The Adults and Health Select Committee met on Thursday, 11 June 2026, to discuss performance assurance, the use of prisons as places of safety for individuals with mental health needs, and to review the recommendations tracker and forward work programme. Key discussions included the performance of adult social care services, the challenges in providing timely care placements, and the effectiveness of the liaison and diversion service in preventing the use of prisons as places of safety. The committee made several recommendations, including a joint presentation on supporting vulnerable offenders, reporting on the implementation of the Mental Health Act 2025, developing a plan for health-based places of safety, and producing local statistics on the use of prisons as places of safety.

Performance Assurance Monitoring

The committee reviewed the performance of Surrey County Council's Adults, Wellbeing and Health Partnerships (AWHP) directorate for Quarter 3 and Quarter 4 of the 2025/26 financial year. Two red indicators were highlighted: the proportion of people assessed or reviewed within the last 12 months, which stood at 69.9% against a target of 80%, and the chlamydia detection rate.

Regarding the assessment and review target, Councillor Tony Pearce asked about plans to improve performance and whether the 80% target could be met. Sinead Mooney, Cabinet Member for Adult Social Care, expressed confidence that the target would be met by the end of the financial year, attributing the current shortfall to a recent restructure of adult social care services. Claire Edgar, Executive Director for Adults, Wellbeing and Health Partnerships, clarified that this 80% target is a local, ambitious goal set by the cabinet member, not a statutory requirement. Despite the current performance, the volume of assessments and reviews had reached its highest level, showing a 5% improvement since the last CQC inspection.

On the chlamydia detection rate, Councillor Abby King inquired about barriers to increasing detection rates in young women and the reasons for lower concern regarding men. It was noted that this is a national indicator, and Surrey's detection rates are performing reasonably well compared to other local authorities. While acknowledging the ambition of the target, the committee discussed the importance of public health campaigns and agreed to receive a detailed plan on future publicity efforts, particularly focusing on engaging all age groups and sexes.

The committee also discussed an amber indicator concerning residential and nursing care placements, noting that while performance had recovered from an earlier decline, delivery remained inconsistent. Councillor Carla Morson raised concerns about challenges in sourcing timely placements, including a shortage of local care home beds, internal funding issues, and delays in approval processes. She also highlighted the slow progress on building new residential beds and extra care facilities, such as the one in Camberley. Safeguarding performance was also noted as inconsistent, with questions raised about driving more consistent improvement. Sinead Mooney acknowledged the complexity of sourcing placements, often dependent on individual needs and provider availability. She also confirmed that outline planning permission had been granted for the Camberley extra care facility and that the first scheme, Meadowcroft, was due to open towards the end of winter.

Councillor Rebecca James-Evans questioned the sustainability of the 88.2% performance in residential and nursing care placements, given ongoing market pressures. Claire Edgar emphasised the council's statutory duty under the CARE Act to ensure market sustainability and detailed the strong engagement with providers through a provider market group. She explained the various approaches to market engagement, including spot purchasing, frameworks, and dynamic purchasing systems, and acknowledged the challenging financial landscape for social care providers.

Health-Based Places of Safety and Mental Health in Surrey Prisons

A significant portion of the meeting was dedicated to scrutinising the support available to prisoners with mental health needs in Surrey, following a Prevention of Future Deaths report by the Coroner and concerns raised about the use of prisons as places of safety. Andy Erskine, presenting the report, highlighted that the Coroner's concerns were primarily a national system issue, stemming from a shortage of secure psychiatric beds. He noted that while the Mental Health Act 2025 signals an intent to end the use of custody settings as places of safety, implementation details are still emerging.

The committee heard from Manveen Brah, Service Manager for Liaison Diversion, and Emma Hicks, Clinical Team Lead for Liaison Diversion at Surrey and Borders Partnership NHS Foundation Trust. They detailed the work of the liaison and diversion service, which supports individuals with vulnerabilities throughout the criminal justice pathway. The service aims to reduce police custody time, court adjournments, repeat arrests, and health inequalities. They also highlighted the ReConnect service, which provides care after custody to ensure continuity of care for individuals with identified health needs. The team covers female prisons such as Bronzefield, Send, and Downview, and male prisons including Warmsworth, Hightower, and Coldingly.

The presentation detailed how the liaison and diversion team operates within police custody suites, magistrates' courts, and Crown Courts, providing vulnerability assessments and court reports. They also have an assertive outreach team and a peer support team. The service works holistically, assessing a wide range of vulnerabilities beyond mental health, including alcohol misuse, neurodevelopmental concerns, domestic abuse, housing issues, and social isolation.

The committee raised concerns about the use of prisons as de facto places of safety for individuals experiencing acute mental health crises. While Surrey and Borders Partnership Trust stated they do not believe Surrey residents are remanded to prison as a place of safety, they acknowledged the national issue and the potential for it to occur. The committee recommended that Surrey and Borders Partnership NHS Foundation Trust, in conjunction with Central and North West London NHS Foundation Trust (CNWL), develop a clear plan to transition to health-based places of safety. They also recommended that the Trust produce local statistics on the use of prisons as a place of safety, despite the lack of national data.

Discussions also covered the transfer of prisoners to hospital for mental health treatment, with an average delay of 32 days for forensic beds, exceeding the 28-day target. The committee noted that while the intention of the Mental Health Act 2025 is to move away from using prisons as places of safety, the legislative framework, including the Bail Act 1976, still allows for this.

Recommendations Tracker and Forward Work Programme

The committee reviewed the recommendations tracker and forward work programme. They made several recommendations for future work:

• A joint presentation from Adult Social Care, the police, and Surrey and Borders Partnership NHS Foundation Trust on innovative work to support vulnerable offenders in Surrey, to be held in October.
• Reporting on the progress of implementing the objectives of the Mental Health Act 2025 for facilities located in Surrey.
• Surrey and Borders Partnership NHS Foundation Trust, in partnership with CNWL, to develop a clear plan for transitioning to health-based places of safety as an alternative to the prison system, with updates provided to the committee.
• Despite the lack of national statistics, the Trust should produce statistics for Surrey on the use of prisons as a place of safety.

The committee also noted that the next public meeting was scheduled for Thursday, 1 October 2026.