Kingston's children's mental health waiting lists remain a concern, despite efforts to improve services and reduce waiting times.
A Health Overview and Scrutiny Panel meeting on Thursday, 22 October 2026, heard that while progress has been made in addressing the backlog of referrals for children and young people's mental health services, significant challenges persist.
An independent review of these services, which began in December 2023 and was published in March 2024, identified five key recommendations. These include the implementation of a new core delivery model with a lead provider, a shared place-based vision informed by the iThrive framework, clearer governance and accountability, a more flexible model of care, and a redesigned neurodevelopmental pathway.
The expected outcomes of these recommendations are to stabilise services, review waiting lists, manage clinical risk, and align with new systems and processes. Efforts have also focused on improving partnership working and implementing the iThrive framework.
Responsibility for neurodevelopmental assessment services and Tier 2 'getting help' therapy services transferred from Achieving for Children to the NHS Trust, South West London, St George's, in November 2025. This transition involved integrating approximately 11 whole-time equivalent staff into existing services at Richmond Royal and Tolworth Hospital. Efforts have since focused on stabilising services, reviewing waiting lists, managing clinical risk, and aligning with new systems and processes. The Trust has also commissioned additional external support.
Referrals for neurodevelopmental assessments have seen a dramatic increase, from 47 in 2018-19 to a projected 1,319 in 2025-26. This rise is a national trend, attributed to increased distress and mental health difficulties among young people, and a higher demand for ADHD and autism assessment services. The review also highlights a significant increase in 'comorbidity or co-occurring conditions', where individuals may present with multiple issues such as ADHD or autism alongside distress, anxiety, and depression. Plans to address this include moving towards a needs-based system and strengthening partnership working across health, social care, and education, as resources alone are not seen as the sole solution.
In Kingston alone, 547 children were awaiting assessment, with some facing waits of up to two and a half years. A third-party provider was commissioned to help clear this backlog, completing nearly 200 assessments to date.
For 'getting help' services (Tier 2), approximately 315 children and young people were waiting for support at the time of transfer. Since then, while referrals have increased, the number of children and young people waiting for treatment has reduced by around 40%, now standing at 145. This reduction includes those who confirmed their ongoing need and were offered options such as online therapy.
Councillor Roger Hayes raised concerns about the increasing complexity of referrals alongside the rise in numbers, which was acknowledged. The panel was assured that despite resource challenges, there is a strong emphasis on partnership working across health, social care, and education. Councillor Brian Austin questioned the reduction in waiting list numbers, and it was clarified that this included those who had confirmed their ongoing need and were offered options such as online therapy. David Still highlighted the potential for young carers to experience burnout and escalate to Tier 3 services if waiting lists remain long, a concern echoed by Councillor Rizwana Malek regarding support for families during waiting times.
Families waiting for neurodevelopmental assessments are provided with a 'while-you-wait' pack. Additionally, psychoeducation groups for parents have been introduced to offer support around behaviours and sleep. A duty clinician is also available for families who need to speak to someone. The effectiveness or success rate of these measures is not explicitly stated, but they are described as ongoing support mechanisms.
When reviewing waiting lists, individuals are contacted to confirm their ongoing need for support. If they still require the service, they are offered options, including online therapy, if they would consider it suitable for them. The meeting minutes do not explicitly detail the criteria for offering online therapy or how equitable access is managed beyond this confirmation process.
The long-term strategy involves building on the progress made to date, strengthening collaboration across mental health, social care, education, and voluntary services, and improving transitions between organisations to reduce variation for children and young people and their families. The vision is to create a more seamless, place-based system where services work together around the needs of children and young people, regardless of organisational boundaries. The meeting mentions that it is about kind of thinking about moving to a needs-based system
and that it's not just about resources. I think it's also about doing things kind of slightly differently.
However, specific details on additional resources or training for clinicians to manage complex cases are not provided.
Despite these ongoing challenges, partnership working has been a key focus, with regular pathway interface meetings and a memorandum of understanding with Achieving for Children. A pilot 'one-stop shop' in Sutton for children and young people with neurodevelopmental needs is also being evaluated for potential rollout in Kingston. This pilot is designed to provide earlier support and signposting for children and young people aged 5 to 18 with neurodevelopmental needs, allowing them to drop in without a referral or appointment. The premise of the pilot is to test whether this needs-led, earlier support can improve the family experience and reduce escalation of needs. The findings from the evaluation of this pilot will inform its long-term viability and the potential for its rollout in other boroughs, including Kingston. Specific criteria and evaluation metrics are not detailed, nor is a projected timeline for potential rollout in Kingston.
Further details on the meeting and the review can be found in the Public reports pack.