The signed discharge plan cancels the earlier request for suture removal. Nora Bell’s letter must request a wound review using the replacement instructions.
Original practice material written by OETify. All people, services and records in this sample are fictional, for writing practice only. By the OETify editorial team.
The signed plan replaces the proposal
Nora’s final plan explicitly replaces the provisional follow-up entry. This replacement belongs to the fictional record; it establishes no general rule about suture care.
| Record | Fictional surgical ward notes |
|---|---|
| Patient and admission | Nora Bell, aged 48, on Copper Surgical Ward following abdominal surgery |
| Earlier provisional entry | Proposed follow-up at Ash Practice for wound review and suture removal; awaiting surgical team confirmation |
| Final signed discharge plan | Surgical team replaces the provisional entry: Ash Practice nurse to review wound and follow the attached dressing instructions; no suture removal requested |
| Specialist responsibility | Surgical clinic will assess the sutures at Nora’s booked follow-up; appointment details accompany discharge documents |
| Current nursing review | Dressing dry and intact; Nora reports discomfort when bending; observations recorded on accompanying chart |
| Discharge decision | Surgical team confirms discharge home today; Nora has written discharge instructions and medication list |
| Requested communication | Practice nurse to send wound review findings to the surgical clinic using the contact route in the plan |
| Patient’s question | Nora asks which follow-up service is responsible for the sutures; ward nurse explained the final plan |
Write the discharge request
You are a nurse on Copper Surgical Ward. Today is 9 October 2026. Write to Ms Karen Mills, Practice Nurse, Ash Practice, 10 Ash Grove, Copperfield. Request the wound review in the signed discharge plan, and make clear which service does each piece of work.
Check whether the earlier provisional entry still applies before you mention it. Decide whether Nora’s question needs repeating once the clinic’s responsibility is explicit. Keep the observed wound condition without presenting it as permission to remove sutures.
Model discharge letter following the replacement instructions
Model letter
Ms Karen Mills
Practice Nurse
Ash Practice
10 Ash Grove
Copperfield9 October 2026
Dear Ms Mills,
Re: Nora Bell, aged 48
Ms Bell is being discharged home today from Copper Surgical Ward following abdominal surgery. Please review her wound and follow the attached dressing instructions, as set out in her signed discharge plan.
Please note that the surgical team has replaced an earlier provisional follow-up entry, so suture removal is no longer requested from your practice. Instead, the surgical clinic will assess her sutures at her booked follow-up appointment. The details of this appointment are included with her discharge documents. Ms Bell asked which service is responsible for her sutures, and the ward nurse has explained the final plan to her.
At today’s nursing review, her dressing was dry and intact. She reported discomfort when bending. Her observations are recorded on the accompanying chart.
The surgical team has confirmed her discharge home today. Ms Bell has received written discharge instructions and a medication list. After your review, please send your wound review findings to the surgical clinic through the contact route given in the signed plan.
Thank you for your assistance with Ms Bell’s care. Should you require any further information, please contact Copper Surgical Ward.
Yours sincerely,
Ana Dela Cruz
Registered Nurse, Copper Surgical Ward
Criterion annotations for a changed instruction
The changed request is the main content decision in this letter.
These notes apply OET’s Writing assessment criteria.
| Criterion | What the model does |
|---|---|
| Purpose | The request for wound review and the attached dressing instructions. |
| Content | Keeps the explicit replacement and the surgical clinic’s role. The weaker letter below quotes a real entry but ignores that it was provisional and then cancelled; accuracy means showing which instruction is still active. |
| Conciseness and Clarity | Nora’s question takes one sentence: it tells the practice she knows the final plan, without retelling the ward conversation. |
| Genre and Style | Records the surgical team’s decision without proposing a different wound plan. |
| Organisation and Layout | The replacement comes straight after the opening request, before current wound observations, so the practice nurse sees the changed responsibility first. |
| Language | “Has replaced” explains the proposal’s status; “will assess” names the clinic’s future work. “She also has a booked surgical clinic appointment” in the weaker version gives no reason why that appointment matters. |
Your revised letter should let Ash Practice find its requested work without consulting the cancelled proposal. Check each instruction against the final signed entry, then check where the review findings should go.
An outdated letter that preserves the wrong request
The following draft copies the provisional entry into today’s request.
Weaker version (do not copy)
Ms Karen Mills
Practice Nurse
Ash Practice
10 Ash Grove
Copperfield9 October 2026
Dear Ms Mills,
Re: Nora Bell, aged 48
Ms Bell is being discharged today after abdominal surgery. Please review her wound and remove the sutures as proposed in the ward notes.
Her dressing is dry and intact, and she reports discomfort when bending. She has received written discharge instructions and a medication list. The observation chart and dressing instructions accompany this letter.
She also has a booked surgical clinic appointment. Nora asked about suture care, and the ward nurse explained her follow-up. Please send your findings to the surgical clinic.
Yours sincerely,
Ana Dela Cruz
Registered Nurse, Copper Surgical Ward
Replace the suture-removal request with the signed plan’s wound review and dressing instructions. Then say that the surgical clinic will assess the sutures, so the practice knows that work is not theirs.