The Patient Journey

Referral

To ensure we have a good understanding of your situation, and to help us pair you with a psychiatrist, we will normally ask for a referral letter ahead of confirming an initial appointment. Referral letters are typically sent by your GP or insurer, though we can also accept referrals from other mental health specialists, or medical professionals.

These referral letters are then reviewed by either our Clinical Director, Dr Roger Howells, or by another member of our psychiatry team if you have been referred to a particular specialist. Following review of the letters, the clinician will confirm acceptance of the referral, and our Patient Services team will contact you to schedule your initial consultation, and send you our Patient Registration documentation.

Insurance or Self-Pay

As we are a private clinic, we will need to confirm how payment for your sessions will be arranged. Whilst around two-thirds of our current patients are self-pay, we work with all major national and many international insurance providers, and accept their fees.

If you are a self-paying patient, you will be asked to make payment ahead of any sessions you have. These payments are managed by our trusted medical billing provider, Trust Health, and can be made via BACS, online payment, or cheque.

If you are registered with an insurer, you will need to contact them and ask for treatment approval. They will provide you with an authorisation code (or similar) and confirm with you how much coverage you are able to access. You will need to share your membership number, authorisation code and coverage limit with our Patient Services team prior to your first appointment. Depending on the terms of your individual insurance policy, you may be required to pay fee ‘top ups’ for sessions; to establish whether this would apply to you, we’d suggest speaking and confirming with your insurer direct (and in writing).

Whilst our team are very happy to help track your insurance coverage usage, it is the patient’s responsibility to make sure the coverage limit isn’t unknowingly exceeded – payment for any sessions not covered by your insurer will be liable for self-pay.

Initial Consultation

Your first consultation with a psychiatrist will be primarily ‘information gathering’ in nature; this can often be a surprise to patients who may feel they want to discuss the matter at hand straight away, but understanding your full medical and mental health history is vitally important in ensuring we can provide you with the care and support that is best suited going forwards. Occasionally, it will be necessary to have two or more initial sessions with a psychiatrist to provide a full history.

Following these sessions, your psychiatrist will then devise a care plan with you. This may involve medication introduction, changes or reduction, blood tests and other medical investigation, and / or a referral for psychological therapy. Your psychiatrist will also provide a formal written letter for your referrer, and for you. If you have indicated that you do not wish for any letters to be sent out, your psychiatrist will instead prepare a case note for your patient file.

Medication and Prescriptions

If it is mutually decided that medication introduction or change could be beneficial, our psychiatry team are able to prescribe for you. However, if it is preferred by the patient that medication prescribing is managed by your GP or family doctor, our team are very happy to facilitate this. In this instance the GP and psychiatrist will work together closely; the psychiatrist would oversee and review your medication and its impact, but your GP will issue you your prescriptions – this is occasionally termed a ‘Shared Care Agreement’.

Economically, this can also have its advantages – you are able to consult with a private psychiatrist whilst still receiving your medication via the NHS, rather than having to pay for medication privately, which can sometimes prove costly. Some GP practices prefer not to share care in this way, but it is more likely where they have written a letter of referral.

Referrals for Psychological Therapy

If it is felt that you would benefit from psychological therapy, your psychiatrist will discuss members of our psychology team with you, to ensure you’re both happy with the referral choice. Whilst our psychology team all have extensive experience with a broad spectrum of general adult psychology, many also have particular specialisms or treatment expertise, and it is important that we identify a good fit for you; not only in terms of therapy type, but also specialist areas if appropriate, as well as personality and approach to the therapeutic relationship.

Once a psychologist has been chosen, your psychiatrist will write to the chosen psychologist with an in-depth referral letter, and our Patient Services team will work with you to schedule your initial appointment, and confirm your standing appointment time, where required.

Commitment to Psychological Therapy

If you are referred to a psychologist, your first session with them will also often include a degree of history, whilst they also explain to you the therapeutic approach, and how you can expect your sessions with them to progress. Again, whilst they will have received the referral letter from your psychiatrist, to ensure full understanding of your situations both past and present, it is of huge benefit to have this conversation directly as well, and typically the information collected has a subtle, yet important difference.

Following the initial session, you and your psychologist will mutually agree a therapeutic plan. This may involve exercises outside of the session time, occasional homework (from completing questionnaires, to reading articles or watching programmes) and crucially how often, and when, you will meet.

Psychiatric Review

Whilst you are engaged in psychological therapy, your psychologist will routinely write to your psychiatrist, giving updates on your progress. A close-knit integrated approach is very important to us and, as such, you will be invited to attend a follow-up with your psychiatrist at intervals during your psychological work. These are not mandatory, as we understand that there may be financial constrictions, but are encouraged.

You may also ask to book an appointment with your psychiatrist at any time, either during or after your psychological work.

Insurance Extension

Often, insurers will confirm coverage for a set amount of psychological therapy sessions – typically 8, 10 or 20. If, during the course of these sessions, you and your psychologist mutually agree that further sessions would be beneficial, your psychologist and / or psychiatrist can and will write to the insurer to ask for an extension. This is typical, in our experience.

Changing Clinician

Very occasionally, we find that patients and psychologists or psychiatrists aren’t able to establish a bond during the course of their initial meetings. This can be for a range of reasons, and is entirely understandable!

We'd encourage you to speak about this with your treating clinician if at all possible, as this can form an important part of the therapeutic process. However, if at any point you feel like you may find more benefit with an alternative clinician and don't wish to enter into discussions with your treating clinician, please don’t hesitate to let the Patient Services team know.

There will be no offence taken, or caused – it is vitally important that you have an open, trusting and respectful relationship with your psychologist, so if you have any concerns or doubts we would happily transfer you to another’s care, and your former psychologist will readily provide a full handover on your work together to date. It is routine and expected that patients may occasionally need re-referring to another practitioner.

Discharge and Longer Term Support

You may reach the stage in your journey with us where you no longer require our proactive support. At this point, we will formally discharge you from our patient roster, though – and we stress this – you are welcome to come back at any time, be it days, weeks, months or years after discharge.

Alternatively, you may not wish to be discharged and may instead prefer to have follow up appointments with your psychiatrist to ‘check in’ at intervals; either annually, bi-annually or quarterly. Again, we are more than happy to facilitate this, and will work with you to schedule this for your convenience.

Questions or Queries

If at any point during your time with us you have any questions or queries, you can contact our brilliant Patient Services team. We are a small clinic, and have three members of our Patient Services desk, so you may find yourself quickly knowing each of them by name, and feeling comfortable asking them routine questions about the administration of your care. If the Patient Services team are unsure of the answer to your question, they will bring the query to either the General Manager, or our Clinical Director, who will be able to provide you a conclusive response.

If your query is related to specific clinical aspects to your case, you are also free to contact your treating psychiatrist or psychologist by email at any point.