How can I send consultation notes back to a patient’s NHS GP?
Why you should share, how to get consent, and the secure routes private GPs can actually use: MESH, document transfer services, secure email and the patient.
- England
The short answer
With the patient’s consent, send a short summary of each private consultation to their NHS GP. The most direct routes are electronic document transfer into the GP practice’s workflow over the NHS MESH service, either through your own MESH mailbox, a document transfer service or a record system that sends over MESH. Where that is not possible, use secure encrypted email or give the summary to the patient to pass on.
Key points
- Aim to send a summary to the NHS GP after every private consultation, with the patient’s consent.
- Include problems, relevant findings, medicines prescribed, tests, and who is responsible for follow-up.
- MESH is the NHS’s secure messaging service. Documents sent over it can land directly in the GP practice’s workflow.
- Access to NHSmail (now NHS.net Connect) is limited for purely private providers, so do not plan around it.
- If the patient declines, respect that, record it, and think about whether it is still safe to prescribe.
Why share notes with the NHS GP
Yes, you should. For most patients the NHS GP record is the one complete record of their health. It is what A&E, out-of-hours services and hospital teams see. If your consultation is missing from it, the next clinician may not know about a new diagnosis, a medicine you started or a test result that needs following up.
- Continuity: the NHS GP can pick up where you left off.
- Safety: it reduces the risk of double prescribing and interactions.
- Clear responsibility: everyone knows who is following up what.
GMC prescribing guidance says that if you are not the patient’s regular doctor, you should ask for consent to share information with their GP when the episode of care is complete.
Consent, and when patients say no
Ask at booking and again at the end of the consultation. Most patients agree. Some decline, for example because they worry about their relationship with their NHS practice or do not want a diagnosis on their NHS record.
If a patient with capacity objects, respect that and record it. Then decide whether it is still safe to go ahead. GMC guidance is clear that if you cannot share information that is needed to prescribe safely, you should not prescribe. Explain that to the patient and offer alternatives. That applies particularly to medicines that need monitoring or are open to misuse.
What to include
NHS GPs are busy. A short, structured letter is more likely to be read and coded than a full copy of your notes.
- patient identifiers, including the NHS number if you have it
- reason for the consultation and the main findings
- diagnosis or working diagnosis
- medicines started, stopped or changed, with dose and duration
- tests ordered, results, and who is acting on them
- any referral you have made
- what, if anything, you are asking the NHS GP to do. Be explicit, and do not assume they will take over care.
The routes, from most to least direct
| Route | How it reaches the GP | What you need |
|---|---|---|
| Your own MESH mailbox | Into the GP practice’s MESH inbox and document workflow | An ODS code, a valid use case and NHS England approval. Setup can take weeks. |
| Document transfer service | Into the GP practice’s workflow over MESH | A subscription. OneAdvanced’s Clinical Document Transfer (formerly Docman Connect) says it reaches 97% of GP practices in England. |
| Record system that sends over MESH | Letter sent from the patient record, with delivery tracking in some systems | A system with this feature. You do not need your own mailbox. |
| Secure email | To the practice’s NHS email address | An encrypted email service, and the right practice address |
| Via the patient | The patient hands in or forwards the letter | A secure way to send it to the patient |
| Post | Scanned in by the practice | Time |
MESH
MESH (Message Exchange for Social Care and Health) is the NHS’s secure messaging service. NHS England says any health and social care organisation can use it if it has a valid use case. It is free, but you need an ODS code for the mailbox owner, and onboarding takes from about one week to more than a month depending on how you connect. Documents sent over MESH arrive in the GP practice’s document workflow, the same way hospital letters and lab results do.
GP Connect Send Document
NHS England’s GP Connect Send Document product sends consultation summaries back to the registered GP over MESH. It is mainly used within primary care networks and needs a supplier that has built it and a data sharing agreement, so it is not a self-serve option for most private practices.
NHSmail (NHS.net Connect)
NHSmail has been renamed NHS.net Connect, and addresses still end in @nhs.net. Eligibility for independent organisations depends on providing or supporting publicly funded care and holding a current Data Security and Protection Toolkit (DSPT) assessment, so a purely private GP service may not qualify. See can I use NHSmail as a private GP? If you cannot, a paid encrypted email service is the usual alternative. See secure email without NHSmail.
Outside England
MESH, document transfer services and GP Connect are England-focused, and coverage of GP practices in Scotland, Wales and Northern Ireland differs. Check with your supplier which practices you can reach, and use secure email or the patient route where you cannot.
Make it routine
- Capture the NHS GP practice and NHS number at registration.
- Ask for consent at booking and confirm it at the end of the consultation.
- Use a letter template so summaries are quick and consistent.
- Send on the same day and record when and how you sent it.
- Audit a sample each quarter: were letters sent, and did they arrive?
Tools that can help
Frequently asked questions
Should I send consultation notes to the patient’s NHS GP?
Yes, with the patient’s consent, after every private consultation. It keeps the NHS record complete for other clinicians and reduces prescribing risk.
Can I write directly into the patient’s NHS GP record?
Not as a private provider in general. You send documents that the practice files and codes. Direct write-back is limited to specific NHS arrangements.
Do I need an NHSmail account to send letters to NHS GPs?
No. You can use MESH, directly or through a document transfer service or record system, or encrypted email. NHSmail access for purely private providers is limited.
What if the patient has no NHS GP?
Give the patient a copy of the summary. Encourage them to register with a GP, and take extra care before prescribing without access to their history.
