Physiotherapy — Discharge to Community Physio after Total Hip Replacement
An inpatient physiotherapist discharges a 68-year-old woman to the community physiotherapist on day 7 after a total hip replacement. The discharge letter must hand over the hip precautions, the current functional status, and the home programme — the community physiotherapist must be able to plan the next session from this letter alone.
Letter type
Discharge
Write to
Community Physiotherapist
Target length
180–200 words
The case notes
Patient: Mrs Patricia Cunningham, 68 years old
Procedure: Left total hip replacement (posterior approach) — day 7 post-op; unremarkable recovery
Hip precautions: Posterior hip precautions for 12 weeks: avoid hip flexion >90°, no internal rotation, no adduction past midline; patient demonstrates understanding and compliance
Mobility: Ambulant with a single-point stick indoors; requires supervision on stairs (one rail, one step at a time); independent on level ground
Pain: Mild resting pain; NRS 3/10; managing with regular paracetamol and PRN ibuprofen — does not limit activity
Home exercise programme: Issued and practised: hip abductor strengthening (clam and abductor squeeze), knee extension, ankle pumps, gentle hip extension — all in hip precaution range; patient performs independently
Equipment: Single-point stick (patient's own); raised toilet seat (10 cm, issued); sock aid and long-handled shoe horn issued
Goals: Progress to independent mobilisation without stick by week 8; return to driving by week 6 (subject to surgeon clearance); resume swimming by week 12
Surgeon review: 4-week outpatient orthopaedic review booked
Task: Write a discharge letter to the community physiotherapist, Ms Laura Greene, summarising Mrs Cunningham's functional status and providing guidance for ongoing rehabilitation.
Writing task
Write a discharge letter to the community physiotherapist, Ms Laura Greene, summarising Mrs Cunningham's functional status and providing guidance for ongoing rehabilitation.
What to include, what to cut
The hardest mark to win is selection. The same case notes contain decision-relevant facts and distractors. Here is what an examiner expects to see in a Grade B letter for this scenario, and what should be left out.
Include
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The hip precautions and their 12-week duration
A safety-critical handover — if the community physiotherapist does not know the precautions, they could prescribe exercises or activities that cause dislocation. This is the single most important item in the letter.
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Current mobility: single-point stick indoors, supervised on stairs
The community physiotherapist's starting baseline. The rehabilitation progression — from stick to independent — must begin from the actual current level.
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The home exercise programme already issued and that she performs it independently
The community physiotherapist builds on the existing programme, not duplicates it. Knowing she is already independent with the exercises tells them where to advance.
Leave out
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The analgesic regimen in detail
Pain is well-controlled and does not limit activity. State this in one line; the specific drugs and doses are for the nursing and medical discharge summary, not the physiotherapy handover.
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The surgeon review date
An orthopaedic milestone for the medical team. The community physiotherapist works within the 12-week precaution window; the specific surgical review date does not change their session plan.
Criterion in focus · Content
Physiotherapy discharge letters to community colleagues are graded on functional specificity. 'Good mobility' is not a baseline; 'ambulant with a single-point stick indoors, supervised on stairs' is. Examiners check whether the community physiotherapist could write a session plan from the letter — vague functional descriptions fail this test.
Now write the letter — and find out what is blocking your Grade B
Write a 180–200 words discharge letter from these notes, paste it into the free checker for an instant read, then submit it for a human grade against all six criteria. Dr Mariam's team returns line-by-line feedback, from $12.