First reported 21 Mar 2024•Latest report 10 Mar 2026
Definition
What this concern includes
Includes failures in prison arrangements for recognising and assessing food or fluid refusal, applying relevant policy, informing healthcare and custodial staff, monitoring intake and deterioration, considering medical or psychiatric review and hospital transfer, involving next of kin appropriately, and escalating when risk increases.
Not included
Excludes general nutrition, hydration or meal-provision deficiencies where food or fluid refusal is not the material unsafe condition.
Excludes generic staff training, communication, documentation or escalation failures unless they directly impair the prison food-and-fluid-refusal management process.
Excludes ordinary treatment or care decisions after refusal-related risks have been reliably identified and escalated.
Excludes food or fluid refusal outside prison settings unless the assertion explicitly concerns the same prison refusal-management process.
Reports
3
Distinct published reports
Individual concerns
8
A report can raise multiple concerns
Date range
2024–2026
First to latest report issue date
Stated actions
10
Described in published responses
Reports over time
Reports over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
Recipient name withheld2
Cardiff Prison1
Cardiff & Vale University LHB1
Government Legal Department1
Midlands Partnership University NHS Foundation Trust1
Ministry of Justice1
Practice Plus Group1
Swansea Bay University Local Health Board1
Type not available2
Independent healthcare provider1
Local health board1
Ministerial department1
NHS trust1
Non-ministerial department1
Prison or young offender institution1
Concerns and responses across reports
Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.
Worcestershire
Concerns raised4
Failure to inform Next of Kin of a prisoner’s decision to refuse food or fluids
Lack of prison staff awareness of the HMP Hewell food refusal policy
Lack of healthcare staff awareness of the food refusal policy
Failure to ask the prisoner whether food refusal information should be shared
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.5
Action
Deliver awareness sessions to prison and healthcare staff on supporting prisoners who refuse food, including contact with next of kin.
Stated by HM Prison and Probation ServiceStated plannedThe respondent said that this action was planned when they made their response on 12 March 2026.
Action
Ensure partner healthcare policies affecting mental health services are shared in advance for clinical input and alignment.
Stated by Midlands Partnership University NHS Foundation TrustStated plannedThe respondent said that this action was planned when they made their response on 12 March 2026.
Action
Disseminate relevant policies within mental health teams with guidance on roles, responsibilities, and interfaces with primary care.
Stated by Midlands Partnership University NHS Foundation TrustStated plannedThe respondent said that this action was planned when they made their response on 12 March 2026.
Action
Provide local feedback to primary healthcare staff on the inquest outcome and food-and-fluid refusal pathway.
Stated by Practice Plus GroupStated completedThe respondent said that this action was complete when they made their response on 12 March 2026.
Action
Deliver national talks in July 2026 on recent food-and-fluid cases and the need to follow the pathway fully.
Stated by Practice Plus GroupStated plannedThe respondent said that this action was planned when they made their response on 12 March 2026.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
Position
The food and fluid refusal pathway is considered robust and fit for purpose regardless of the reason for refusal.
Stated by Practice Plus GroupExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Position
Practice Plus Group is responsible for responding to concerns about healthcare delivery at HMP Hewell.
Stated by HM Prison and Probation ServiceRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
County Durham and Darlington
Concerns raised1
Failure to escalate information about food and fluid refusal
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
Action
Write to all Governors highlighting the case and requesting staff reminders and assurance that local food-refusal recording and healthcare-sharing systems are in place.
Stated by HM Prison and Probation ServiceStated plannedThe respondent said that this action was planned when they made their response on 1 August 2024.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
Governors are responsible for assuring that local processes record and share information about food and fluid refusals effectively.
Stated by HM Prison and Probation ServiceRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
South Wales Central
Concerns raised3
Failure to provide staff with clear information about food and fluid refusal duration and warning signs
Failure to devise and implement a clear plan for assessing capacity to refuse food or fluid
Lack of a food and fluid refusal policy
This report raised 10 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.4
Action
Establish and train staff on a joint food and fluid refusal policy at HMP Cardiff.
Stated by Cardiff & Vale University LHBStated completedThe respondent said that this action was complete when they made their response on 25 March 2024.
Action
Provide basic life support, mental capacity and bespoke prison-nursing training, with the bespoke programme underway from May 2024.
Stated by Cardiff & Vale University LHBStated in progressThe respondent said that this action was in progress when they made their response on 25 March 2024.
Action
Provide mental capacity assessment training to medical staff and plan annual refresher updates.
Stated by Cardiff & Vale University LHBStated plannedThe respondent said that this action was planned when they made their response on 25 March 2024.
Action
Develop electronic templates to support application of the food and fluid refusal policy.
Stated by Cardiff & Vale University LHBStated in progressThe respondent said that this action was in progress when they made their response on 25 March 2024.
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Includes failures in prison arrangements for recognising and assessing food or fluid refusal, applying relevant policy, informing healthcare and custodial staff, monitoring intake and deterioration, considering medical or psychiatric review and hospital transfer, involving next of kin appropriately, and escalating when risk increases.
