All Wales Nutrition and Catering Principles and Standards for Food and Fluid Provision for Patients in Hospital (2026) (WHC/2026/030)

Status: 

Action and Information for Compliance

Category: 

Quality and Safety, Policy and Governance

Title: 

All Wales Nutrition and Catering Principles and Standards for Food and Fluid Provision for Patients in Hospital (2026)

Date of Expiry / Review: 

September 2031

Action by:

Chief Executives
Executive Directors of Nursing
Directors of Therapies and Health Sciences
For Information:
DG/Chief Executive, Health, Care & Prevention Group
NHS Wales Deputy Chief Executive, Health, Care & Prevention Group
Directors of Public Health, Health Boards/Trusts
Medical Directors, Health Boards/Trusts
Directors of Primary Care, Health Boards/Trusts
Chief Operating Officers, Health Boards/Trusts
Chief Pharmacists, Health Boards/Trusts
Executive Director of Public Health, Public Health Wales
General Practitioners, dental practices and community pharmacies and optometry practices
Welsh NHS Partnership Forum
British Medical Association (Cymru)
Royal College of GPs
Royal College of Nursing
Royal College of Midwives
Royal College of Paediatrics and Child Health
College of Optometrists
British Dental Association
British Association for Parenteral and Enteral Nutrition (BAPEN)
Royal College of Speech and Language Therapists (RCSLT)
Hospital Caterers Association (HCA)
British Society of Gastroenterology (BSG)
Parenteral and Enteral Nutrition Group (PENG)
Royal Pharmaceutical Society
Community Pharmacy Wales
Optometry Wales
Care Inspectorate Wales
Healthcare Inspectorate Wales

Required by: 

Within 12 months of publication

Sender: 

Dame Sue Tranka, Chief Nursing Officer, Nurse Director NHS Wales

Welsh Government Contacts:

Office of the Chief Nursing Officer, Nursing, Experience and Safety Directorate, 
Welsh Government, 
Cathays Park, 
Cardiff CF10 3NQ
QualityAndNursing@gov.wales 

This Welsh Health Circular announces the publication of the new All Wales Nutrition and Catering Principles and Standards for Food and Fluid Provision for Patients in Hospital (2026), with an accompanying Self-Assessment Tool.

These revised standards provide updated technical guidance for staff responsible for ensuring the nutritional and hydration needs of hospital patients who can eat and drink are met.

They replace the 2011 standards following a defined implementation period.

The standards establish 7 overarching principles for safe, effective and person-centred food and fluid provision.

They reinforce the importance of nutrition and hydration as essential elements of clinical care, recognising their contribution to improved health outcomes, patient safety, recovery and dignity.

The standards address:

• leadership and accountability
• assessment of nutritional and hydration needs
• workforce capability
• learning and development
• sustainability
• 24-hour food service provision
• meeting the diverse nutritional needs of people in hospital

The purpose of this Circular is to notify NHS organisations in Wales of the publication of the revised standards and to support their consistent implementation across healthcare settings.

Organisations are expected to use the accompanying Self-Assessment Tool to:

• evaluate current practice
• identify areas for improvement
• monitor ongoing compliance

The standards are designed to function as an integrated framework for food and fluid provision and should therefore be read and applied as a whole.

Individual sections should not be used in isolation, as the principles and requirements are interdependent and collectively support safe, effective and person-centred nutrition and hydration care.

The standards apply to hospital settings across Wales and are intended for:

• caterers
• dietitians
• nursing staff
• other staff involved in planning, procuring, preparing, delivering, supporting and monitoring food and fluid provision for patients

The scope also includes patients cared for outside traditional ward settings, including:

• emergency care departments
• day units

It also addresses:

• adults
• children and young people
• those who are nutritionally vulnerable and nutritionally well
• people with therapeutic, specialist, religious, cultural, lifestyle or communication requirements.

The accompanying Self-Assessment Tool provides a structured method for NHS organisations to:

• review evidence against the standards
• identify areas of quality and areas for improvement
• assign a red, amber or green rating to each applicable standard

Red ratings indicate no or insufficient evidence and require escalation and mitigation.

Amber ratings indicate that evidence is available, but further quality improvements have been identified and are being introduced.

Green ratings indicate sufficient relevant evidence of quality nutrition and hydration provision.

The completed assessment should inform the organisation’s quality report and quality improvement plan.

It should also support oversight of the seven principles, even where a principle does not have a specific standard aligned with it.

Each NHS organisation is expected to complete an initial, internal baseline assessment within 12 months following publication.

Following the baseline assessment, organisations should:

• undertake a review at least annually
• identify and share good practice
• plan actions to address areas requiring improvement

The outcomes should be:

• summarised within a local nutrition and hydration quality report and quality improvement plan
• shared at Board level and with relevant stakeholders

Welsh language delivery must form part of local implementation, governance and quality assurance.

Organisations should:

• include Welsh language actions within implementation plans, self-assessment, audit and quality improvement activity
• monitor access to bilingual menus, information and digital services at the point of care.

Chief Executives, Executive Directors of Nursing and Directors of Therapies and Health Sciences are asked to ensure that:

• the revised standards and Self-Assessment Tool are communicated to relevant clinical, catering, dietetic, facilities, procurement, digital and governance teams
• an Executive Director is identified as responsible for food and drink for patients, including nutrition, hydration and safety, and for reporting on compliance
• a local multidisciplinary governance route is established to oversee implementation and annual review;
• the baseline self-assessment is completed within 12 months of publication
• red-rated criteria are escalated and mitigated, and amber-rated criteria are included within improvement planning
• evidence, actions and progress are reflected in the organisation’s quality report and quality improvement plan;
• arrangements support the Active Offer and equivalent Welsh and English provision
• learning and good practice are shared through relevant all-Wales nutrition, catering and patient experience networks

NHS organisations should begin implementation planning on receipt of this Circular and use the enclosed Self-Assessment Tool to establish their baseline position.

Local plans should identify:

• accountable leads
• evidence requirements
• governance arrangements
• priority actions

Further national learning and good practice will be shared through the All Wales Nutrition Coordinators Group and associated professional networks.

The revised standards provide a national framework for strengthening the quality, safety, consistency and patient experience of food, fluid, nutrition and hydration provision across NHS Wales.

Successful implementation will depend on:

• strong leadership
• multidisciplinary ownership
• meaningful engagement with patients and carers
• robust arrangements for monitoring and continuous improvement

By embedding these standards into everyday practice, NHS organisations will support improved patient outcomes, enhance the care experience, and ensure that nutrition and hydration are integral to the delivery of safe, effective and person-centred healthcare.

Yours sincerely

Dame Sue Tranka

Chief Nursing Officer, Nurse Director NHS Wales