Note: This statement focuses on a technology formerly known as Oxevision, produced by a for-profit company formerly known as Oxehealth. Both the parent company and possibly the technology were rebranded as “LIO” or “LIO Health” in August 2025, during the course of the Lampard Inquiry. In order to create a coherent digital record, we use both names.
The Lampard Inquiry is an independent statutory inquiry investigating the deaths of more than 2,000 people under the care of psychiatric services in Essex between 2000-2023. The inquiry has come about thanks to the tireless campaigning of bereaved families and activists.
This week, the Inquiry turned its attention to healthcare company LIO (formerly Oxehealth) and Oxevision, the highly controversial surveillance technology it provides to Essex Partnership University NHS Foundation Trust (EPUT) for use in psychiatric inpatient bedrooms, with written and oral evidence from Oxehealth/LIO, EPUT, and representatives from the user-led campaign group Stop Oxevision who detailed grave ethical concerns with the technology and called for the end of camera usage in mental health patient bedrooms.
The evidence and recordings/transcripts from Monday and Tuesday’s hearings are available on the Lampard Inquiry website. Please note that these materials include distressing details and references to methods of suicide, self-harm, sexual violence, and abuse.
On Monday 13th October, Oxehealth/LIO acknowledged for the first time that cameras in patients’ bedrooms, recording 24/7, could possibly constitute “a significant invasion of privacy”.
On Tuesday 14th October, EPUT admitted that “there is the possibility” that Oxevision is being misused, not just at EPUT, but at all trusts using it.
This technology is currently present in half of mental health trusts in England. NSUN is calling on all trusts using Oxevision to suspend use immediately.
What is Oxevision/LIO?
Oxevision is a camera-based surveillance technology developed by the for-profit company, LIO (formerly Oxehealth), a spinout company from the Oxford University Bioengineering Institute funded by the NHS Innovation Accelerator (which also funded the infamous SIM programme). It is used in psychiatric inpatient bedrooms alongside other settings to enable the remote monitoring of patients through vital signs readings, access to a video feed, and an incident alert/warnings system.
What are the concerns about Oxevision/LIO?
There is widespread outrage about the legality of the use of Oxevision as a blanket surveillance technology and restrictive practice, and fears it will exacerbate existing systemic issues of understaffing, poor practice and lack of consent in the mental health system. You can read an overview of concerns about this technology in this open letter by Stop Oxevision, first published in 2023.
There are a range of legal issues with its use, from widespread failure to obtain informed consent from patients to the violation of their right to privacy under the Human Rights Act. This is on top of further issues pertaining to the ownership of and access to video footage recorded by Oxevision technology. In September 2023, NHS England wrote to all mental health trusts urging them to ensure that their use of the technology was lawful, including a laundry list of potential legal problems that the technology could cause.
There are extensive reports of Oxevision worsening distress among patients (see case studies here, here, here, and here). In particular, the impact of constant surveillance is experienced by patients as intrusive, (re)traumatising, and intimidating. Staff are also deeply concerned about its use. Where Oxehealth/LIO give examples of patients feeling reassured by the technology, this is often based on overestimations/misunderstandings about its capabilities.
A 2023 report from the HM Chief Inspector of Prisons found it to be ‘intrusive and unnecessary’ as a routine practice. A 2024 systematic review into studies on surveillance technologies in inpatient settings found that the research into their efficacy were generally of ‘low methodological quality, lacked lived experience involvement, and a substantial proportion (28.1%) declared conflicts of interest’. In their written and oral evidence to the Lampard Inquiry, Stop Oxevision also highlighted research using video generated through Oxevision cameras that has been deemed unethical by the Health Research Authority.
Key developments from the hearings
On Monday 13th October, for the first time, Oxehealth/LIO conceded that Oxevision vision-based monitoring systems record video footage of patients in their rooms for 24 hours a day. This is an incredibly important admission, especially given that many patients are never told that this is happening, and one that Oxehealth/LIO was forced to accept as a “possibly” significant invasion of privacy. It is outrageous that it took a statutory public inquiry in order for the manufacturer of this technology to make this clear.
In their questioning, representatives of the Inquiry explored the extent to which Oxehealth/LIO could be seen as responsible for how Oxevision is used by trusts. In response, it seemed as though the company was attempting to push responsibility for ensuring the ethical and lawful use of Oxevision onto individual trusts. While Oxehealth/LIO agreed that informed consent should be obtained from patients for the use of Oxevision, as far as we have been aware, in practice, patient consent is rarely actively sought by trusts using the technology.
On Tuesday 14th October, EPUT accepted possible misuse of Oxevision in its psychiatric inpatient wards. EPUT accepted there could be an overreliance on the technology, and that there is little – other than new internal policies – preventing staff from using it maliciously to access live video footage into patients’ bedrooms. EPUT also agreed that the risk of cameras in patient bedrooms exacerbating existing mental distress “should have been anticipated”.
The Trust’s evidence around the absence of patient awareness or consent for the use of Oxevision is particularly concerning, with its representative admitting that staff have relied on assuming patients’ ‘implicit consent’ upon admission and conceding that it “should have done better” to ensure and record consent. Technology that records patients 24/7 should never be used as a default option that patients must opt out of, especially if patients may never have explicitly consented to it in the first place.
EPUT’s insistence that the misuse of Oxevision by its staff goes against its internal policies offers little reassurance when, practically in the same breath, it tells us that it is difficult to ensure full compliance with these policies. In the same way that Oxehealth/LIO appears to blame trusts for the misuse of Oxevision, EPUT appears to pass the blame to its staff.
The Trust also said there had been insufficient national guidance to support it in its roll out of Oxevision. While private companies and trusts are failing to take the necessary accountability for the ethics and risks of the technology they are producing and procuring, regulatory and oversight bodies are also failing to ensure it is used safely.
Implications
It was made clear that the failings at EPUT may be the case at all trusts using Oxevision. It is unacceptable that other trusts continue to use this technology despite its risks.
Ultimately, while Oxehealth/LIO emphasises that the technology can be used in different ways, it offers very little guidance on how to ensure it is used ethically and lawfully. Instead, the company leaves NHS trusts to develop their own policies, protocols and training – found in many cases, such as inquests into patient deaths referenced by the Inquiry, to be inadequate – without any oversight. This means that trusts must navigate complex legislation and national guidance on remote patient monitoring – such as the “brief guide” provided by CQC – independently.
This approach leaves under-resourced trusts signing millions of pounds’ worth of contracts with Oxehealth/LIO – which claims its technology is cost-saving – only to find themselves open to lengthy and expensive legal battles over its use.
It is important to highlight that Oxehealth is not the first or the last for-profit company to become dangerously entangled with our health service. Previously, the High Intensity Network marketed tactics used in policing to mental health services through the controversial Serenity Integrated Mentoring programme, and currently, Palantir – the US data company known for its collaboration with the Israeli defense ministry – holds a multi-million pound contract to build a ‘federated data platform’ for the NHS. The implications of issues with this ‘innovation’ should extend far beyond LIO/Oxevision, serving as a warning of the dangers of placing public services in the hands of for-profit companies.
Right now, Oxevision is used – and likely, given what we heard at the Lampard Inquiry, misused – in half of mental health trusts, and continues to expand its reach nationally and internationally.
Our demands
It is now clearer than ever that the continued use of Oxevision is not safe or ethical. Rights abuses are happening right now. The Lampard Inquiry is not due to publish its final report and recommendations until 2027. This is too late. We are therefore making the following demands now:
- We call on all mental health trusts using Oxevision to immediately suspend its use on the basis of safety and legality concerns.
- LIO/Oxehealth must allow trusts to exit contracts with them.
- We call on the Lampard Inquiry to take any urgent action possible to urge all trusts to suspend usage of Oxevision.
- Regulatory/oversight bodies such as NHS England and the Care Quality Commission must take long-overdue action to halt the use of Oxevision.
- The NHS Innovation Accelerator* must take accountability for and address the harms it has facilitated.
*The NHS Innovation Accelerator is a publicly-funded initiative focussed on implementing new healthcare products across the NHS that awarded funding to Oxehealth. We feel it is clear that Oxevision breaches the NIA’s Code of Conduct, which explicitly prohibits illegal, dishonest or unethical behaviour.
To end this statement, we are naming the trusts we believe are using Oxevision in patient bedrooms and/or 136 suites/seclusion rooms, based on research undertaken by Stop Oxevision, which is available here.
- Active Care Group (private; previously called Huntercombe)
- Berkshire Healthcare NHS Foundation Trust
- Cambridge and Peterborough NHS Foundation Trust
- Central and North West London NHS Foundation Trust
- Coventry and Warwickshire Partnership NHS Trust
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust
- Derbyshire Healthcare NHS Foundation Trust
- Devon Partnership NHS Trust
- East London NHS Foundation Trust
- Essex Partnership University NHS Foundation Trust
- Hampshire and Isle of Wight Healthcare NHS Foundation Trust (previously Southern Health, Solent and some services from Isle of Wight and Sussex Partnership)
- Hertfordshire Partnership University NHS Foundation Trust
- Kent and Medway NHS and Social Care Partnership Trust
- Lancashire and South Cumbria NHS Foundation Trust
- Midlands Partnership University NHS Foundation Trust
- North East London NHS Foundation Trust
- North Staffordshire Combined Healthcare NHS Trust
- Oxford Health NHS Foundation Trust
- Pennine Care NHS Foundation Trust
- Rotherham, Doncaster and South Humber NHS Foundation Trust
- South London and Maudsley NHS Foundation Trust
- South West London and St George’s Mental Health NHS Trust
- Surrey and Borders Partnership NHS Foundation Trust
- Tees, Esk and Wear Valleys NHS Trust
- West London NHS Trust
Note on other trusts
Trusts that previously used Oxevision in patient bedrooms but stopped using it after a trial are Camden and Islington (now North London NHS Foundation Trust), Leicestershire Partnership NHS Trust, and Nottinghamshire Healthcare NHS Foundation Trust. We believe that Black Country Healthcare NHS Trust planned to implement it, and possibly had the monitors installed, before deciding against it.
Live Well South West – a Devon-based NHS Trust operated by a Community Interest Company (CIC) – have persistently refused to respond to Freedom of Information requests. The technology may also be used in detention centres and secure children’s homes. However, due to the fact that these services are privately run, and therefore not subject to the FOI Act, the extent of its use in these settings remains obscured.
We would also like to direct readers to the statement provided by Hat Porter on behalf of Stop Oxevision, which can be found here.
If you are a journalist covering this news and you would like to speak to an NSUN representative for comment, please contact Kieran Lewis, NSUN’s Rights and Migration Policy Manager, at kieran.lewis@nsun.org.uk.