The Adult Social Services, Health and Housing Committee met on Wednesday 14 January 2026, discussing a range of important issues including the performance of South West London and St George's Mental Health NHS Trust, the adoption of a new charter for carers, and plans for the future of day services in Richmond. Key decisions included the approval of the Richmond Adult Carers' and Young Carers' Charter and the formation of a Community Partnership to deliver day services.

South West London and St George's Mental Health NHS Trust Report

The committee received a comprehensive report from South West London and St George's Mental Health NHS Trust, covering their activity primarily from 2024-25. Ian Garlington, Best Communities Programme Director at the Trust, presented the report, highlighting the Trust's overall performance, its services for Richmond residents, and detailed clinical information. He noted that the Trust serves approximately 1.2 million people across five boroughs, with a budget of around £350 million. The Trust has seen significant improvements in staff experience, with vacancy rates falling from 24% to 13%, which contributes to better continuity of care for patients.

The report detailed the Trust's commitment to improving the Adult Patient Journey, focusing on timely access to high-quality care in the least restrictive environment possible. This includes a transformation of adult community mental health services, with new Integrated Recovery Hubs established in Richmond. The Trust is also introducing DIALOG+ care planning in the community, moving away from the Care Programme Approach (CPA). Crisis pathway reviews are underway to ensure better access to mental health support, aiming to avoid unnecessary A&E attendances. Significant progress has been made in reducing the length of stay for adult acute inpatient services, with a 26% reduction achieved.

The Trust is also actively working to tackle health inequalities and become an actively anti-racist organisation. This includes cultural sensitivity training for clinicians, targeted support for underrepresented groups, and initiatives to improve recruitment and retention of staff, particularly from Black, Asian, and Minority Ethnic backgrounds. Estate developments are also a key focus, with significant investment in new facilities at Barnes Hospital and Richmond Royal Hospital, aiming to provide state-of-the-art mental health environments.

The committee heard that in Richmond, 100% of adult patients are receiving treatment within 18 weeks of referral from outpatient mental health services. The Trust is also one of the few in England still accepting adult ADHD referrals, though waiting lists are long. The report also touched upon the integration of mental health services with social care and housing, and the performance of NHS Talking Therapies, which has consistently met waiting time targets.

Councillor O'Shea raised concerns about equality and diversity, and staffing levels for psychotherapists. Ian Garlington and Sarah, Clinical Manager for Richmond Community Adult Mental Health Services, responded, explaining the Trust's focus on health inequalities, culturally sensitive training, and efforts to recruit more psychological professionals. Councillor Bennett expressed concerns about staff pressure regarding admissions and discharges, and the emphasis on reducing length of stay, particularly for those with serious mental illness. The Trust acknowledged these concerns, highlighting the balance they strive to achieve and their commitment to learning from any instances where they do not get it right. Councillor Vollum questioned how the adult patient journey addresses complex cases and confusion around single points of contact. The Trust acknowledged the complexity of their services and the need for clearer communication. Mr. Bullock inquired about collaboration with housing and the effectiveness of Dialogue Plus care planning. The Trust confirmed strong engagement with local authorities and positive progress with Dialogue Plus. Councillor Hill raised concerns about ADHD and ASD waiting times, and the disparity between children's and adult services. The Trust acknowledged the significant waiting times for adult ADHD assessments and outlined plans to address this, including exploring digital pathways. Councillor Vollum also raised questions about medical misogyny and biases in treatment for women, which the Trust acknowledged as a significant area of concern and intersectionality with other inequalities.

The Richmond Adult Carers' and Young Carers' Charter 2026

The committee considered the Richmond Adult Carers' and Young Carers' Charter 2026, a co-produced document aimed at improving support for unpaid carers. Leah Wilson, Programme Manager for the Richmond Day Services Alliance, and Lisa Wilson, Programme Manager for the Modern Day Service Offer, presented the report. The Charter, developed following the expiration of the Richmond Carers Strategy 2020-25, aims to encourage organisations to pledge to support carers in their health and well-being and caring journey.

Over 250 carers responded to engagement surveys, providing input on what is most important to them. The Charter includes statements reflecting these priorities, and organisations will be invited to sign up and pledge their commitment. The Charter is intended to increase awareness of carers' needs, empower them, and foster inclusive organisations.

Councillor Vassileva raised concerns about ensuring the goodwill of employers in supporting carers in employment, suggesting a dedicated section at the council's employment fair. The presenters confirmed ongoing work with partners like WorkMatch and acknowledged the idea of integrating this into future events. Councillor Vollum inquired about the pledging process, and it was explained that a dedicated webpage would be developed for organisations to sign up and pledge their actions. Councillor Bennett questioned the replacement of a strategy with a charter and the lack of measurable targets within the Charter itself. The presenters clarified that the strategy's tenets still underpin the Charter and that annual reporting to the Health and Wellbeing Board would allow for evaluation. The committee ultimately approved the adoption and publication of the Charter.

Richmond Day Services Alliance: Co-Designing Care for Tomorrow

The committee discussed proposals for the Richmond Day Services Alliance, aiming to modernise and deliver compassionate community-based services for older people, adults with dementia and disabilities, and their carers. Rachel Soney, Director of Commissioning for Adults and Public Health, presented the report. The proposal is to form a Community Partnership with Age UK Richmond and Homelink to deliver services at upgraded centres in Woodville and Sheen Lane, alongside Homelink's service in Whitton. This partnership aims to create a borough-wide network, improve transport coordination, reduce isolation, and enhance carer support.

The committee heard that the partnership would be an equal arrangement, with shared risk and decision-making. The proposed contract is for five years, with an option to extend for a further five years, valued at approximately £17.9 million over 10 years. The committee approved the creation of this Community Partnership and the associated financial and delegation arrangements. Questions were raised regarding the future of the Nella Road site, the risks associated with replacing council-run services with charity-run centres, and the clarity of commitments from organisations signing up to the Carers Charter. The presenters addressed these points, explaining the council's ongoing oversight and commitment to supporting residents and carers. Concerns were also raised about the geographical coverage of services, with assurances given that the partnership with Homelink in Whitton would ensure borough-wide provision, supported by an integrated transport service. The financial implications and the light touch regime for procurement were also discussed, with clarification provided on the flexibility offered by this approach. The committee approved the recommendations, including the formation of the partnership, the contract award, and the delegation of authority for entry into the partnership and commissioning of transport solutions.

Richmond Corporate Plan 2025/26 Mid-Year Performance Report

The committee reviewed the mid-year performance report for the Richmond Corporate Plan 2025/26. BBE Gingleska from the Corporate Performance Team presented the report, highlighting that while 50% of indicators showed a decline compared to the previous year, all remained within the green-rated bracket and were on target. Several areas of strong performance were noted, including increased smoking cessation rates, a higher percentage of carers receiving assessments, and a significant increase in completed disability adaptations. Homelessness prevention figures were also strong, with more than double the target achieved.

Councillor Vassileva sought clarification on the wording regarding performance decline versus being on target, and the presenters explained the distinction between direction of travel and performance against the set target. Councillor Hill praised the overall positive achievements of the council and highlighted specific successes in NHS health checks and disability adaptations. Questions were also raised about affordable housing targets and the progress of the Rough Sleeper Hub, which is expected to open in early Spring 2026. The committee noted the progress on the Corporate Plan actions and performance against key indicators.

Joint Health Overview and Scrutiny Committees Update

There were no significant updates from the Joint Health Overview and Scrutiny Committees, as neither had met since the last Adult Social Services, Health and Housing Committee meeting.

Committee Work Programme

The committee reviewed its work programme, noting that the Annual Report of the St George's University Hospitals NHS Trust would be added for consideration in January 2026. The Dementia Strategy was removed from the programme as it had been discussed at this meeting. The next committee meeting on 10 February 2026 will focus on the council's budget.