The Health and Adult Social Care Scrutiny Panel is scheduled to receive an update on the transformation of mental health services provided by Oxleas NHS Foundation Trust. The panel will also consider public questions on agenda items.

Oxleas Mental Health Services Improvement and Transformation Update

A presentation is scheduled to provide an update on the progress of Oxleas NHS Foundation Trust's mental health service transformation and improvement programme. This programme aims to address variations in service provision, improve productivity, and ensure safe, evidence-based care. Key drivers for the redesign include responding to national scrutiny, such as the Valdo Calocane case, and implementing recommendations from independent enquiries. The programme is being developed with design principles focused on using demand and capacity evidence, a trusted assessor approach for streamlined transitions, NICE-concordant care, and robust leadership structures.

The report pack details the ACMH Psychosis Redesign, which has seen its go-live on 7 September 2026. The focus is now on stabilisation, assurance, and measurable improvement, with post-go-live monitoring, Rio migration implementation, workforce induction, and value improvement measurement underway. An ACMH Administration Redesign project aims to align administrative capacity with demand, strengthen support, improve service user experience, and reduce bottlenecks. Evidence from surveys indicates that while clinicians rate admin support highly, managers report insufficient capacity and identify high-risk processes.

The ADAPT and Mental Health Hub Redesign programme is reviewing and redesigning Mental Health Hubs and ADAPT services across Greenwich, Bexley, and Bromley to ensure clinical safety, financial sustainability, and operational robustness. Governance and workstreams are established, with current focus on mapping current pathways, building a baseline of access, activity, and quality, and using workshops for future-state design. The emerging Oxleas clinical operating model outlines a phased approach to mental health care, from initial access and formulation to core treatment, specialist interfaces, and recovery/step-down.

The report also highlights challenges within the Adult ADHD Service, including long waiting times for assessment (around 21 months) and a high prescriber-to-patient ratio. Despite these challenges, the service has seen improvements in assessment wait times, a reduction in DNA rates, and the implementation of e-prescribing. The South East London Integrated Care Board (SEL ICB) priorities for mental health in Integrated Neighbourhood Teams (INTs) include developing a mind and body focus, addressing the SMI mortality gap, and integrating community mental health services into the neighbourhood offer. The SIF programme is focused on strengthening integrated neighbourhood care for people with Severe Mental Illness (SMI) and frailty, supported by defined workforce and data infrastructure.

The Timely Care programme, which aims to reduce length of stay in adult acute wards, is transitioning to business as usual. While average length of stay has fallen and acute out-of-area placements have significantly reduced, challenges remain with very long stays and delayed discharges. The report also notes that Oxleas has a Good overall Care Quality Commission (CQC) rating, with no conditions registered. However, ongoing assurance is required regarding the implementation of various actions, including caseload reduction, personalised risk assessment, and evidence of outcomes. Performance data for Greenwich Adult Mental Health services is provided, detailing referral waiting times for first and second appointments, as well as data on Mental Health Hub referrals and referral to treatment times for psychological therapies and allied health professionals.

Public Questions on Agenda Items

The panel is scheduled to allocate 15 minutes for questions from members of the public on agenda items. Questions are to be submitted in writing to scrutiny@royalgreenwich.gov.uk before the meeting.