Outpatient letters 2.1

Supporting Documents


PRSB standards for digital outpatient letters allow clinical information to be recorded, exchanged and accessed consistently across care settings. Best practice for most outpatient letters is writing directly to patients.

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.

The PRSB standard for outpatient letters is designed to improve and standardise the content of outpatient letters so that professionals, patients and carers receive consistent, reliable, high quality information between clinicians and patients.

Watch the video
Freeman Hospital renal consultantDr Ian Logan, explains how the outpatient letter standard has benefited patients he works with who receive regular kidney dialysis.

Version 2.1 - Standard update
This standard has now been updated to version 2.1. Detailed release notes are available outlining the changes. These can be found in the supporting documents link above. The standard has been updated in-line with new PRSB digital medications information assurance.

Supporting documents for the Outpatient letter standard

Implementation Guidance Report - Outpatient Letter Standard v2
This guidance sets out issues identified during the project which relate to the implementation of the headings and sub-headings.

Release Notes V2.1
The Outpatient letter standard has been updated to version 2.1 (Dec 17 2019). V2.1 includes an update to:
- structured dose direction cluster
- structured dose amount
- structured dose timing and dose direction duration.

Previous revisions
Release notes - V2.0
Release notes V1.1

Outpatient example letters V1.7
Clinicians from different specialties were asked to compose example outpatient letters to represent different types of appointments (initial and follow-up, doctor, and AHP led clinics) to demonstrate how the information might be best structured. The letters were quality assured by the PRSB assurance committee.

Information model - Outpatient letter standard
View the standard as a detailed mindmap.

Final report - Outpatient letter standard
The final report outlines the process taken to reach the final standard. This is currently in draft form while we await endorsement.

Safety case report
The combined Clinical Safety Case document sets out the work done to manage clinical safety risks associated with four PRSB transfer of care projects between hospital and general practice. These include the e-discharge summary, mental health discharge summary, emergency care (EC) discharge summary and outpatient letter standards.

Hazard log - excel file
The Hazard Log records both generic and specific implementation hazards identified during the transfer of care projects. It includes associated mitigations and actions as well as guidance for system developers and implementers.

Transfer of care FHIR specifications


  • Royal College of General Practitioners
  • Royal College of Midwives
  • Royal College of Nursing
  • Royal College of Obstetricians and Gynaecologists
  • Royal College of Occupational Therapists
  • Royal Pharmaceutical Society
  • Royal College of Physicians
  • Royal College of Psychiatrists
  • Royal College of Radiologists (Faculty of Clinical Oncology)
  • British Psychological Society
  • Resuscitation Council (UK)
  • Chartered Society of Physiotherapy
  • Institute of Health Records and Information Managers (IHRIM)
  • TechUK