Your NHS GP record is the closest thing you have to a single account of your health. It holds your diagnoses, your medicines, your allergies, your test results and letters from every clinician who has written to your practice. Private care sits outside that record by default – and whether it joins up is largely down to decisions you make.
This guide explains how private video psychiatry and NHS general practice fit together, and where the joins are.
The clinical summary, and where it goes
After an assessment or review, your psychiatrist writes a clinical summary: what was discussed, the diagnosis or working diagnosis, the plan, any medication started or changed, and what happens next. With Happy Clinic, this goes to you, and to your GP with your consent.
Two things follow from that.
The copy sent to you is worth keeping properly. It is your evidence of a diagnosis, useful if you move, change GP, or need to explain your history to another clinician. Save it somewhere you can find it in three years, not just in an inbox.
The copy sent to your GP is what allows the NHS side of your care to see what has happened. Without it, your GP is working from an incomplete picture – which matters most precisely when it matters most, such as when another doctor is about to prescribe something that interacts with what you are taking.
Why consent matters, and what happens if you decline
Sharing information with your GP is your decision, and it is a real one. You may have good reasons for hesitating: worries about employment, insurance, immigration, or simply not wanting a diagnosis on your record.
The General Medical Council’s guidance on remote consultations sets out what doctors are expected to do here. Doctors should ask for consent to obtain information from your GP practice, send treatment details to your GP, and – if you refuse – explore the reasons with you, explain how it affects your care, and document the decision. If you continue to refuse, the doctor has to consider whether treatment can safely go ahead at all.
That last clause is the honest part. Declining information sharing is permitted, but it has consequences:
- Prescribing becomes harder to justify for some medicines, because the psychiatrist cannot verify your physical health history or what else you are taking.
- Shared care becomes impossible. A GP cannot take over prescribing on the basis of a letter they have never received.
- Safety-netting weakens. If something goes wrong between appointments, whoever you turn to locally will not know what you are on.
A useful middle path is to discuss what would be shared. A summary can often be factual and proportionate rather than exhaustive, and it is reasonable to ask what it will say before you agree.
What a GP does with a private psychiatrist’s letter
Less, and more, than people expect. In practice a GP receiving a private psychiatric letter will usually:
- file it in your record, so it is visible to any clinician who opens your notes;
- update your problem list and medication list, if the letter names a diagnosis or a medicine;
- note any monitoring the letter asks for, such as a blood test or a blood pressure check;
- decide whether to act on any recommendation, which is a separate matter entirely.
That last point is the one that causes most friction. A letter from a specialist is a recommendation, not an instruction. Your GP reads it as clinical advice from a colleague and then exercises their own judgement about whether to prescribe, refer or monitor. That is not obstruction; it is how professional responsibility works. A doctor who prescribes is accountable for that prescription.
Who is responsible for prescribing
Responsibility follows the signature, which produces a simple rule: whoever writes the prescription is responsible for it.
| Private psychiatrist | NHS GP | |
|---|---|---|
| Prescription type | Private | NHS |
| You pay | Pharmacy price in full | NHS charge, or exempt |
| Who reviews | The psychiatrist | The practice, with specialist advice |
| Changes to dose | Made by the psychiatrist | Usually referred back to the specialist |
While your psychiatrist is prescribing, they hold responsibility for the medicine, its monitoring and its review. If prescribing transfers to your GP, responsibility transfers too – which is exactly why GPs do not accept the transfer automatically. The guide to prescriptions after an online consultation covers the practical side, including what is included in an appointment fee.
Why a GP may decline to take over
Shared care is voluntary and at the GP practice’s discretion. There is no obligation, and a refusal is not a judgement on you or on your psychiatrist. Practices weigh up:
- whether the medicine is covered by a local shared care protocol – these are agreed area by area, and they vary;
- whether the practice has the capacity and confidence to do the monitoring involved;
- whether the specialist will remain available for advice and review;
- local policy on shared care with private providers, which differs considerably across the country.
ADHD medication is the most common sticking point, because it involves controlled drugs and specific physical monitoring. Some practices accept shared care readily; others decline as a matter of policy.
If your GP declines, private prescribing usually continues with your psychiatrist. That is workable, but it has a cost, so it is worth asking your practice about their approach early – before your dose is stable, not after. The detail is in the guide to shared care with your GP, and the ADHD-specific route is covered in adult ADHD assessment by video.
If you have no GP, or need to re-register
A surprising number of adults are not registered anywhere: people who moved, or were removed from a list after a long absence abroad, or never registered after leaving a family home.
This is fixable, and easier than most people assume. Registering in England can be done online, through the NHS App, or in person at a surgery. According to NHS guidance on how to register with a GP surgery, you need only your name, date of birth and address: you do not need ID, proof of address or proof of immigration status, and you do not need an NHS number, although having one makes your records easier to find. If you have no permanent address you can register using a temporary address or the surgery’s own address. If a surgery refuses to register you, it must write to you within 14 days explaining why.
Without a GP, private video psychiatry can still assess you and, in many cases, treat you – but three things become harder: blood tests and physical checks that need arranging locally, any prospect of transferring prescribing to the NHS, and continuity if you become unwell. Registering is usually the single most useful thing you can do alongside starting private treatment.
Records, and how to see them
Two separate records now exist: the one your private provider holds, and your NHS record.
Your private clinical record is held by the provider. You can ask for a copy of what is held about you; ask the clinic how to make that request and what it involves.
Your NHS record you can increasingly read yourself. In England, the NHS App and NHS website let you view your GP health record, including test results and messages, if you are aged 13 or over and registered with a practice in England – see the NHS page on viewing your GP health record. It is worth looking, because it shows you whether your psychiatrist’s letters have actually arrived and been filed. If something looks wrong or missing, tell the practice.
One practical habit makes all of this easier: whenever a summary is sent, check a few weeks later that your GP record reflects it. Letters do get lost, and the person most motivated to notice is you.
Both sides of your care are meant to be held to the same standards. Appointments arranged through this site are provided by Happy Clinic, which is registered with the Care Quality Commission (CQC), and its psychiatrists are registered with the General Medical Council, just as your GP is. More about the arrangement is on the about page, and the mechanics of an appointment are set out in how it works.
This article is general information, not personal medical advice. If you are worried about your mental health, speak to a doctor. In a crisis call 999 or NHS 111.
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