Free OET Writing guide · Case notes

OET Writing case notes: what to keep and what to leave out

In OET Writing you get a page of case notes about one patient 5 minutes to read them, then 40 minutes to turn them into a letter. A big part of the mark is choosing well: the reader needs some notes, a few in passing, and not the rest. Below is an invented nursing case with every note sorted, and the reason why.

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Read the task before the notes

Who is the reader? A district nurse, a practice nurse or a specialist each need different things.
What are you asking them to do? That request goes in your opening lines.
For each note, ask: will this reader do anything differently because of it? If yes, include it. If it helps a little, keep it brief. If not, leave it out.
Report where things stand now. A later note often replaces an earlier one, such as oxygen that has since been stopped.

Discharge letter · Nursing

The task

You are a staff nurse on Ward 7 (Respiratory), Riverside General Hospital. Mr Holloway is being discharged home today. Using the information in the case notes, write a letter to Ms Amira Shah, Community Respiratory Nurse, Elmfield Community Respiratory Team, 4 Station Road, Elmfield EL2 9QA, who will visit him at home.

The case notes, sorted for this reader

IncludeKeep briefLeave out

Patient details

Mr Derek Holloway, DOB 03/06/1953 (73 yrs)
Include
Name and date of birth go in the Re: line so the reader knows who the letter is about.
Admitted Mon 19/10/2026. Discharge today, Fri 23/10/2026
Include
The reader needs to know he went home today to plan the visit. The admission date goes in with the reason he came in.
GP: Dr P Okafor, Elmfield Surgery
Leave out
The respiratory nurse isn't being asked to contact the GP, and nothing in her visit depends on it.

Social background

Lives with wife (her own mobility limited by arthritis)
Keep brief
Worth a few words: it tells the nurse he has someone at home but that his wife can't do much physical caring.
2nd-floor flat, lift in building
Keep brief
She is visiting him, and stairs are hard for him, so the lift matters. One phrase is enough.
Retired bus driver
Leave out
It changes nothing about his care.
Smokes 15 cigarettes/day (approx. 40 pack-years); says he wants to stop
Include
Smoking is the most important thing he can change for his COPD, and the nurse is being asked to support him to stop.
Enjoys his allotment; owns a dog
Leave out
Nice to know, but she won't plan anything differently because of it.

Medical history

COPD diagnosed 2019 (FEV1 48% predicted)
Keep brief
She needs a sense of how severe his COPD is. The diagnosis, its year and the FEV1 in a short phrase are enough.
Usual inhalers: LAMA/LABA combination inhaler (unchanged); salbutamol inhaler PRN
Include
She is going to check his inhaler technique, so she needs to know what he uses.
Hypertension: amlodipine 5 mg OD (unchanged)
Leave out
Unchanged and nothing to do with the visit. Some teachers would list current medicines in one short clause; either way, it doesn't need its own sentence.
Appendicectomy 1971; cataract surgery R eye 2022
Leave out
Old history with no bearing on his breathing.
No known drug allergies
Keep brief
Safety information. With no allergies, a short clause is enough.

Admission

19/10: 3 days increasing SOB, cough, green sputum; SpO2 86% on air
Keep brief
One sentence says why he came in. The exact reading on arrival matters less than where he is now.
Controlled O2 via 28% Venturi mask, target SpO2 88 to 92%
Leave out
It has been stopped, so it is overtaken by the later note that he is off oxygen.
Chest X-ray: no consolidation
Leave out
A test result that led to no action for the reader.
Dx: infective exacerbation of COPD
Include
The diagnosis is the reason for the admission and for the visit.
Nebulised salbutamol; prednisolone 30 mg OD and amoxicillin 500 mg TDS, both for 5 days
Keep brief
What matters to her is that both courses finish today, so she isn't expecting him to still be taking them.

Progress

21/10: oxygen stopped; SpO2 90 to 92% on air since
Include
This gives her a figure to compare with when she checks his saturation at home.
22/10: walking independently on the ward; breathless on stairs
Include
How he manages now, which shapes what she checks at home.
Inhaler technique poor: taught to use a spacer with salbutamol; still needs prompting
Include
This is the main thing she is asked to follow up.
Nicotine patch 21 mg/24 h started 21/10; using it
Include
She is supporting him to stop smoking, so she must know what he is already using.
23/10: sputum now clear; apyrexial
Keep brief
Shows the infection has settled. Half a sentence.

Discharge plan

Community respiratory nurse to visit within 48 h: check SpO2 and inhaler technique
Include
The request itself. It belongs in the opening lines, with the details later.
Referred to local stop smoking service; continue nicotine patch
Include
She will follow up the referral and support him to keep going.
Refer for pulmonary rehabilitation once recovered from this exacerbation
Include
A job for the reader, so it must be clear and easy to find.
Advised to seek help if: breathlessness worsens, fever, sputum changes colour
Include
She needs to know what he has been told so she can reinforce it.

From notes to sentences

Four notes from the case, a weak version and a better one.

Note: Inhaler technique poor: taught to use a spacer with salbutamol; still needs prompting

Weak: Inhaler technique poor, taught spacer, needs prompting.

Better: His inhaler technique was poor, so he has been taught to use a spacer with his salbutamol inhaler, but he still needs prompting.

Full sentences, with the link between the facts (so, but) made clear.

Note: 21/10: oxygen stopped; SpO2 90 to 92% on air since

Weak: On 21/10 O2 was stopped and SpO2 has been 90 to 92% on air.

Better: His oxygen was stopped on 21 October, and his oxygen saturation has remained between 90 and 92% on air since then.

Dates and abbreviations written out so the reader never has to decode them.

Note: Smokes 15 cigarettes/day; says he wants to stop. Nicotine patch 21 mg/24 h started 21/10

Weak: He smokes. He wants to stop. He has a patch.

Better: He smokes 15 cigarettes a day and wants to stop. He started a 21 mg nicotine patch on 21 October, and he has been referred to the local stop smoking service.

Notes from different headings combined, because they belong to one topic for this reader.

Note: Prednisolone 30 mg OD and amoxicillin 500 mg TDS, both for 5 days (started 19/10)

Weak: He was given prednisolone 30 mg OD and amoxicillin 500 mg TDS for 5 days on 19/10.

Better: He has completed five-day courses of oral prednisolone and amoxicillin, which finish today.

Reported as it stands now. The doses don't help this reader, the finish date does.

Write a real-format letter

Get your letter marked on all six criteria, with notes on what you kept and what you left out. A free practice day, no card needed.

Abbreviations and terms you will see in case notes

Case notes are full of shorthand. In your letter, write these out unless you are sure the reader uses them too.

In the notes	Means
OD	once a day
BD	twice a day
TDS	three times a day
QDS	four times a day
PRN	when required
NKDA	no known drug allergies
SOB	shortness of breath
c/o	complains of
Hx / PMH	history / past medical history
Dx	diagnosis
Rx	treatment or prescription
obs	observations (temperature, pulse, blood pressure and so on)
SpO2	oxygen saturation
apyrexial	no fever
2/52, 3/7	2 weeks, 3 days
yrs, pt	years, patient

See a whole letter

For a complete example, see a model nurse discharge letter with its case notes or a model nurse referral letter, each with why it works under the six criteria.

OET case notes questions

How long do I get to read the OET Writing case notes?

5 minutes of reading time, when you may read the task and the notes but not write. Then you have 40 minutes to write the letter, and the case notes stay in front of you for the whole time.

Do I have to use all the case notes in my OET letter?

No. Not every note is relevant, and copying them all in costs marks under Conciseness & Clarity. Keep what the reader needs to act on your request or carry on the patient's care, and leave out the rest.

Can I copy sentences from the case notes?

The notes are in note form, and the task asks you not to use note form. Turn each note you keep into a full sentence, write out abbreviations the reader may not know, and join related notes together.

What headings do OET case notes have?

Usually patient details, social background, medical history, then notes on the admission or visits, and a discharge or care plan. The headings change with the setting, so read the task first to know which parts matter most.