Physiotherapy — Discharge Letter after Pulmonary Rehabilitation
A physiotherapist writes a discharge letter to the GP following a 70-year-old man's completion of a 6-week pulmonary rehabilitation programme for COPD. This is a beginner case: a clear outcome, a short set of notes, and one ongoing recommendation. Ideal for practising the discharge letter structure before more complex respiratory cases.
Letter type
Discharge
Write to
General Practitioner
Target length
180–200 words
The case notes
Patient: Mr Henry Osei, 70 years old; COPD (GOLD Stage II)
Programme: 6-week hospital-based pulmonary rehabilitation programme (two group sessions per week); completed all 12 sessions
Baseline (pre-programme): 6-Minute Walk Test (6MWT): 280 m; MRC dyspnoea score 3; CAT score 24
Outcome (post-programme): 6MWT: 340 m (+60 m, exceeds 30 m minimal clinically important difference); MRC dyspnoea score 2; CAT score 18 — significant improvement in exercise tolerance and breathlessness
Exercise programme: Home maintenance programme issued: brisk walking 30 minutes five days per week, cycling on static bike if available
Patient understanding: Understands the need to maintain physical activity; attended all education sessions (inhaler technique, breathlessness management, energy conservation); inhaler technique checked and correct
Smoking status: Ex-smoker (stopped 3 years ago)
Recommendation: Annual review by GP; re-refer to pulmonary rehabilitation if condition deteriorates (next 6MWT at annual COPD review)
Task: Write a discharge letter to the patient's GP, Dr Fiona Murphy, summarising the outcome of pulmonary rehabilitation and the ongoing management recommendation.
Writing task
Write a discharge letter to the patient's GP, Dr Fiona Murphy, summarising the outcome of pulmonary rehabilitation and the ongoing management recommendation.
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 6MWT results pre and post, with the change and clinical significance
The outcome data is the core of a rehabilitation discharge letter. The GP needs to know whether the programme worked and by how much. A +60 m change that exceeds the MCID is the clinical conclusion.
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The home maintenance programme: brisk walking 30 minutes five days a week
Pulmonary rehabilitation benefits are lost without ongoing activity. Handing over the specific maintenance programme to the GP means they can reinforce it at the annual COPD review.
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The recommendation to re-refer if condition deteriorates
The GP needs to know when to re-refer. Pulmonary rehabilitation is most effective when repeated at the right clinical trigger, not routinely.
Leave out
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The group session curriculum and education topics in detail
State briefly that education sessions were attended and inhaler technique is correct. The GP does not need the group programme content — they need the outcome.
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Smoking history beyond a brief mention
Ex-smoker for 3 years is one fact worth noting as positive context. A narrative about the cessation journey is not relevant to the discharge summary.
Criterion in focus · Organisation & Layout
A pulmonary rehabilitation discharge letter has a clear three-part structure: (1) the programme completed, (2) the outcomes with data, (3) the recommendation for ongoing management. Beginner candidates sometimes write the recommendation before the outcomes — this loses Organisation & Layout marks because the GP cannot evaluate a recommendation without first reading the results.
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.