Performance review

South West London and St George’s Mental Health NHS Trust provides mental health and learning disability services to around 1.1 million people across the London boroughs of Kingston, Merton, Richmond, Sutton and Wandsworth.

We are a diverse team of around 3,100 staff, supporting approximately 43,000 individual patients every year. We provide a wide range of services, including community and inpatient care, crisis support, and specialist national services.

Our mission is “Making Life Better Together”. This means working to be the heart of our communities, at neighbourhood level, in partnership with patients, carers and local people, to support recovery, improve wellbeing and help people live the lives they want.

We structure our organisation and services across four main clinical areas (service lines), which sit alongside corporate services. Our over 100 clinical services aim to ensure seamless care across:

• acute and urgent care
• community services
• children and young people’s services
• specialist services, including forensic and national services 
   

We provide care from a range of locations across South West London and beyond, including our main sites at Springfield University Hospital and Tolworth Hospital, alongside community sites. We are continuing to invest in modern, high-quality facilities to improve patient experience and reduce stigma.

We have a number of strategic principles, which along with our values, guide our decisions. We are:

• actively anti-racist and inclusive
• ambitious for mental health
• patient‑centred, clinically-led and expertly-managed
• digital first and accessible 24/7
• evidence‑based and consistent
• rooted in our communities
• continuously improving and building confidence across the system
   

As a teaching Trust, we work with a number of universities and partners to support education, training and research. We continue to invest in innovation and new ways of delivering care, including digital services and community-based support. Through our Better Communities Programme, we are investing in an ambitious programme for our estate to create better environments, improving care pathways and patient experience and strengthening digital services to support both patients and staff. 

Together, this work supports our ambition to deliver high-quality, equitable and sustainable mental health care for the communities we serve.

Our mission is “Making Life Better Together”. Alongside our values, this guides everything we do and reflects our commitment to working alongside patients, carers and communities to improve mental health and wellbeing.  

Our strategy focuses on delivering better outcomes for the people we serve. It is centred on four long-term ambitions:

• increasing quality years
• reducing inequalities
• making the Trust a great place to work
• ensuring our services are sustainable

Over the past year, we have refreshed our strategy following engagement with staff, patients, partners and communities. The new strategy reflects the changing health and social care landscape and the challenges and opportunities we face as a modern mental health provider. The refreshed strategy was agreed by our Board in May 2026 and will be formally launched in 2026 — 2027.

 

Our priorities for 2025/26

To deliver our long-term ambitions, we set five clear priorities for 2025/26. These focus our work on the areas where we can make the greatest difference for patients, staff and our communities.

• Delivering great care: Improving access, reducing waiting times and delivering safer, more inclusive and culturally responsive care that helps increase quality years and reduce health inequalities.
• A great place to work: Supporting staff wellbeing, inclusion, leadership and development while continuing work to become an actively anti-racist and inclusive organisation.
• Sustainability: Improving productivity, making best use of resources, reducing environmental impact and using digital innovation to support more joined-up care.
• Better environments: Investing in modern, welcoming and recovery-focused environments that improve experience for patients, carers and staff.
• Partnerships: Strengthening collaboration with health, care, voluntary sector and community partners to deliver more connected, community-based support.

A focus on coproduction, inclusion and anti-racism and continuous improvement

Across all our priorities, we are committed to continuous improvement. We use quality improvement methods to test changes, learn quickly and scale what works. We work closely with people with lived experience to design and improve our services, ensuring that care is shaped by those who use it. Throughout this work, we apply a strong focus on inclusion, anti-racism and reducing health inequalities, making sure that our improvements address differences in access, experience and outcomes across our communities.  

 Challenges and areas for improvement

While we have made progress in many areas this year, we recognise that there are still significant challenges that we must address.  

Demand for mental health services continues to grow, placing pressure on access and waiting times across parts of the system. At the same time, we know that patient experience is not yet consistent, with further improvement needed in key areas.  

Reducing health inequalities remains a key priority. While we are making progress, differences in access, experience and outcomes persist for some communities, and addressing these inequalities will require sustained and targeted action.  

Alongside this, we are operating in a complex, pressured and evolving health and social care system that is seeing significant reform, with increasing focus on neighbourhoods and national scrutiny of mental health services.  

These challenges reinforce the importance of working closely with partners, using data to drive improvement and maintaining a clear focus on quality, experience and outcomes.

This section summarises our performance in 2025— 2026 against our strategic ambitious, in numbers and stories.  

Our year in facts and stats  

Overall

• We have 3,100 staff, 80% are clinical
• 54% of our staff are from Black, Asian and Minority Ethnic Communities
• 1.1m people served across our five boroughs
• 45,000 referrals to our secondary services (same as last year)
• Made 463,000 individual contacts with our services users (427,000 last year)
• Admitted 1,800 people to our inpatient services (excludes Lotus and out of area admissions) (1,600 last year
• 17,500 children and young people accessed our services (16,000 last year)
• 41,000 calls to our crisis line – average of 110 a day
• Received 33,000 referrals into our Talking Therapies (38,000 last year)
• Seen 43,000 distinct patients in year (40,000 last year).

 Increasing quality years

• We are helping more people receive care closer to home. We reduced average length of stay from 73 to 63 days.
• More community patients say their team always treats them with care and compassion: 62% in 2023/24 to 69% in 2024/25
• We reduced readmissions from 5.2% to 3.3%, supporting better recovery and continuity of care.
• We reduced the use of independent sector beds from a peak of 41 to 18, improving both patient experience and efficiency.
• Nearly 95% of eligible patients now have a personalised care plan (using DIALOG+), improving the consistency of care planning.
• Over 1,300 young people and their families waiting for Tier 2 services in Kingston and Richmond were transferred to us in October. Since then, nearly 300 have been referred for online therapy and over 250 for online neurodevelopmental assessment.
• Our digital campaign promoting alternatives to A&E reached over 1.5 million views and generated more than 29,000 interactions, improving awareness of mental health support.

Reducing inequalities

• We saw early improvements in discharge delays for some ethnic groups, we have reduced ethnic inequalities in length of stay by two-thirds
• Peer support debriefers following incidents have contributed to a 70–80% reductions in prone restraint rates for ethnic minority groups
• Recovery rates in Talking Therapies improved for Black, Asian and Minority Ethnic patients (50%) and they are now equal to those of white patients (50%)
• Depending on ethnicity, restrictive practice reduced by between 30% and 60%
• Our FIND service supported forensic patients with learning disabilities and autistic people to come back home to South London – 62% of those repatriated were from ethnic minority backgrounds.
• Over 90% of staff who completed cultural capability training reported improved anti-racist practice.

Great Place to Work

• More recommend us as a place to work (from 58% in 2022 to 69% in 2025) and receive care (from 55% in 2022 to 65% in 2025).
• We reduced vacancy rates from 13% to 8.4% and turnover from 12% to 10%. Medical vacancies have reduced from 8.6% to 2.6%.
• We reduced agency usage by 52%, improving workforce stability and continuity of care.
• Our apprenticeship programme supported 189 apprentices, with 66% from Global Majority backgrounds, supporting workforce diversity and progression.

Ensuring sustainability

• We met our target to deliver over £200k surplus, supported by strong financial management.
• We delivered £24.9 million in cost improvements, with 65% recurrent, strengthening long-term sustainability.
• Our underlying deficit improved from £8.5 million to £3.6 million, reflecting improved financial performance.
• We invested over £52 million in Better Environments, including £47 million at Tolworth Hospital and £4.5 million at Barnes.
• We invested in digital and innovation, including using virtual reality to help children and young people as well as a number of carefully selected AI (artificial intelligence) pilots.

Our year in stories

Increasing quality years 

Helping people access the right support in a crisis: Feedback from patients, carers and partners has directly shaped changes to our crisis pathway, including plans to strengthen access routes, improve liaison services and develop alternatives to waiting in the community or in Emergency Departments. Home Treatment Teams now provide more flexible support, including assessing people in their own homes within four hours, helping avoid unnecessary hospital visits. This approach is helping people receive timely support in the least restrictive setting, improving both experience and outcomes. 

Intensive and assertive care: support for people with complex needs: We strengthened our approach to supporting people with the most complex mental health needs by developing a more intensive and assertive model of community care. This work focuses on people who may be underserved by our services or who are at risk of relapse, crisis or hospital admission, particularly those from Black, Asian and Minority Ethnic communities. This can include people with psychosis, as well as those facing additional challenges such as housing difficulties, financial problems or substance use. 

Using technology to personalise care for young people: We introduced new digital therapies to support children and young people experiencing anxiety. Using immersive technology, young people can safely explore real-life situations, such as school or social settings, as part of their therapy. This approach is helping improve confidence, engagement and outcomes for young people, while offering more flexible and innovative ways of delivering care. 

Intensive outreach support for young people with eating disorders: We introduced an Intensive Outreach Team to provide early, focused support for children and young people with eating disorders who are at risk of hospital admission. The team offers rapid assessment and a short period of intensive support in the community. In its first year, this approach led to a 40% reduction in paediatric bed days, a 50% reduction in average length of stay, and a 40% reduction in specialist eating disorder bed days, compared to the previous year. 

Waiting well: A quality improvement pilot designed with people with lived experience, is supporting those adult community patients who are waiting for care, to make sure we provide support in the most timely way. Those waiting receive a call to check in within 28 days of referral. The call will offer reassurance, find out if needs have changed and direct patients to support, such as the mental health resources on our website. A DIALOG+ care plan will also be updated during the call, identifying key needs and tailoring support during their wait. Future plans are to send a text message and email every six weeks, providing further signposting information and reassurance.  

We also improved support for children, young people and families waiting for mental health services. Our Virtual Waiting Room now provides resources and support to around 10,000 families, helping them understand their care and access support while they wait. More than 60% of families accessed wellbeing content, helping to reduce anxiety and improve engagement with services. This approach is helping ensure that support starts earlier, rather than when treatment begins. 

Improving access to support through ‘Know who to turn to’: Our ‘Know who to turn to’ campaign launched to provide clear, accessible information about mental health services across South West London. Through digital and printed resources, the campaign helps people understand how to access urgent and non-urgent support, improving access and awareness across our communities. This is particularly important for reaching people who may be unfamiliar with how to navigate services.

Reducing inequalities  

Launch of ambitious new Health Inequalities Strategic Plan: This year we  launched our ambitious new Health Inequalities Strategic Plan (2025–2030), setting out a clear approach to reducing inequalities in access, experience and outcomes across mental health services. The strategy, developed with our communities, focuses on improving culturally responsive care, strengthening community partnerships and using data more effectively to target support towards communities experiencing poorer outcomes. As part of this work, the Trust also established a new Health Inequalities Advisory Panel, bringing together community organisations, partners and people with lived experience.  

Reducing restrictive practice: A range of quality improvement initiatives have significantly reduced the use of prone restraint, and we are seeing an overall shift towards least restrictive practice for all communities, and particularly those from Black and Asian backgrounds. These include teams introducing cultural safety plans and peer-led debriefs to improve how incidents are managed and to reduce the need for restrictive interventions. A key enabler has been the introduction of safety pods across all inpatient settings. In line with a number of other organisations, we will no longer teach prone restraint techniques, prioritising supine approaches supported by safety pods. This change supports our commitment to ensuring that any restrictive intervention is planned, evidence-based, proportionate, dignified and in the patient’s interests. 

Reducing restrictive care in forensic services: The Forensic Intellectual and Neuro‑disability (FIND) Service was expanded to address long‑standing inequalities for forensic patients with learning disabilities and autistic people, who are disproportionately placed far from home and remain in restrictive settings for longer. As a result, the number of forensic patients cared for out of area has reduced significantly, with particular impact for ethnic minority patients.

Introducing cultural capability: We expanded our cultural capability training programme for frontline staff following a successful pilot. The training was co-produced with people with lived experience, carers and family members to help ensure it reflected real experiences and practical learning. The programme focused on cultural awareness, anti-racist practice, psychological safety and culturally responsive care, helping staff strengthen conversations about race, inclusion and patient experience. Early feedback was positive, with 90% of participants reporting more anti-racist practice, 67% feeling more confident challenging discrimination at work and 56% adapting their communication style to better meet people’s needs.