Nurses heading to the UK: your OET letter needs a C+ (300) for the NMC. Here is how to write for it
Published 7 min read
If you are a nurse applying to join the register in the UK, your OET Writing result can hold up your whole application even when your other three scores are strong. The Nursing and Midwifery Council (NMC) asks for at least grade C+ (300 or above) in Writing, and a letter that falls short means booking and paying for the test again. This article explains what that C+ means, why Writing has its own number, and how to practise a clinical letter so it is ready for the level the NMC asks for.
Writing is often the skill that nurses find hardest to judge for themselves. You can count your correct answers in Listening and Reading, but a letter is marked against criteria, so it helps to know exactly what you are aiming for before you sit the test.
What the NMC asks for in OET
The NMC sets its own English language requirements for nurses and midwives who trained outside the UK. For OET, its page says it accepts OET (Nursing) with at least grade B (350 or above) for reading, listening and speaking, and at least grade C+ (300 or above) for writing, and it also accepts OET@Home. You can read the current wording on the NMC page on accepted OET results.
So the requirement is not one overall score. It is four separate results, and Writing is the only one where the minimum is a C+ rather than a B. Requirements can change, so always check the NMC page before you book.
How OET reports your Writing score
OET reports each sub-test on its own. On the OET results page, each sub-test is reported on a scale from 0 to 500 in ten-point increments, and each score is mapped to a letter grade from A (highest) to E (lowest). You can see the scale on the OET results and scoring page.
That means your Writing result might read as a number, such as 300 or 340, with a grade next to it. For the NMC, what matters is that the Writing number is 300 or above and the other three are 350 or above.
The same Writing number in New Zealand
If you are keeping New Zealand open as an option, the Nursing Council of New Zealand also asks for OET 350 or more for reading, listening and speaking and 300 for writing. Its page sets out its own rules for combining results from more than one sitting, so read the Nursing Council of New Zealand English requirements before you plan around them.
Why C+ in Writing is still a real target
A C+ is lower than the B the NMC asks for in the other skills, and some nurses relax about Writing for that reason. That can be a costly mistake. If your Writing result comes back below 300, the strong scores in your other sub-tests do not make up for it, and you may need to sit OET again.
The letter task also has firm time limits. The OET Writing sub-test is one letter task lasting 45 minutes: 5 minutes of reading time and 40 minutes of writing time, as set out in the OET Test Handbook. Nurses who write well at work can still run out of time if they have not practised choosing what to include under that pressure.
What usually pulls a letter down
- Copying the notes in order. The reader of your letter needs the information that matters for the next step of care, not a full history.
- An unclear purpose. If the reader cannot tell in the first lines why you are writing, the letter loses its focus.
- Too much detail. Normal results and old, unrelated events make the letter longer without helping the reader.
- The wrong tone. A letter to a doctor, a district nurse or a care home manager should be professional and polite, without casual phrases or text-message style.
- Grammar that changes meaning. Small errors are less serious than mistakes that confuse dates, doses or who did what.
How to plan a clinical letter in the reading time
The reading time is short, so use it for decisions, not for re-reading every line. A simple routine helps you start writing with a plan.
- Find the reader and the reason. Who is receiving the letter, and what do you need them to do? Write this as a short note to yourself.
- Mark what the reader needs. Go through the notes and tick only the information that helps this reader with this task.
- Group the ticked points. Put them into three or four short groups, such as the current problem, relevant background, current treatment and what happens next.
- Decide the order. The most important information for the reader usually comes first, after a clear opening that states the purpose.
- Leave time to check. Plan to stop writing a few minutes early so you can read the letter once for meaning and once for grammar.
Example: a clear opening and a vague one
Example, vague: "I am writing about Mrs Lin, who has been on the ward."
Example, clearer: "I am writing to refer Mrs Lin, who is being discharged home today following treatment for a chest infection, for continued wound care and medication review by the district nursing team."
The second opening tells the reader who the patient is, why they are receiving the letter and what they are being asked to do. These sentences are examples only; the patient and details are made up.
A study plan built around your Writing target
Practise letters in stages. Early on, take your time and focus on choosing the right information. Later, write under full test timing so the planning routine becomes automatic.
- Week one: selection. Read a set of notes and list what you would include and leave out, without writing the full letter. Compare your choices with the purpose.
- Week two: openings and closings. Write only the first paragraph and the final request for several cases until stating the purpose feels natural.
- Week three: full letters with time. Write complete letters in 40 minutes after 5 minutes of planning, then check them against feedback.
- Final weeks: fix one problem at a time. If feedback keeps pointing to the same issue, such as tone or too much detail, work on that one thing in every letter.
Your Writing practice should sit alongside the other three skills, because the NMC needs all four results to meet its numbers. If you are still deciding which test to take, the article on choosing between OET and IELTS as a nurse compares the two, and the overview of NMC English requirements for IELTS and OET sets both tests' scores side by side.
Practising OET letters on PractiseNow
PractiseNow has OET Writing practice with clinical letters for nursing and medicine, at three levels: Starter, Builder and Exam. Your letters get AI marking against the OET Writing criteria, with an estimated score per criterion, the key ideas you covered and missed, and line-by-line corrections. These scores are practice estimates, not official OET results, and an official result can differ. The free plan gives you the first three Starter sets and the first Builder set of every task type in your test, plus a few AI credits to try the marking. Start free, or compare passes if you need more letters marked.
Once your scores are in, they also belong on your CV for UK employers; Build AI CV has a section for language test results. Some nurses also add their OET results and work history to a candidate profile on Talent Tabloid before they start applying.
Frequently asked questions
Is C+ enough in OET Writing for the NMC?
Yes, the NMC page asks for at least grade C+ (300 or above) for writing, with at least grade B (350 or above) in the other three skills. Check the NMC page before you book, as requirements can change.
Does the NMC accept OET@Home?
Yes. The NMC page on OET says it accepts OET@Home as well as the test taken at a venue.
How long is the OET Writing sub-test?
It is one letter task lasting 45 minutes in total: 5 minutes of reading time and 40 minutes of writing time.
Is an estimated practice score the same as an OET result?
No. Only OET issues the official result that the NMC accepts. A practice estimate helps you see your progress, but it may differ from your real score.
Last checked: 26 October 2026. Test rules and score requirements change: confirm on the official pages linked in this article before you book or apply.
