East London NHS Trust downgraded over Hackney mental health safety risks

Emergency mental health support in Hackney and the City of London has been downgraded by the Care Quality Commission after inspectors found repeated safety failures. The East London NHS Foundation Trust, which runs the services, was told on 28 July 2026 that its rating had fallen from ‘Good’ to ‘Requires Improvement’ following an inspection in November 2025.

The CQC identified breaches in four of its five core quality areas: Safe, Effective, Responsive and Well-led. The trust retained its ‘Good’ rating only for Caring, where inspectors noted staff showed kindness and used the least restrictive options to calm patients in distress.

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Supervision gaps and extended stays

In Hackney and the City of London, 68% of staff missed mandatory supervision sessions, which are designed to support workers dealing with acute psychiatric crises. The CQC found this issue had not improved after its inspection. Inspectors also discovered a CCTV blind spot in a bathroom at the health-based place of safety, which staff said had remained unresolved for two years.

Patients faced longer stays than legally permitted. Around 30% remained in the emergency suite for more than 72 hours, with an average stay of 70 hours. Staff used a legal loophole, admitting patients to temporary ‘swing beds’ to avoid breaching the 24-hour detention limit under the Mental Health Act.

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Training and staffing shortfalls

Only half of the trust’s staff had completed adult basic life support training, raising risks for both clinicians and patients. Staffing levels were also critically low, with more than one in 10 temporary shifts left unfilled. The CQC noted that physical and chemical restraints were used more frequently in Hackney and the City of London than in other areas covered by the trust.

The trust’s wider services also faced issues. In Luton, 29 patients detained under emergency police powers were kept beyond the legal 24-hour limit, with one patient waiting more than 72 hours for release. In Tower Hamlets, sickness absence among specialist home treatment workers peaked at 15.1%.

Our colleagues do extraordinary work every day, often supporting people through some of the most challenging moments of their lives. The feedback we received from the CQC report relating to some of our crisis teams recognises the commitment, kindness and expertise of our colleagues.

Claire McKenna, chief nurse, East London NHS Foundation Trust

Savings plan and service changes

The trust announced last week that it aims to save £24.1 million this year. It plans to restructure nine front-line services, including adult mental health crisis care. Up to 330 posts across its 6,000-strong workforce could be affected. Unions have criticised the plans and said they will ballot members on strike action.

The trust must now submit an action plan to the CQC outlining how it will address the identified failures. Residents can review the plan once it is published, though no formal consultation has been announced. The trust’s overall CQC rating remains ‘Outstanding’, but the downgrade for emergency mental health support reflects persistent challenges in delivering safe and effective care.