One country, four health systems
The UK has one currency and one passport, but not one health service. England, Scotland, Wales and Northern Ireland each run their own public health care. In Northern Ireland it is called Health and Social Care (HSC) rather than the NHS.
For most people this only becomes obvious when something crosses a border. You might live in Cardiff with a GP there, but see a specialist based in England. You might study in Glasgow while your family GP is in Belfast. Video consultations make these situations more common, because the distance between you and the doctor stops mattering.
This page looks at telepsychiatry nation by nation: how the public services use video, how private online psychiatry fits in, and the practical differences in prescriptions, regulation and urgent help.
Video appointments in the NHS
All four health systems use video for some appointments. Whether you are offered one depends on your local service and whether video suits your situation.
England. The NHS website explains that GP practices and other health professionals may offer video consultations. You need a smartphone, tablet or computer with video calling, an internet connection, and somewhere private, quiet and well lit. If the video fails, they will try a phone call instead. NHS Talking Therapies, which many adults can refer themselves to, can also be delivered through a video or phone call, or an online course.
Scotland. Near Me is the video consulting service administered by the Scottish Government and NHS Scotland. It is widely used across NHS Scotland and other public services. There is no app to download and no account to create. You join through a link from your service at your appointment time.
Wales. The NHS Wales Video Consultation Service was rolled out nationally as part of the Welsh Government’s response to the Covid pandemic. It uses a product called Attend Anywhere in primary and secondary care.
Northern Ireland. Health and social care trusts also offer some appointments by video. The Belfast Trust, for example, publishes patient guide videos about its video consultations.
In every nation, NHS psychiatry usually needs a referral, often from a GP. Video is a way of attending, not a separate route in.
Private online psychiatry UK-wide
Private telepsychiatry works differently. You book directly and pay for your care, and the service is not tied to any one NHS boundary.
A few things stay the same wherever you live:
- Doctors are regulated UK-wide. The General Medical Council registers doctors to work across the whole UK. A psychiatrist in one nation can hold the same registration as one in another.
- Your GP can still be kept informed. A letter can reach a GP practice in any nation, if you agree.
- Shared care is always the GP’s choice. Some people hope to move prescribing to their NHS GP after private treatment. Local arrangements differ, and a GP does not have to agree.
Some things are worth checking because they can vary:
- Which nations the service accepts patients from.
- Whether any prescriptions will be issued on paper and posted, or sent another way.
- Which regulator the service is registered with.
If you move between nations. Students, people working away and those relocating often change nation part way through treatment. Tell your psychiatrist about the move before it happens, not after. Register with a GP in your new area as soon as you can, and give the service the new practice details so letters reach the right place. If you have a shared care arrangement, it will not transfer automatically; your new GP will need to consider it afresh. Plan ahead for prescriptions too, so you are not left waiting for a form to arrive at an old address.
Prescriptions across the borders
For most medicines, a private prescription is simple: you take it to a pharmacy and pay the pharmacy’s price. Controlled drugs are different, and this matters in psychiatry because some medicines used to treat mental health conditions fall into this group.
Special forms by nation. Private prescriptions for Schedule 2 or 3 controlled drugs dispensed in the community must be written on a standard form. Community Pharmacy England lists the forms for each nation:
- England: FP10PCD
- Scotland: PPCD(1)
- Wales: WP10PCD or WP10PCDSS
- Northern Ireland: PCD1
Crossing into England. Community Pharmacy England states that private prescriptions for Schedule 2 or 3 controlled drugs issued in Scotland, Wales or Northern Ireland can be dispensed by a pharmacy based in England.
Crossing into Northern Ireland. Guidance from the Business Services Organisation in Northern Ireland tells pharmacies what to do with private Schedule 2 or 3 prescription forms issued outside Northern Ireland once dispensed: they must be submitted to the BSO.
A short shelf life. Prescriptions for Schedule 2, 3 and 4 controlled drugs are only valid for 28 days after the appropriate date.
If you live in Scotland or Wales and your prescriber is elsewhere, phone your pharmacy before sending a prescription. Ask whether they can accept it and whether they can order the medicine. Never change or stop a medicine without talking to your prescriber first.
Who regulates care in each nation
Doctors answer to the GMC wherever they work. Organisations that provide independent healthcare are overseen by a different body in each nation.
| Nation | Regulator of health services | What it covers |
|---|---|---|
| England | Care Quality Commission (CQC) | Registration is a legal requirement for providers of regulated activities in England |
| Scotland | Healthcare Improvement Scotland | Independent hospitals, independent clinics and independent medical agencies |
| Wales | Healthcare Inspectorate Wales | Independent hospitals, clinics and medical agencies, among other services |
| Northern Ireland | Regulation and Quality Improvement Authority (RQIA) | Monitors and inspects health and social care services |
Healthcare Improvement Scotland says private clinics in Scotland must be registered with it, and it publishes a report after each inspection.
An online service may treat people in several nations. If it is not clear which regulator oversees a service, ask. The Care Quality Commission (CQC) regulates Happy Clinic, for example.
Urgent help in each nation
A booked video appointment, whether NHS or private, is not the place to turn in a crisis. The right number depends on where you are.
- Everywhere in the UK: phone 999 or go to A&E when someone’s life is in danger.
- England: call NHS 111 and choose the mental health option, or use 111.nhs.uk online.
- Scotland: call NHS 24 on 111.
- Wales: call 111 and press 2. The Welsh Government says this is free from a landline or mobile, even with no credit, and open 24 hours a day for all ages.
- Northern Ireland: call Lifeline on 0808 808 8000. nidirect describes it as confidential, free and open 24 hours every day.
You can also call Samaritans free on 116 123 at any time, or text SHOUT to 85258.
Seeing Happy Clinic from anywhere
Happy Clinic is a private online psychiatry service whose consultant psychiatrists are GMC-registered and work by video. Its consultations are open to anyone aged 18 or over living in any part of the UK, so your nation does not change whether you can book.
The steps are the same wherever you are. You book online, meet a consultant psychiatrist by video, and receive a treatment plan. The plan may include medicine, advice about therapy pathways and follow-ups. Afterwards a clinical summary comes to you, and it can go to your GP as well if you say yes.
Once adult ADHD treatment is stable, Happy Clinic may suggest a Shared Care Agreement with your NHS GP, who decides whether to accept it.
Happy Clinic does not provide emergency or crisis care, psychological therapy, or care for children. Use the urgent numbers above if you need help quickly.
Wherever you live, the same questions help you compare online psychiatry services, and the same groundwork helps you prepare for a first appointment.