Care bodies ask PM to make nutrition a pillar of the National Care Service

Most malnourished older people live at home, not in care

Care and catering bodies have asked Prime Minister Andy Burnham to make nutrition and hydration a fundamental pillar of the National Care Service planned for England. The National Association of Care Catering (NACC) led the open letter, sent at the start of National Meals on Wheels Week (2-6 November 2026).

An estimated 1.3 million people aged over 65 in the UK suffer from malnutrition, according to the letter (opens in a new tab), and 93% of them live in the community rather than in care settings. Most of what the letter asks for therefore falls to community services and the councils that commission them, not to care homes.

The meals that reach them are not a council duty

Meals on Wheels is not a statutory requirement for councils, and the letter warns that these services are being steadily lost.

"At a time when the Government is rightly emphasising prevention, the loss of these services risks undermining that ambition," the signatories wrote (opens in a new tab). Those older people most at risk live at home, and the meals that reach them are optional for the council.

Four asks, made while the service is still being designed

The signatories want four commitments from government. They ask it to make nutrition and hydration fundamental to the National Care Service and to protect and invest in preventative nutritional services. They also want nutritional support built into health and social care pathways and stronger accountability for nutritional outcomes, as set out in the letter (opens in a new tab).

By asking now, the coalition wants nutrition written into the service from the start, not added once the framework is set. Much of the service is still to be decided, as our report on what ministers have said so far shows.

Signatories include NACC national chair Neel Radia, NACC patron Baroness Barker, Care England chief executive Martin Green, National Care Forum chief executive Vic Rayner and APSE chief executive Mo Baines. Leaders from the British Dietetic Association and the Hospital Caterers Association also signed, among others.

The £11 billion savings claim comes without the sums

Earlier intervention and preventative nutritional support could save more than £11 billion across the public purse, the signatories claim (opens in a new tab). The letter does not show how that figure was reached, and it does not name the study behind the malnutrition figures.

Without those sums, the financial case for making Meals on Wheels a statutory duty is not yet made. A formal nutrition pillar with no new money attached would also land on councils already short of the money to pay for existing duties.

Will the new service make home meals a duty?

Whether Meals on Wheels or community nutrition services become a statutory duty within the National Care Service has not yet been decided. No government response to the letter has been published.

If prevention is the aim, will the service give the meals that reach older people at home a duty and the money to match, or leave them as they are now: optional, and being steadily lost?