Seeing a private psychiatrist without a GP referral

Waiting for an NHS mental health appointment can be hard, especially when symptoms are affecting work, sleep or relationships. Some people decide to see a private psychiatrist instead, or as well. In most cases you can do that without asking your GP first.

Self-referral is simple to arrange, but it comes with choices about cost, insurance, prescriptions and your GP. This page explains each one so there are no surprises later.

What self-referral means

Self-referral means you contact a private service and book directly. There is no referral letter and no GP gatekeeper. You fill in the booking details, pay the fee and meet the psychiatrist, often by video.

The person you see will be a doctor with specialist training in mental health. They can assess symptoms, make a diagnosis, prescribe medicine and plan follow-up care. People commonly self-refer for things like persistent low mood, anxiety that isn’t improving, suspected adult ADHD or a second opinion on current medication.

It helps to gather a few things before the appointment: a list of your current medicines and doses, any previous letters or diagnoses, and a short timeline of when your symptoms started. You will also need a private space for the video call.

Self-referral does not replace urgent help. If you are at risk of harming yourself, call 999, go to A&E, or call NHS 111.

Upsides and downsides

Possible advantages

• You decide when to seek help, without waiting for a GP appointment first.
• Private appointments may be available sooner than NHS specialist care.
• You can choose a psychiatrist whose experience matches your concern.
• Video appointments avoid travel and time off work.

Possible drawbacks

• You pay the full cost, and follow-ups add up.
• Medicine on a private prescription is paid for in full, rather than at the NHS prescription charge.
• Your GP won’t automatically have the information unless you agree to share it.
• Your GP is not obliged to take over prescribing later.
• A private service may not offer everything, such as crisis support or a full team of therapists.

Weigh these against how you are coping now. For some people, starting privately and moving to the NHS later works well.

Costs and what is included

Private psychiatry fees vary widely between providers. Before booking anywhere, ask:

• how long the first appointment lasts
• whether a written report or letter is included
• whether a prescription issued in the appointment costs extra
• what follow-up appointments cost and how many are usually needed
• whether tests, such as blood tests or heart checks, are charged separately
• what the cancellation terms are

Happy Clinic’s fees

Happy Clinic is one private option you can book yourself. Its fees are paid in advance.

Any prescription written during one of these appointments costs nothing extra, but you pay the pharmacy separately for dispensing. Fees checked September 2026 — see Happy Clinic’s pricing page for current fees.

Private medical insurance

If you have health insurance, check it before booking. According to the Private Healthcare Information Network (PHIN), insurers typically want a referral from your GP, although some plans increasingly let you refer yourself.

Points to confirm with your insurer:

• Is mental health covered? MoneyHelper notes that cover for mental health isn’t always included.
• Are existing conditions excluded? Conditions you had before buying cover usually aren’t covered, unless you have a group or company policy.
• Do you need pre-authorisation? PHIN advises speaking to your insurer at every stage and getting appointments approved first.
• Is there an excess or an outpatient limit? These can leave you paying part of the bill.
• Does the insurer recognise the provider? Some policies only pay for approved specialists.

Get the answers in writing. If the insurer won’t pay, you can still self-refer and pay yourself.

Keeping your GP informed

You don’t need your GP’s permission to go private. Even so, there are good reasons to keep them in the picture:

• Safety. Your GP knows your other medicines and physical health conditions, which matters if something new is prescribed.
• Monitoring. Some medicines need blood pressure, weight or blood test checks that your GP practice may help with.
• Future prescribing. If you hope your GP will prescribe later, they will need the psychiatrist’s letters.
• A complete record. If you later need NHS care, the full story is in one place.

After an assessment, Happy Clinic writes up a clinical summary for you, and your GP gets a copy too if you say yes.

If you’d rather your GP didn’t know yet, say so at the start and ask the psychiatrist to explain what that means for your care. Some treatment decisions, especially around medicines that need monitoring, are harder to make safely without your GP’s involvement.

Paying for private prescriptions

A private psychiatrist can write a private prescription, which you take to a pharmacy. You then pay the pharmacy for the medicine itself, usually plus a dispensing fee. The NHS prescription charge does not apply, so the price depends on the medicine, the quantity and the pharmacy.

It is worth phoning two or three pharmacies to compare prices and check they have the medicine in stock. Some medicines, including many used for ADHD, are controlled drugs with extra prescribing rules and shorter validity.

If you need the medicine long term, ask the psychiatrist early whether your GP might be willing to prescribe it on the NHS in future. Guidance used by NHS prescribers is clear that a GP does not have to prescribe a recommended treatment if it is contrary to their normal clinical practice.

Moving between private and NHS

Many people use both systems at different times. Guidance from the Department of Health for England sets some ground rules. People who pay for private care should not be put at any advantage or disadvantage in the NHS care they receive. Private and NHS care should be kept as clearly separate as possible.

In practice, that can mean:

• a GP may check whether the medicine is on the local formulary and would have been used on the NHS
• some NHS services may want their own assessment before providing NHS treatment
• for certain medicines, a formal shared care agreement between the specialist and your GP may be needed

Where adult ADHD treatment has settled, Happy Clinic can put a Shared Care Agreement proposal to your NHS GP. The GP decides whether to take it on.

After the first appointment

At the end of an assessment, a psychiatrist usually explains what they think is going on and what they recommend. With Happy Clinic, the plan may include:

• a diagnosis, or a plan to clarify one
• medication, where clinically appropriate, with a prescription issued during the appointment
• advice on therapy pathways, since Happy Clinic doesn’t provide therapy itself
• follow-up appointments to check progress or adjust treatment

You get a written clinical summary. Read it carefully and ask questions if anything is unclear.

If you start a new medicine, expect a follow-up to check how you are getting on. This is the time to mention side effects, doubts or practical problems with taking it. If you disagree with the diagnosis or plan, you can ask for more explanation or seek a second opinion.

How to choose a psychiatrist

A little checking goes a long way:

1. Confirm GMC registration. Search the GMC’s registers. A consultant psychiatrist will normally be on the Specialist Register.
2. Check who regulates the service. Happy Clinic, for example, is regulated by the Care Quality Commission (CQC).
3. Look at what they treat. Make sure your concern is on the list. Happy Clinic, for example, sees adults only and doesn’t assess dementia or write medico-legal reports.
4. Read the fees in full. Look beyond the first appointment.
5. Ask about GP letters and aftercare. Find out what happens if you need a prescription between appointments.

You can meet Happy Clinic’s psychiatrists before you decide.