Most people booking an online psychiatry appointment want to know one thing about prescriptions: will I get one, and what will it cost? The short answer is that a prescription issued during your appointment is included in the consultation fee, the medicine itself is not, and some medicines carry rules that shape the whole arrangement. This page sets those out.
What is included, and what the pharmacy charges
Two separate costs, and they get confused constantly.
| What | Who charges it | Included in the appointment fee? |
|---|---|---|
| Issuing the prescription during your appointment | Happy Clinic | Yes |
| The medicine itself | The pharmacy | No |
| A repeat prescription request between appointments | Happy Clinic, £150 for existing patients | No, and subject to clinical review |
| Follow-up or monitoring appointments | Happy Clinic, £200 for 20 minutes | No |
On a private prescription you pay the pharmacy’s own price for the medicine plus its dispensing charge. There is no fixed national figure and it differs between pharmacies, so it is worth asking two before you hand the prescription over. That is the biggest practical difference from an NHS prescription, where in England you pay a flat charge and in Scotland, Wales and Northern Ireland nothing at all.
Fees are paid in advance. Fees checked September 2026 — see the fees page for the current list.
Paper and electronic private prescriptions
NHS prescriptions in England are normally handled through the NHS Electronic Prescription Service, which NHS England describes as allowing prescribers to send prescriptions electronically to a dispenser of the patient’s choice. Private prescribing has developed differently and more unevenly.
In general terms, a private prescription may reach you as a signed paper document, as a signed electronic document, or sent directly to a pharmacy you have chosen. What is possible depends on the medicine, the prescriber’s systems and whether the pharmacy accepts that format. Controlled drugs are the strict exception, covered below.
Two practical points. Ask at the appointment how your prescription will be sent and when, rather than assuming. And keep the original: a paper private prescription is the legal instrument, the pharmacy retains it when dispensing, and a photograph of one is not a prescription.
Controlled drugs and the 28-day rule
Some psychiatric medicines are controlled drugs, and they are governed by the Misuse of Drugs Regulations 2001 rather than by clinic policy. The rules are not negotiable and no prescriber can waive them.
The 28-day limit on dispensing. A prescription for a controlled drug in Schedules 2, 3 or 4 may not be dispensed more than 28 days after the appropriate date. The appropriate date is the later of the date the prescriber signed it and any later date the prescriber specified as the date before which it must not be supplied. Miss that window and the prescription is dead — you need a new one, which for a private patient means a new request and a new fee.
Quantity. NICE’s guideline on the safe use and management of controlled drugs says to prescribe enough of a controlled drug to meet the person’s clinical needs for no more than 30 days, and that if a larger quantity is prescribed in exceptional circumstances, the reasons should be documented. This is why controlled drugs are prescribed a month at a time rather than in six-month batches, and why they generate more appointments than other medicines.
Form. In England, a private prescription for a Schedule 2 or 3 controlled drug must be written on the designated form. The NHS Business Services Authority confirms that FP10PCD is the private controlled drug prescription form, and that dispensing pharmacies submit the originals to the NHSBSA monthly. That form requirement is a large part of why private controlled drug prescriptions remain paper-based.
Part supplies. If a pharmacy cannot give you the whole quantity at once, NICE says you should be asked to collect the remainder within 28 days of the date on the prescription.
ADHD stimulants and the monitoring that comes with them
Most controlled drug questions at a psychiatry clinic are about ADHD medication. Stimulants are controlled drugs, and everything above applies to them.
They are also medicines that require ongoing physical monitoring. NICE’s ADHD guideline says that before starting, there should be a review of physical health including a medical history, and baseline measurements of height, weight, pulse and blood pressure. It then says to monitor heart rate and blood pressure before and after each dose change and every six months, to measure weight every six months in adults, and to review treatment at least annually, looking at how well it is working through the day and at adverse effects.
That is the honest reason ADHD prescribing generates more appointments than people expect. Happy Clinic’s ADHD pathway reflects it: a structured assessment by a consultant psychiatrist, medication where clinically appropriate with physical health checks and monitoring, and titration reviews while the dose is being settled. Stimulants are not prescribed on request, and not at a first contact without assessment. The detail is on the adult ADHD page.
Repeat prescriptions, and why a review is needed
Existing patients can request a repeat prescription between appointments. The fee is £150, and it is subject to clinical review.
That last phrase is the important part. A repeat request is not a vending machine. The psychiatrist reviewing it has to be satisfied that continuing is still appropriate: how long since you were last seen, whether monitoring is up to date, whether the medicine is a controlled drug, and whether anything has changed. Sometimes the answer is that a review appointment is needed instead, and the request fee is not a way around that.
Two situations where a full review is likely rather than optional:
- Controlled drugs, where quantity limits mean frequent contact is built into the treatment anyway.
- A long gap since you were last seen, where NICE’s general position on repeat prescribing of controlled drugs is that the frequency of review should take account of the drug and the person’s individual circumstances rather than a fixed interval.
If a review appointment is needed, a follow-up is £200 for 20 minutes. If your medicine has stopped working, or you are on several at once, a fuller medication review is the more useful appointment to book.
Shared care with your NHS GP
The long-term aim for most people is that their NHS GP takes over routine prescribing, because it is cheaper and more convenient. For ADHD, NICE says that once the dose is stabilised, prescribing and monitoring should be carried out under shared care protocol arrangements with primary care.
Happy Clinic can propose a Shared Care Agreement to your NHS GP once treatment is stable, using a dedicated appointment. What happens next is not in the clinic’s hands.
GMC guidance on shared care says it requires the agreement of all parties, including the patient, and that all parties must communicate effectively. A doctor asked to prescribe on a colleague’s recommendation must be satisfied that the prescription is needed, appropriate for the patient and within the limits of their competence, and that they have enough information to proceed safely — and will be responsible for the steps they take. It also says decisions about continuing care should be based on the patient’s best interests rather than convenience or the cost of the medicine.
In plain terms: your GP can say no, and some do, for reasons including local policy on private providers and confidence in monitoring a particular medicine. If shared care is declined, private prescribing can usually continue where clinically appropriate, at private cost. Ask your surgery about their policy before you spend money on the assumption they will accept.
With your consent, a clinical summary of what was prescribed and why goes to your GP after each episode of care. Giving that consent makes shared care possible later; withholding it usually rules it out.
Reporting side effects
If you get a side effect, tell the prescriber first. They may need to change the dose, switch the medicine or arrange a check, and only they can do that.
Separately, report it to the Medicines and Healthcare products Regulatory Agency through the Yellow Card scheme. GOV.UK describes the scheme as vital in helping the MHRA monitor the safety of all healthcare products in the UK, and makes the threshold clear: you do not have to prove causality to report a suspected adverse reaction, only a suspicion is needed. Patients and professionals can both report, online or by telephone. The details are in the GOV.UK guidance on the Yellow Card scheme.
Reporting is not a complaint and it does not go on your record as a grievance. It is how uncommon problems with medicines are identified at all.
Travelling with your medicine
Taking psychiatric medication abroad is usually straightforward, but controlled drugs need preparation, and the rules belong to the country you are visiting rather than to the UK.
GOV.UK’s guidance on taking medicine in or out of the UK says you must carry medicine containing a controlled drug with you in your hand luggage when entering or leaving the UK, that you can bring up to three months’ supply, and that before travelling out of the UK with a controlled drug you should check the rules for the country you are going to with its embassy. It warns that you could be fined or imprisoned for travelling with medicine that is illegal in another country.
A letter from your prescriber is the practical safeguard. GOV.UK says such a letter should include your name, a list of the medicine prescribed including doses, strength and frequency, and the signature of the prescriber together with their professional registration details. Ask for one well before you travel, and remember that a 28-day controlled drug prescription and a three-week holiday need planning around each other.
What this clinic does not do
Happy Clinic prescribes for the conditions it treats, in adults aged 18 and over, anywhere in the UK. Consultations are provided by Happy Clinic, which is registered with the Care Quality Commission (CQC). It does not provide psychological therapy, see under-18s, assess or treat dementia, or write medico-legal or benefits reports, and it is not an emergency or crisis service.
If a life is at risk, call 999 or go to A&E. For urgent mental health help, call NHS 111 and choose the mental health option in England. Samaritans are on 116 123, free, at any hour.
If you have a question about a specific medicine, get in touch before booking. Otherwise you can book an appointment or read how online psychiatry works.
Speak to a Consultant Psychiatrist
Book a secure video consultation with Happy Clinic, for adults aged 18 and over anywhere in the UK. No GP referral is needed and appointments are often available within days.
This page is general information and is not a substitute for personal medical advice. Consultations, diagnosis and prescriptions are provided by Happy Clinic, which is registered with the Care Quality Commission (CQC). If you are in crisis, call 999, go to A&E, call NHS 111 or call Samaritans free on 116 123.