Outpatient Letter Standard
Due to the rise in the number of specialist services delivered out of hospitals, well-structured outpatient letters have become increasingly important to provide good care. Outpatient letters are the main method of contact and communication between hospital staff and GPs, and are often the sole record of the consultation held by the outpatient department and hospital. Best practice for most outpatient letters is writing directly to patients.Â
The PRSB standard for outpatient letters allows clinical information to be recorded, exchanged and accessed consistently across care settings.
Current release
From 01 January 2026, this standard will be owned and managed by NHS England and is made available for reuse or amendment under the Open Government Licence v3.0 (OGL 3.0). A review of the ongoing requirement for this standard will be undertaken by NHS England. Details on this and any update to the standard will be published on the NHS Standards Directory. If you have any questions or feedback relating to this standard, please email: england.standards.assurance@nhs.net.
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Conformant partners
The following Partners have successfully achieved conformance against the Outpatients Letter Standard.
| Conformant Partner | Conformant System | Version conformant with | Level attained | Valid until |
|---|---|---|---|---|
| Epro | Version 2.2 | 3 | 15.07.2027 |
About this standard
The Outpatient Letters Standard is designed to improve and standardise the content of outpatient letters so that professionals, patients and carers receive consistent, reliable, high-quality information that can be shared between them all.Â
Potential benefits from having interoperable electronic outpatient letters, which reflect the requirements of patients, carers, people being supported in care services and care professionals, are significant.  Watch our video case study to find out more.
Summary table
The Outpatient Letters Standard operates by ensuring that all relevant information is recorded and shared in a structured and coded format. This facilitates seamless communication and continuity of care across different healthcare settings.
Below is a summary table of the standard which comprises 27 sections, 6 mandatory (must be included), 12 required (should be included where the information is available), 9 optional (local choice whether to include the information):
Section | Description | MRO* |
Patient demographics  |  Patient details and contact information.  | mandatory |
GP practice  |  Details of the GP practice where the patient is registered. | mandatory |
Individual requirements  |  Individual requirements that a person has, e.g. communication, cultural, cognitive or mobility needs.  | required |
Participation in research | The details of any research studies participated in. | required |
Attendance details |  The details of the patient contact.  | mandatory |
Referrer details | Details of the individual or team who referred the patient. | required |
History | Information relating to the development of each presenting complaint, and the patient’s relevant health history. | required |
Medications and Medical Devices  | The details of and instructions for medications and medical equipment the patient is using. | optional |
Allergies and adverse reactions | The details of any known allergies, intolerances or adverse reactions. | mandatory |
Legal information | Legal information captured relating to patient care, such as consent to treatment and mental capacity. | required |
Safety alerts | The details of any risks the patient poses to themselves or others. | required |
Social context | The social setting in which the patient lives, such as their household, occupational history, and lifestyle factors. | optional |
Family history | Information on illness in family relations relevant to the health or care of the patient. | optional |
Clinical review of systems | Information gathered on symptoms related to physiological systems. | optional |
Patient and carer concerns, expectations and wishes | A description of the concerns, expectations or wishes of the patient. | optional |
Examination finding | The record of findings from clinical examination. | optional |
Assessment scales | A description of any assessment scales used. | optional |
Diagnoses  | A list of the patient’s diagnoses. | required |
Problems and issues | A summary of the problems that require investigation or treatment. | required |
Case study
Explore our case study to see how the standard is applied in practice. This case study highlights a pilot project with Frimley Health Foundation NHS Trust, in collaboration with Nuance and Epic.
