The Health Overview and Scrutiny Panel was scheduled to discuss urgent and emergency care services at Kingston and Richmond NHS Foundation Trust, as well as receive an update on children's and young people's mental health services. A verbal update on public health matters in the borough was also on the agenda.

Emergency Care: Prevention and Pathways

The panel was scheduled to receive a report providing an overview of urgent and emergency care (UEC) at the Kingston and Richmond NHS Foundation Trust. The report was set to detail how patients access and move through emergency care services, outline current pressures within the system, and explain how population growth and an ageing demographic are being managed. It was also intended to cover how prevention, alternative pathways, and collaboration with system partners can help reduce avoidable emergency department (ED) attendance, and identify areas where further system-wide collaboration could improve outcomes.

The report highlighted that the Kingston site operates a co-located Emergency Department (ED) and Urgent Treatment Centre (UTC), supported by Same Day Emergency Care (SDEC) and virtual wards. The Trust also runs a UTC at Teddington Memorial Hospital. A significant challenge identified was a mismatch between the capacity required and that available to avoid ED attendance and expedite discharge, particularly concerning nursing home capacity, mental health inpatient provision, and seven-day ambulatory services.

The report noted that the population of Kingston is aging, leading to increased healthcare needs. In response, the Trust is investing in a new frailty model to support frail patients in the community and has been selected as one of seven sites across England to represent South West London in the NHSE National Frailty Discovery Collaborative. This programme aims to develop a model of frailty management for national rollout. Kingston and Richmond have also been selected to lead a national digital frailty project to explore how health and care information systems can be better integrated.

The Proactive Anticipatory Care (PAC) Programme, rolled out across all ten Primary Care Networks (PCNs) in Kingston and Richmond in September 2023, was also detailed. This programme aims to provide proactive care via multidisciplinary teams (MDTs) to identify and support patients with escalating health and/or social care risks, with the goal of reducing unplanned hospital admissions and length of stay. Data presented indicated a 35% reduction in unplanned care and a 28% reduction in length of stay for patients on the PAC programme for four months or longer.

The Kingston and Richmond virtual ward, which provides hospital-level care at home, was also discussed. This service uses technology and multidisciplinary teams to help speed up recovery and free up hospital beds. The report indicated that the virtual ward has been successful in providing safe home care, particularly for elderly patients, leading to reduced hospital admissions and improved patient satisfaction.

The report also addressed the pathway between substance use treatment and Kingston Hospital, noting that Kingston Hospital is one of the few in London without a hospital-employed Alcohol Care Team (ACT). While attendances for patients with drug and alcohol issues are comparatively low, Public Health has funded an in-reach post from the Kingston Wellbeing Service (KWS) linking with a worker within the Psychiatric Liaison Team.

Urgent and emergency care performance data for 2025/26 was presented, showing a seasonal deterioration in performance during the third quarter, with adult ED performance identified as a priority area for improvement. The report stated that performance trends reflect national patterns and winter pressures.

Independent Review of Children's and Young People's Mental Health Services

A verbal update was scheduled to be provided on the Independent Review of Children's and Young People's Mental Health Services. This review had previously been reported to the People Committee in March 2025.

Public Health Verbal Update

The panel was scheduled to receive a verbal update on public health matters within the borough. This update was expected to cover key areas such as health protection and prevention. The Director of Public Health was to provide information on preparedness for winter pressures and the importance of seasonal vaccinations. Findings from a recent schools health survey, which would inform future public health priorities, were also anticipated to be discussed.

Previous Meeting Minutes

The panel was scheduled to approve the minutes of the previous meeting held on 2 December 2025 as a correct record.