those five minutes is turn to the writing task at the very end of the booklet. Read the name of the target reader and the address before you read a single case note. Everything after that becomes a filter.
Ask yourself three things:
- Is the reader a general practitioner who already knows this patient’s background? Then you do not need to explain the full history again.
- Is the reader a specialist who only cares about the acute problem in front of them? Then old surgeries and social details are noise.
- Is the reader a community nurse who has to dress a wound in the patient’s living room? Then wound size, dressing type and frequency matter more than anything that happened on day two of the admission.
This single habit changes your case notes selection OET Writing approach completely. Instead of asking “did this happen?” you start asking “does my reader need this to look after the patient?” Only the second question earns marks.
Our Base camp, a five-day orientation, does not begin with grammar. It begins with reading tasks and identifying recipients, because a grammatically perfect letter written to the wrong person still fails.
What Is an OET Discharge Letter?
A discharge letter will be produced only after the patient completes his/her active treatment in your organization and he/she is medically stable and is being discharged to his/her home, to a nursing home or back to the care of his/her family physician.
The audience is not interested in knowing what happened on the third day, but they want to know what their duties are starting tomorrow.
What to include
- Discharge medications
- Follow up appointments, with dates and the department involved
- Wound care instructions, including dressing type and how often to change it
- Dietary restrictions and fluid limits
- Mobility status and aids
- Social factors that affect recovery, like living alone or stairs at the entrance
What to summarise
The hospital stay itself. You do not need daily temperature readings or a list of every nursing intervention. One or two lines will do. Something like “During admission she was treated with IV antibiotics and responded well” carries the whole stay.
What to leave out
Anything that has already been resolved and has no effect on home care. An abnormal potassium level on day one that was corrected by day two is not relevant. A normal blood pressure reading from three days ago is not relevant either.
The typical reader for this letter is a Community Health Nurse, a GP, a social worker, or a care home manager. That is why “how to write an OET discharge letter” is really a question about planning, not reporting.
If you want a working OET discharge letter format, the shape is simple. Introduction, brief background, short summary of treatment, condition at the point of discharge, and then a clear discharge plan. The plan should be the longest and most detailed part of the letter, because it is the only part your reader will act on.
What Is an OET Transfer Letter?
Transfer letters are issued when the patient is under your care and requires something that you are unable to give him/her. This includes transferring the patient to the ICU, to the tertiary hospitals, to rehabilitation facilities, or to some other ward equipped with suitable equipment.
Here the tone shifts. The urgency of care is the whole point of the letter. Your reader is often going to receive this patient within the hour.
What to include
- The reason for transfer, stated clearly in the opening paragraph
- The chief complaint and how the current episode developed
- The latest vital signs, with actual figures
- Medications already given today, with times and doses, so the receiving team does not double dose
- Investigations already done and any results available
- Current mobility, consciousness level, and oxygen requirement
- What you need the receiving team to do on arrival
What to summarise
Relevant medical history, if a patient is being transferred with chest pain, the previous MI and the diabetes matter. The knee replacement from 2014 does not.
What to leave out
Long term lifestyle advice like diet plans and exercise goals will be in a discharge letter, not in a transfer letter for a patient who is being wheeled into an ambulance.
A good OET transfer letter sample for nurses always reads like a handover at the bedside. Short sentences. Concrete numbers. No decoration.
One more habit helps here. Put the most alarming clinical fact where the reader will see it first, not buried in paragraph three. If the patient dropped their oxygen saturation to 84 percent an hour ago, that belongs near the top of the letter.
Referral Letter vs Discharge Letter: A Quick Note
Candidates often mix up all three letter types, so it helps to separate them in one line each.
- A referral letter asks another professional to assess or investigate a patient who is usually in the community. It ends with a request.
- A transfer letter moves a currently admitted patient to another facility for continued acute care. It ends with immediate actions.
- A discharge letter releases a stable patient into ongoing care. It ends with a plan.
The referral letter vs. discharge letter confusion costs marks under Genre & Style, because the polite request language of a referral sounds odd when the patient is already stable and going home.
Structure and Layout Compared, Paragraph by Paragraph
The two letters share an opening formula and almost nothing else. Here is how the bodies differ.
Discharge letter structure
- Introduction: Patient name, age, admission and discharge dates, diagnosis, and why you are writing. Usually one or two sentences.
- Background: Relevant history and how the admission started.
- Hospital treatment: A short summary. Two or three lines at most.
- Condition at discharge: How the patient is right now. Wound clean and healing, mobilising with a frame, eating independently.
- Discharge plan: The longest section. Medications, diet, wound care, follow-up, and anything the reader must arrange.
Transfer letter structure
- Introduction: Patient name, age, current diagnosis, and the reason for transfer. State the urgency here.
- Current acute situation: The longest section. What happened today, latest observations, and deterioration timeline.
- Treatment given so far: Drugs, doses, times, oxygen, fluids, any procedure done.
- Relevant history: Only what connects to the acute problem.
- Action required: What the receiving team should do on arrival.
Notice the inversion. In a discharge letter, the weight sits at the end. In a transfer letter, the weight sits near the beginning. Same word count, opposite centre of gravity.
We teach this in our OET writing course using a technique we call Blank2Brilliant, which takes a candidate from a blank page to a full letter plan in under six minutes. Candidates map the case notes into these five boxes before they write a single sentence. It stops the panic writing that eats the clock.
Common Mistakes That Keep Candidates Below Grade B
- The chronological trap
The case notes are dated, so candidates write in date order. Do not. Group information by theme instead. History goes together. Treatment goes together. The plan goes together. Chronology is the format of the notes, not the format of the letter.
- Memorised templates
A rigid opening sentence used for every letter type is easy to spot and easy to penalise. If your first line for a transfer letter sounds identical to your first line for a discharge letter, one of them is wrong. The Genre & Style criterion exists exactly to catch this.
- Over inclusion
Every extra sentence dilutes the letter. If a piece of information does not change what your reader does, cut it. Assessors reward the letter that says less and says the right things.
- Burying the reason for writing
Your purpose should be visible in the first two sentences. If the assessor has to read to paragraph three to work out why the letter exists, you have already lost marks under Purpose.
- Copying case note abbreviations
Case notes are written in shorthand. Letters are not. “SOB on exertion” becomes “shortness of breath on exertion.” Expand everything.
- Writing to nobody in particular
Some candidates write a letter that could be sent to any healthcare worker. It reads safely, includes a bit of everything, and scores badly. A letter written for a community nurse should sound different from one written for an emergency physician. The vocabulary changes, the level of clinical detail changes, and the closing request changes with it.
How We Train This at Tiju’s Academy?
We are the best OET academy in Kerala because we do not treat Writing as a grammar problem. We treat it as a decision-making problem.
Our online OET classes are built around a set of methods we developed after correcting thousands of letters:
- Base check, a diagnostic assessment that tells you exactly which criterion is holding your grade down before you waste months on the wrong module
- 250in60, our writing correction system, where your letter comes back marked against the official CBLA criteria with every wrongly included or omitted case note highlighted
- Testfinity, unlimited mock tests taken under real exam conditions and timing
- 40in60 for reading and Listenlock for detailed listening explanations
- Word savvy and Read savvy for medical vocabulary and text handling speed
- Fluent sphere and Brain spark for speaking fluency and fast idea generation in role plays
- TenX, our final exam batch, and Mic drop day, a full readiness session the day before your test
- 4 in 1, a single session covering strategy for all four sub-tests
You also get a target grade roadmap, daily practice tasks, progress tracking, live and recorded lessons, and a peer group of nurses sitting the same exam. That combination is why candidates searching for the best OET online course for nurses keep landing with us. Whether you want structured OET online coaching or self paced practice with feedback, Tiju’s Academy OET programmes are built for working nurses with limited study hours.
Ready to Fix Your Writing Score?
Knowing the difference between a discharge letter and a transfer letter in OET is the starting point. Applying it under a 45-minute clock, with unfamiliar case notes and exam nerves, is a different skill. You cannot build it by reading alone. You build it by writing letters and having someone competent tell you exactly what you got wrong.
At Tiju’s Academy, we provide unlimited OET writing correction. Our tutors mark your letters against the official CBLA criteria, point out every case note you should have dropped or kept, and show you how to restructure it.
Explore our OET coaching packages and send in your first letter for correction this week.
