- SERVICE PROVIDER
East London NHS Foundation Trust
This is an organisation that runs the health and social care services we inspect
Assessment report published 28 July 2026
Contents
Ratings - Mental health crisis services and health-based places of safety
Our view of the service
We carried out an inspection of the trust’s mental health crisis services and health-based places of safety on 25 to 27 November 2025. The mental health crisis services and health-based places of safety form part of the trust’s mental health services in the community. This inspection was completed as part of CQC's Adult Community Mental Health Programme. We also inspected community-based mental health services for adults of working age as part of the programme. The programme of inspections contributes to CQC's commitment to assess the standard of care in community mental health services across the country. We undertook a short-notice announced, comprehensive inspection of this service, looking at all 5 key questions to assess if services are safe, effective, caring, responsive and well-led.
East London NHS Foundation Trust is part of the North East London Integrated Care System (ICS) and was part of the Bedfordshire, Luton and Milton Keynes ICS. Since April 2026, Bedfordshire, Luton and Milton Keynes ICS has been replaced with a new single organisation serving 3.5 million people across Bedfordshire, Luton, Milton Keynes, Hertfordshire, Cambridgeshire Peterborough called NHS Central East Integrated Care Board (ICB). There are 3 local authorities across Bedfordshire and Luton, 1 of which is in the most deprived category of all local authorities in England.
The population of the North East London ICS area is over 2 million, with significant health inequalities across the 6 local authorities and City of London Corporation. Each local authority is more ethnically diverse than the national average. Three of the local authorities are in the most deprived category of all local authorities in England. Suicide rates within the ICS are lower than the national averages for both males and females across all local authorities and rates of emergency hospital admissions for self-harm are lower than the national average for both males and females across all local authorities.
The trust’s mental health crisis services and health-based places of safety are spread across 4 geographic localities:
- Bedfordshire and Luton
- Newham
- City and Hackney
- Tower Hamlets
The way in which services were organised and delivered varied across the 4 localities and across different teams. This included differences in governance systems.
In Bedfordshire and Luton locality there were 2 Crisis Resolution Home Treatment (CRHT) teams who worked with people in mental health crisis to support them in their own homes. In Newham, City and Hackney and Tower Hamlets localities, mental health crisis services were provided by Home Treatment Teams (HTT) and Crisis Assessment Teams (CAT). HTTs worked to support people in mental health crisis in their own homes. CATs carried out urgent assessments for people presenting in mental health crisis.
The trust operated 2 NHS 111 option 2 telephone services for people to call when experiencing a mental health crisis. These operated 24 hours a day, 7 days a week and were based in Tower Hamlets and Bedfordshire and Luton localities. The 111 option 2 service in Tower Hamlets provided the crisis phone line for the trust and a neighbouring NHS trust.
The trust had 2 health-based places of safety (HBPoS) at City and Hackney Centre for Mental Health and Luton and Central Bedfordshire Mental Health Unit. Health-based places of safety, otherwise known as 136 suites, are used if someone is detained by police under Section 136 of the Mental Health Act 1983, to remain for a maximum of 24 hours until a Mental Health Act assessment is undertaken.
At our last inspection, in June 2016, we rated the service as good overall. We rated safe, effective, caring and well-led as good and responsive as outstanding. There were no breaches of regulation. At this inspection the rating changed to requires improvement. We rated safe, effective, responsive and well-led as requires improvement. We rated caring as good. We found 5 breaches of regulation relating to:
- the suitability of environments, including lack of access to fresh air in the HBPoS
- the deployment of sufficient staff
- consent and use of the Mental Health Act
- timely access to appropriate care and treatment
- governance.
We have asked the provider for an action plan in response to the concerns found at this inspection.
People's experience of this service
During our inspection we spoke to 13 people who used services and 2 carers. Feedback from people was mixed with some people commenting positively about support received from crisis teams and others commenting negatively on the attitude of some staff. Some people told us they felt the crisis team had supported them to stay safe saying “They were so kind and absolutely helped me to avoid risks. They did their best to keep me out of hospital.” However, some people told us not all staff had treated them with respect, using words such as condescending and rude to describe some interactions with staff. Some people told us they found the 111 option 2 service difficult to access and they did not always find it helpful.
Feedback from the 2 carers we spoke with was mixed. One carer told us about the difficulties they and their loved one had when transitioning between child and adult services whilst in crisis. Another shared concerns about how they had not felt listened to when trying to complain. However, both gave positive feedback about the attitude of some staff in the crisis teams.
People we spoke with who had used the HBPoS spoke very positively about staff. They told us they had family involved when they wanted this, they were supported to maintain contact with friends and family, and they felt supported.
Bedford Borough Healthwatch received feedback throughout 2025 from people using services and carers about the difficulties in contacting and getting help through the 111 option 2 service. They also expressed concern about the reduction in crisis café provision. A crisis cafe is a safe, welcoming place where people who are struggling with daily life or their mental health can go if they urgently need support. They are generally provided by NHS trusts, other mental health service providers or mental health charities. They aim to provide an alternative to emergency departments and other urgent services which may not be appropriate.