Provision of food and drink
The arrangements and best practice for providing food and drink to elderly patients require constant review, monitoring and implementation.
- Regulation 14 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 mandates that the nutritional and hydration needs of service users must be met (The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, SI 2014/2936).
- The Department of Health and Social Care and NHS England stated in April 2025 that the CQC provides specific guidance for providers on meeting these regulations (DHSC and NHS England implementation update provided to the Thirlwall Inquiry, April 2025).
- No further published evidence specific to the constant review of arrangements for elderly patients has been identified since 2022.
How was this evidence gathered?
Response
Accepted
Response
AcceptedThe government published "Hard Truths: the Journey to Putting Patients First" (Cm 8777) on 19 November 2013, responding to all 290 recommendations of the Francis Report. This followed an initial response "Patients First and Foremost" in March 2013. Key reforms included a new Chief Inspector of Hospitals, strengthened Care Quality Commission inspection regime, a statutory duty of candour, and the fit and proper person test for NHS directors. Volume 2 (Cm 8754) contains the government's detailed responses to each of the 290 recommendations. See: https://assets.publishing.service.gov.uk/media/5a7cd486ed915d63cc65d167/34658_Cm_8777_Vol_1_accessible.pdf
Progress Timeline
DHSC and NHS England implementation update provided to the Thirlwall Inquiry (April 2025). This is the government's own account of progress, submitted to the inquiry. Reviewed extent of implementation: Implemented - Ongoing. NHS England publish national standards for healthcare food and drink in hospitals. Outcomes should be detailed and measured, allowing the organisation to demonstrate how it is meeting required standards. Regulation 14 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 sets out that the nutritional and hydration needs of services users must be met. CQC also provide guidance for providers.
Published Evidence
Published assessments of progress from inspectorates, select committees, official progress reports, and other sources. Source type badge indicates whether each assessment is independent or government self-reported.
Research published 2023 marking ten years since the Francis Report found mixed results. Structural and legislative changes largely delivered (duty of candour, FPPR, CQC overhaul, revalidation, Freedom to Speak Up Guardians). However, cultural change not fully embedded; understaffing, fear of speaking up, and poor complaint handling persist in parts of the NHS.
Monitor merged with the Trust Development Authority to form NHS Improvement from 1 April 2016. NHS Improvement then merged with NHS England from 1 July 2022 under Health and Care Act 2022. Francis recommended incremental merger of system regulatory functions between Monitor and CQC; this was partially achieved through structural reorganisation.
Government published "Culture Change in the NHS" (Cm 9009) reporting progress on all 290 recommendations. Key achievements: 19 hospitals placed in special measures; those trusts recruited 109 additional doctors and 1,805 additional nurses; 129 board-level changes made; excess avoidable deaths fell by 450 in less than a year.
Government published "Hard Truths: The Journey to Putting Patients First" (Cm 8777) in two volumes. Vol 1 set out new actions; Vol 2 provided detailed response to each of the 290 recommendations. Approximately 204 of 290 recommendations were fully accepted.