Confidentiality and Patient Identity in OET Letters: What to Include

OET Writing simulates real clinical correspondence, and real clinical correspondence lives inside professional standards: patients are identified precisely, sensitive information is shared on a need-to-know basis, and third parties appear only in their proper role.

None of this is a named OET criterion. All of it is scored anyway — through Content (did you select what the reader needs?) and Genre & Style (does this read like a professional clinical document?).

Identifiers: use what the notes give you

A recurring mistake across the 11,000+ letters we have corrected: candidates withhold identifiers out of a vague instinct for privacy, producing letters about “the patient” with no re: line.

Real letters do the opposite. The recipient must be certain who the letter concerns, so clinical correspondence identifies the patient precisely — then never repeats the full identification again.

If the case notes give an identifier, it is there to be used. Leaving the date of birth out of a referral does not make you look discreet — it makes the letter unanchored.

Sensitive details: the need-to-know test

Mental health history, substance use, safeguarding concerns, infectious status — case notes often contain details that feel awkward to transcribe. The test is not comfort; it is whether the reader needs the detail for safe ongoing care.

• A community nurse taking over wound care needs to know about the patient’s alcohol dependence if it affects healing or medication safety.
• A physiotherapist receiving a mobility referral usually does not need the patient’s remote psychiatric history.

Include what changes the reader’s decisions. Omit what does not. This is exactly the selection skill the Content criterion measures — confidentiality thinking and Content thinking are the same discipline.

Third parties: role, not story

Family members, carers and employers appear in case notes constantly. In your letter they appear in their functional role only: “her daughter, who visits twice weekly, will assist with medication supervision.” State what the notes state. Never speculate about family dynamics, and never editorialise (“her son seems unreliable”) — that is a Genre & Style failure dressed as observation.

The professional-tone dividend

Handled well, all of this is invisible: the letter simply reads like it was written by a working clinician. That impression is precisely what Genre & Style rewards — and it is the quality that separates letters that feel trained from letters that feel practised.

For the structural side of professional letters, see our guide to the OET letter format. And if you want a professional eye on whether your own letters strike this balance, our OET writing correction service reviews every letter against all six criteria, including the judgement calls no checklist can settle.