OET Writing for Physiotherapy: referral vs discharge letters
The same patient can lead to two very different letters. A referral asks a colleague to investigate or take over a problem; a discharge letter hands back a patient who has finished treatment. This guide shows physiotherapists how the reader, purpose and emphasis change between the two.
Why the letter type changes everything for physiotherapists
Physiotherapy candidates often ask whether they need a different structure for each letter type. You do not need a template for each one, but you do need to know what each reader is going to do with your letter.
OET Writing and Speaking are profession specific, so physiotherapists write a physiotherapy task. OET describes the Writing task as a document such as a referral, advice, or a letter of transfer or discharge, written from case notes. You have 5 minutes of reading time and 40 minutes to write, with a guide of 180–200 words for the body of the letter.
Both letter types are scored on the same six criteria: Purpose, Content, Conciseness & Clarity, Genre & Style, Organisation & Layout, and Language. What changes is which case notes count as relevant content, because relevance always depends on the reader’s next step.
You are passing a problem you cannot resolve to someone who can: an orthopaedic or sports medicine specialist, a GP, a pain clinic, or another therapist with a different skill set. The letter must justify the request with evidence.
Treatment with you is ending. The reader, often a GP or a community physiotherapist, needs to know where the patient is now, what they should keep doing, and when to act if things change. It is a handover, not a history.
Referral vs discharge: what to emphasise
Use this comparison during your planning minutes. Work through the five rows for the letter type in your task and the structure follows.
- Reader: usually a doctor or specialist who has not seen the patient
- Purpose: request assessment, investigation or a change of management
- Emphasise: the presenting problem, objective findings that show lack of progress or deterioration, treatment already tried and for how long, and the functional impact
- Background: include only history that affects the specialist’s decision, such as diabetes before an injection
- Close with: a specific request, for example review, imaging or an opinion on further management
- Reader: often a GP or community physiotherapist who will continue care
- Purpose: report the outcome of treatment and hand over ongoing management
- Emphasise: current functional status and mobility compared with the starting point, walking aids or equipment, goals achieved or outstanding
- Home exercise programme: the exercises, how often, and for how long
- Close with: follow-up arrangements and clear criteria for re-referral
In both letters, give the starting figure and the current figure rather than every session’s reading. In a referral, the pair shows that progress has stalled. In a discharge letter, the same pair shows what has been achieved.
Practice example: one patient, two letters
This is an invented practice case written by OET with Dr Hesham. It is not an official OET task and does not describe a real patient. The notes are shared; only the outcome after six sessions differs.
- Mr Robert Lane, 66, retired bus driver, right-handed; lives alone in a first-floor flat; plays bowls
- Goals: return to bowls; reach top kitchen shelves
- PMH: type 2 diabetes (metformin 500 mg BD); high cholesterol (atorvastatin); L knee arthroscopy 2015
- Referred by GP 01/08/2026: 3-month history of R shoulder pain, no trauma
- Initial assessment 05/08: active flexion 100°, abduction 80°, passive range near full; pain 6/10; night pain disturbing sleep; external rotation strength 4-/5; cannot lift kettle with R hand
- Treatment 05/08 to 30/09, 6 sessions: education, rotator cuff strengthening, posture advice, activity modification
- Flexion 105°, abduction 85°; pain still 6/10; night pain unchanged
- External rotation strength now 3+/5 (reduced)
- Task: write to Mr Sam Hart, Consultant Orthopaedic Surgeon, Shoulder Clinic, requesting assessment
- Three-month history, no trauma
- Range barely changed (100° to 105° flexion) after six sessions
- Weakness worsening from 4-/5 to 3+/5, with persistent night pain
- Treatment already tried
- Diabetes: relevant if the surgeon considers a steroid injection
Omitted: bowls and shelf goals in detail, the 2015 knee arthroscopy, cholesterol medication, living arrangements.
- Flexion 165°, abduction 160°; pain 1/10; sleeping through the night
- External rotation strength 5-/5; lifting kettle and reaching top shelves; practising bowls
- Plan: continue home exercises 3 times a week for 6 weeks; re-refer if pain or weakness returns
- Task: write to Dr Priya Shah, GP, informing her of discharge
- Starting and current range, pain and sleep: the outcome
- Functional gains: kettle, top shelves, return to bowls
- Home exercise programme with frequency and duration
- Re-referral criteria for the GP
Omitted: diabetes and cholesterol (the GP already manages them), the knee arthroscopy, session-by-session treatment detail.
I am writing to refer Mr Robert Lane, a 66-year-old retired bus driver, for assessment of persistent right shoulder pain and weakness, which have not improved despite six sessions of physiotherapy.
I would be grateful if you could assess Mr Lane and advise on further investigation and management. Please do not hesitate to contact me if you require further information.
I am writing to inform you that Mr Robert Lane, whom you referred with right shoulder pain, has been discharged from physiotherapy today after six sessions, having achieved his treatment goals.
Should his pain or weakness return, I would be grateful if you could re-refer him to our service. Please contact me if you require any further information.
The diabetes note shows the whole principle. In the referral it stays, because it may change what the surgeon does next. In the discharge letter it goes, because the GP already manages it and it does not affect the handover. A note is never relevant on its own; it is relevant to a particular reader and a particular next step.
Common mistakes in physiotherapy referral and discharge letters
Most of these come from writing the same letter regardless of the task. Check your plan against them before you start writing.
Describing all the treatment in detail but never stating what you want the specialist to do. The request belongs in the first paragraph and again at the end.
The reader needs the starting and current figures, plus any clear change in direction, not a table in sentence form.
Range of movement alone does not tell a GP whether the patient can cope at home. Say what the patient can and cannot do, and what mobility aid they use.
"Continue exercises" gives the reader nothing to monitor. Name the exercises or their aim, the frequency and the duration.
A discharge letter should tell the reader what happens next and when to send the patient back.
"ROM", "HEP" and "4-/5" are fine in notes but should be expanded in the letter, for example "range of movement" and "home exercise programme".
For a complete discharge task with a full model answer, see the OET writing sample for physiotherapists.
Official sources
The test facts on this page were checked against these official OET pages on 27 October 2026.
Physiotherapy letters FAQ
Short answers for physiotherapists preparing for OET Writing.
Is the OET Writing task different for physiotherapists?
Yes. OET Writing is profession specific, so physiotherapists write a task based on a physiotherapy workplace situation. The format, timing and six assessment criteria are the same for every profession.
How do I know if the task is a referral or a discharge letter?
Read the task instructions before the case notes. They name the reader and tell you what the letter should achieve, such as requesting assessment or informing the reader that treatment has ended.
Should I include the home exercise programme in a referral letter?
Only briefly, as part of the treatment already tried. In a discharge letter it is central, so give the exercises or their aim, how often and for how long.
Do I need to include every range of movement measurement?
No. Give the starting and current figures so the reader can see the trend. In a referral they show limited progress, and in a discharge letter they show the outcome.
Prepare for physiotherapy Writing with guided practice
The OET course for physiotherapists covers referral and discharge letters, case-note selection and profession-specific feedback, so you can practise the decisions in this guide with correction rather than guesswork.