This report reviews an innovative service that helps GPs in the City of London and Hackney to support people who fall through the gaps in existing service provision. The report finds that it improves health at the same time as reducing costs in both primary and secondary care services. The Primary Care Psychotherapy Consultation Service (PCPCS) is run by the Tavistock and Portman NHS Foundation Trust. It supports people with medically unexplained symptoms, people with personality disorders and people with chronic mental health problems. Many of the people it helps have two or more problems at the same time and many also have poor physical health. The service offers training and support to GPs and a range of psychological therapies to patients. It has been found to improve the mental health of 75% of its patients and to help more than half to recover significantly. It also helps to reduce the number of GP consultations, A&E visits, outpatient appointments and hospital admissions among its patients.