NHS South West London are developing a Clinically-Led Strategic Plan. The plan will be underpinned by high-quality evidence, analysis and insight, and shaped through insight and engagement with patients, the public and partners across the system. This is an opportunity to design a sustainable, effective health and care system that meets the needs of our communities now and in the future.
This will include looking at:
- understanding and predicting the future health needs of our local population in South West London
- our clinical outcomes in South West London compared to national best practice
- local operational data that shows we are performing for patients
- workforce intelligence to support frontline staff to reshape services and work in new ways
- insights from the experience of patients, local people and communities who want more control to manage their own health.
To help inform clinically-led discussions, the South West London ICB community engagement team provided an overview of insights gathered from people and communities on the following areas:
1. Frailty
2. Maternity and neonatal
3. Mental health
4. Planned specialist care (end-to-end care from outpatients to intervention)
5. Long term conditions
6. End of life care
A series of clinically-led workshops are bringing together partners to discuss each area, between October and early 2026. This insight on what matters most for communities was presented at the beginning of each specialist workshop.
What we did
The South West London community engagement team undertook a desk top literature review of insight for each of the specialist clinical areas each workshop is focusing on, pulling out key themes from multiple insight sources to show ‘what matters most to people and communities’.
We started by mapping sources of local existing insight for each area, drawing on reports from partners locally and relevant regional and national reports. A nominated member of the team was responsible for coding and theming the insight for each topic – pulling out the consistent and frequent themes. All the reports we analysed are included in the reference section of ‘Sources of insight’ for each clinical area.
Insight about people and communities
What matters most to people and communities
Themes we have heard about mental health and wellbeing from our people and communities:
Access and long waiting times
- Long waiting times and lack of clarity about services stop people seeking help until things become unmanageable. People feel that the waiting times for therapy are too long, with some needing to self-refer before their situation becomes critical.
- “I find the long waiting times for referrals incredibly stressful.“
- You get told to wait, and while you wait, things get worse.”
- Waiting to be seen by mental health services can leave people feeling alone and unsupported, often until their situation becomes critical and they reach crisis point. Many give up before being seen.
- “It took so long to get seen – I just gave up.”
- “Mental health support needs to be easier to access and there needs to be more specialised GP practitioners.”
- Confusing online systems, reliance on apps, limited appointments, transport issues and lack of translated materials exclude people from accessing information and appointments. Older adults, neurodiverse people, and non-English speakers feel that they are the most impacted by the move to digital healthcare.
- “I have been pushed from pillar to post. I fall in the gap between the CMHT saying you’re not ill enough to the well-being service you’re too well. Where do you turn to?”
Experience of care and complicated pathways
- People do not always feel listened to or understood and that the focus on medication can get in the way of meaningful discussion of the person as a whole.
- “It’s like they just want to medicate you, not understand you.”
- After discharge from an impatient setting, people often felt forgotten and did not know where to turn.
- “Feeling listened to by GPs or supported by community groups was crucial for mental wellbeing.”
- Inconsistent experiences of crisis lines, with some finding them supportive and others saying that calls feel rushed or unhelpful.
- Peer-to-peer groups were seen to be an important alternative to formal therapy. People reported positive experiences of sharing practical support, sharing understanding, in spaces that feel ‘safe’ and ‘without stigma’. For some, peer-to-peer groups were seen as more effective than traditional therapy, and autistic/neurodivergent participants valued spaces run by people with lived experience.
- “I get fed adverts for NHS crisis lines and the sort all the time – how about stopping people getting to a crisis?”
- Complicated pathways and low awareness of mental health services in the community make it difficult to know what support is available and communication between services can be disjointed.
- “Referrals into mental health services seem to be delivered to a black hole.”
Barriers to mental wellbeing
- Loneliness, social isolation, the cost of living and digital exclusion are major issues impacting the mental wellbeing of our communities. This is particularly prevalent amongst older adults and those with caring responsibilities.
Long waiting times for diagnosis and services
- Waiting lists for assessments of up to 9 to 18 months, sometimes longer, can leave families without support in the interim with some seeking private assessments as a last resort.
- “The waiting list is killing us. It really is – parents who generally have neurodivergent children and who need help. You are sitting in limbo for a long, long, long time and you’re trying your best to help them.”
- After diagnosis, children were not always seen quickly by services with some families feeling ‘abandoned’ without support.
- Some families described feeling stuck between health and care services, particularly at the transition from child to adult stage which some families experience as ‘disorganised’.
- Some people described missed opportunities for earlier intervention, which could have helped prevent behaviours and experiences from worsening. Young people with SEND needs experienced more negative emotions, low resilience and self harm with those from global majority and LGBT+ communities identified as particularly vulnerable.
Support in navigating diagnosis, services and information
- Some parents described feeling lost when navigating services, describing the system as fragmented and confusing with not enough signposting.
- Young people and families want to feel like they are being listened to without judgement and given practical advice navigating services as well as advice on how best to parent children with these kinds of needs.
- “My child is quiet and can just sit in the corner. There needs to be more of a holistic approach to look at everything else and how children can be different at home. Sometimes, it’s about taking mum’s word for it.”
- “I got most of my support from Kooth because it was anonymous and I don’t have a super close relationship with my mum or dad.
Kooth gave me someone who listened.” - Parents and carers talked about how they would like to access informal professional support and peer support from other parents whilst young people described a preference for open conversations and informal support settings over clinical settings
- “Sometimes we feel bombarded with information – when really we need some hand-holding to process it.”
Barriers to mental wellbeing
- Stigma and fear of judgement mean that many families delay seeking help and some described feeling dismissed or misdiagnosed with women and mothers sharing experiences of being perceived as “troublesome” “neurotic” or “difficult” when seeking advice for their child.
- Financial considerations are also given as barriers to accessing wellbeing services and can lead to worsening mental wellbeing young people and their parents and carers
- The school environment can affect mental wellbeing, with contributing factors including bullying, loneliness and a lack of safe spaces.
- “Many young people struggle with the stress of secondary school and the changes they face along the way and for some people it may be harder than others for example some students’ parents may be splitting up.”
Experiences of racism, bias and cultural sensitivity
- People from global majority communities shared experiences of racism, mistrust and stigma from health and care services.
- Historic discrimination and stereotyping has led to low trust in mental health services for people from global majority backgrounds, leaving many feeling judged and not listened to, feeling that they might be perceived as aggressive rather than unwell.
- “You go into crisis and then you’re bought in by institutions and detained in hospital. That’s a vicious cycle. Then you no longer trust them, and it goes around again.”
- Some people feel that services do not always have sufficient cultural awareness and representation, people from global majority backgrounds tell us that they would like to be cared for by staff who understand their background, language and culture.
- Mental health care and support that resonates with culture, language, and lived experience was seen as more effective, especially when delivered by trusted local voices.
- Community led and faith-based organisations can be seen as safer and more trusted than some clinical settings.
- Language barriers, poor understanding of different beliefs and cultures and a lack of staff from diverse backgrounds leave people feeling unheard or excluded.
- “Sometimes I don’t understand what the doctor is saying, and they don’t understand me either. It’s scary because I might agree to something that’s not right for me.”
Stigma, fear of judgement and awareness
- Stigma within communities is a major barrier to discussing mental health or seeking help or support
- “For someone who is a member of the African-Caribbean community, there is a huge amount of stigma. My own family would not accept that I had mental health challenge. I was completely isolated which was very difficult.”
- “This is a serious issue with men of ethnicity as mental health is not a topic, they feel suppressed due to culture and religious beliefs – this is stigmatised by the elders within families as they are taught that expressing emotions is a sign of weakness.”
- Cultural upbringing shapes how mental health is discussed. Many women normalised struggles, using “depression” rather than “mental health” and avoiding conversations within families. “We were brought up to just get on with it.”
Insight from other communities experiencing health inclusion factors
- Those experiencing homelessness struggle to register with GPs or access mental health care, often relying on A&E.
- Refugees and asylum seekers who have experienced trauma can face language barriers and digital exclusion, leaving them unsure where to turn.
- “We want a quick decision for the asylum – my mental health is going down I feel like doing suicide I have two small children as I’m unable to work.”
- LGBTQ+ people feared discrimination or being misunderstood if not open about their identity with their GP.
- “The biggest issue for people in the LGBTQ community in seeking help/support is fear. This may be fear of discrimination, fear of recrimination or lack of support based on their sexuality or gender identity.”
- Gypsy, Roma and traveler communities experienced stigma, a high suicide risk and felt they had very limited access to local services.
Sources of insight
These are some examples of the reports we have used in this summary of insights around mental wellbeing. We have used reports from our South West London insight bank drawn together from engagement work across South West London including from our Healthwatch and voluntary and community sector partners:
- Children’s emotional wellbeing and neurodiversity engagement report Sutton (October 2025) – presents findings from engagement with families living in Sutton with primary-aged children with diagnosed or suspected neurodiversity. The report builds on a south west London-wide literature review – reaching 23 families through a survey, one-to-one interviews and coffee morning.
- Literature review on children and young people’s mental health (March 2025) – a literature review which analysed insights across South West London on children and young people’s mental health, including those with Special Educational Needs and Disabilities (SEND) – analysed 15 reports from various sources, reaching an estimate of 5,186 participants
- Merton and Wandsworth children and young people’s engagement fund insight report (March 2025)- findings from engagement with over 420 children, young people and family members across Merton and Wandsworth.
- Grants programmes in spring 2025, winter 2024/25 and winter 2023/24 – partnering with VCSE sector to gather insight from communities disproportionately impacted by health inequalities and most likely to experience the worst health outcomes
- 10 year health plan engagement (January 2025) – around the NHS 10-year plan 3 shifts and key themes from local analysis of engagement reports in 2023/24 – 80 community and voluntary sector leaders
- Insight from local people and communities in South West London updated in 2024 – summarises the insight from people and communities in 2023-24 submitted by Healthwatch organisations, voluntary and community sector organisations, NHS Trusts, local councils, and Place-based public and patient engagement teams – examining 300 reports from various sources
- Our Mental Health Strategy for South West London – NHS South West London Integrated Care Board (October 2023) – analyses population needs and listening to issues raised by residents, stakeholders and those with lived experience of mental health, focusing on prevention (from pregnancy onwards for the whole life course) as much as treatment.
- Our five-year plan for the NHS in South West London. A Joint forward plan 2023-2028 (July 2023) – patient and public insights against the priorities in the plan based on the engagement activities in April to May 2023.
- Joint Forward Plan – Our engagement with people and communities, April to May 2023 (June 2023) – engagement on the first phase of the NHS Joint Forward Plan published in March 2023, focusing on populations and geographies identified through the gap analysis of our insight from people and communities review – 1,446 responses to the survey, 187 people in focus groups and one-to-one interviews
- Ethnicity Mental Health Improvement Programme (EMHIP) – key interventions report (2023) – presents findings from engagement with over 90 people across Wandsworth’s Black and minority ethnic communities, including service users, carers, community leaders and mental health staff- using focus groups and interviews
- Wandsworth Council enough is enough (2023) – community engagement across Wandsworth’s ethnic minority populations, using feedback and data to highlight inequalities in mental health experiences
- Healthwatch Croydon’s young peoples experiences of mental health in Croydon (February 2020) – aimed to understand young people’s experiences and awareness of mental health and mental health services in Croydon – reached 146 young people through various engagement methods.