Tutorial: Building a Referral Letter from Bullet Points

Writing referral letters is one of the most time-consuming administrative tasks in gynaecology. The content is clear in your head. Getting it from your head to a well-structured letter takes longer than it should.

This tutorial shows you how to use an AI tool to convert a rough set of clinical bullet points into a professional referral letter. The approach takes about eight minutes once you are comfortable with it.

The scenario

You are a gynaecologist referring a patient to a urogynaecology service. The patient is a woman in her mid-fifties with stress urinary incontinence following two vaginal deliveries. She has completed a course of pelvic floor physiotherapy without significant improvement. You want to refer her for specialist assessment and possible surgical options.

Step 1: Open the tool and tell it what you need

Open claude.ai or chat.openai.com and start a fresh conversation. Begin by telling the tool its role and the format you want:

You are helping a consultant gynaecologist write a referral letter. 
I will give you a list of clinical bullet points. 
Your job is to turn them into a professional referral letter with clear headings. 
Do not add clinical information I have not provided. 
Do not make recommendations. 
Use a formal but concise tone.

Wait for the tool to acknowledge this instruction. It will typically reply with something like: "Understood. Please share the clinical bullet points."

Step 2: Provide your bullet points

Type or paste your clinical notes as bullet points. Keep them concise and anonymised:

Here are the clinical details:

- Woman, mid-fifties
- Main complaint: stress urinary incontinence — leakage on coughing, 
  sneezing, and exercise
- Obstetric history: two vaginal deliveries, largest birth weight approximately 4kg
- Pelvic floor physiotherapy: completed 12-week supervised programme, 
  minimal improvement
- Urodynamics: not yet performed
- No urgency incontinence symptoms
- No prolapse symptoms on examination
- No significant medical history
- Not sexually active currently
- Reason for referral: specialist urogynaecology assessment, discussion 
  of surgical options
- Urgency: routine

Step 3: Read the first draft carefully

The tool will produce a letter. Here is an example of what it might generate:

Dear Colleague,

Re: Referral for Urogynaecological Assessment

Thank you for seeing this patient, a woman in her mid-fifties, who presents with stress urinary incontinence significantly affecting her quality of life.

Reason for Referral

I am referring this patient for specialist urogynaecological assessment and discussion of surgical management options following failure of conservative treatment.

Clinical Background

The patient reports urinary leakage on coughing, sneezing, and physical activity. She has had two vaginal deliveries, with the largest baby weighing approximately 4kg. There are no symptoms of urgency incontinence or prolapse.

Investigations and Treatment to Date

She has completed a supervised twelve-week pelvic floor physiotherapy programme with minimal symptomatic improvement. Urodynamic studies have not yet been performed.

Examination Findings

Examination revealed no evidence of significant prolapse.

Request

I would be grateful for your assessment of this patient and discussion of her surgical options. This is a routine referral. I would welcome any recommendation regarding whether urodynamic studies should be performed prior to your review.

Yours sincerely, [Your name, title, and contact details]

Read this draft as a clinician. Check: Is every clinical fact accurate? Is anything missing? Is any sentence ambiguous or potentially misleading?

Step 4: Make targeted revisions

Suppose you want to add that the patient has specifically asked about the surgical options available, and you want to note that she is otherwise fit and well for potential intervention. Type a follow-up:

Please add two things: 
1. A sentence noting that the patient is fit and well and would be a candidate 
   for surgical intervention if appropriate.
2. A sentence noting that she has been informed that surgical options will be 
   discussed at the referral appointment, and is keen to explore them.

The tool will revise the letter. Read the new version. If it has placed these additions in an awkward position, ask it to move them: "Move the sentence about surgical fitness to the end of the Clinical Background section."

Step 5: Adjust the tone if needed

If the letter feels slightly stiff or reads like it was written by a committee, try:

The letter reads a little formal. Slightly warm the tone — 
as if written by a senior colleague to another senior colleague. 
Keep all the clinical content.

The tool will soften the language without losing the structure.

Step 6: Copy into your clinical system and add identifying details

Copy the final draft. Paste it into your letter template in your clinical system or word processor. Now add:

• The patient's name and date of birth
• The patient's address and contact details
• The referring clinician's name, title, GMC number, and contact details
• The receiving clinician or service name and address
• The date

These details must never go into the AI tool. They go in here, in your own system, on your own computer.

Step 7: Check and send

Read the completed letter from top to bottom. Check that nothing in the AI-generated sections has inadvertently introduced information that does not apply to this patient — occasionally the tool adds phrases that fit the general template but not the specific case.

Sign or authorise the letter as you normally would, and send.

What the tool does badly

The tool cannot check whether the referral is clinically appropriate — that is your clinical judgement. It cannot flag if the referral criteria for your local urogynaecology service require specific prior investigations. It does not know whether your department's standard letter format looks different from the one it has produced.

It also occasionally over-explains in formal letters — adding a sentence of context that a receiving colleague does not need. Read for concision. Delete anything that does not add clinical value.

Building good habits

Keep a short text file or note with two or three bullet-point prompts you use regularly — one for each type of referral you send most often. Over time, you will refine these into prompts that consistently produce near-final drafts with minimal editing. The investment of ten minutes now saves several hours per month.

Remember: AI is a helpful assistant, not a clinician. You make the call.