Medicine · Referral letter · Task 1

Persistent swallowing difficulty

You are a GP at Cedar Medical Centre. Today is 24 September 2026. Using the case notes, write a referral letter to Dr Alice Hume, Consultant Gastroenterologist, Cedar Hospital, 18 Cedar Avenue, Fairford. Request urgent assessment under the supplied pathway without asserting an unconfirmed diagnosis. Write approximately 180-200 words in the body of your letter.

Patient: Daniel Mercer, born 4 May 1961

Case notes

• N01Patient: Daniel Mercer; reviewed 24 September; progressive difficulty swallowing solid food for six weeks; liquids pass without reported difficulty.
• N02Course: initially noticed with bread; now avoids meat; reports unintentional weight loss of 4 kg over six weeks; no vomiting blood reported.
• N03Examination today: comfortable at rest; abdomen soft; no palpable mass recorded; no diagnosis established.
• N04Background: treated hypertension; current medication list attached; no known drug allergies; no previous upper gastrointestinal investigation.
• N05Plan agreed today: urgent gastroenterology assessment via local urgent pathway; specialist to arrange appropriate investigation; no treatment change by GP today.
• N06Patient concern: brother required investigation for similar symptoms; fears cancer; has been told cause not yet established; consent to referral.
• N07Practical: available any weekday; phone number confirmed; prefers direct telephone contact rather than messages through workplace.
• N08Other: accountant; recently replaced car; routine dental check last year.