Neeshat Dalal

Minister of State for Health (Secondary Care) 

39 Victoria Street 
London 
SW1H 0EU 

HM Assistant Coroner Rachel Redman  
East Sussex Coroners Court,  
Westfield House,  
St Anne’s Crescent,  
Lewes BN7 1UE 

20 July 2026 

Dear Ms Redman,  

Thank you for the Regulation 28 report of 5 June 2026 sent to the Department of Health and 
Social Care about the death of Ms Neeshat Dalal. I am replying as the Minister for Women’s 
Health and Mental Health.        

Firstly, I would like to say how saddened I was to read of the circumstances of Ms Dalal’s 
death, and I offer my sincere condolences to her family and loved ones. The circumstances 
your report describes are concerning and I am grateful to you for bringing these matters to 
my attention. 

The report raises concerns over a lack of funding to employ appropriately qualified dietitians 
who can support inpatients receiving psychiatric care with their nutrition. 

In  preparing  this  response,  my  officials  have  made  enquiries  across  the  Department  for 
Health and Social Care to ensure we adequately address your concerns. 

The Government has provided an additional £29 billion funding for day-to-day spending on 
health by 2028-29 compared to 2025-26. Integrated Care Boards (ICB) are responsible for 
commissioning health services and receive a general non-ringfenced allocation.   

For 2026-27, NHS mental health spending is forecast to increase to a record £16.1 billion, 
representing a real-terms increase of around £140 million compared with the previous 
year. 

Alongside this, the Mental Health Investment Standard remains in place. This means ICBs 
are required to protect mental health spending in real terms over the next three years, 
ensuring that mental health continues to receive the investment needed to improve 
services and outcomes for patients. 

Individual NHS Trusts and other employers are responsible for determining staffing levels 
and workforce composition. They are best placed to understand their services and the 

 
 
 
 
 
 
 
 
 
 
 
 
  
  
  
 
 
 needs of their patients in order to deliver safe and effective care. I understand that you will 
also be receiving a response from NHS England.  

Trusts already have a duty through the Health and Social Care Act 20081 to regularly 
review the number of staff and range of skills needed to safely meet the needs of people 
using their services. 

In our 10 Year Health Plan we committed to publishing a new 10 Year Workforce Plan. 
The plan will help ensure the NHS has the right people in the right places to deliver the 
best care for patients.  

I hope this response is helpful. Thank you for bringing these concerns to my attention.   

Yours sincerely,  

PARLIAMENTARY UNDER-SECRETARY OF STATE FOR 
WOMEN’S HEALTH AND MENTAL HEALTH 

1 Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 – Regulation 18

Ms Rachel Redman 
East Sussex Coroners Court 
Westfield House 
St Anne’s Crescent 
Lewes 
BN7 1UE 

National Medical Director  
NHS England  
Wellington House 
133-155 Waterloo Road  
London 
SE1 8UG 

20 July 2026  

Dear Ms Redman,  

Re: Regulation 28 Report to Prevent Future Deaths – Neeshat Dalal who died 
on 14th December 2022.  

Thank  you  for  your  Report  to  Prevent  Future  Deaths  (hereafter  “Report”)  dated  5th 
June 2026 concerning the death of Neeshat Dalal on 14th December 2022. In advance 
of responding to the specific concerns raised in your Report, I would like to express 
my deep condolences to Neeshat’s family and loved ones. NHS England is keen to 
assure  the  family  and  yourself  that the  concerns  raised  about  Neeshat’s  care  have 
been listened to and reflected upon.   

Your Report raises concern that there is a lack of funding for the specific provision of 
appropriately  qualified  dieticians  who  can  meet  the  nutritional  needs  of  inpatients 
undergoing psychiatric care. 

Integrated Care Boards (ICBs) are responsible for commissioning services in line with 
population need. This includes  providing appropriate care for people with  additional 
nutritional needs when they admitted to hospital whether their primary issue is due to 
a physical or mental health need. NHS England also published coproduced Culture of 
Care Standards for mental health inpatient services in 2024 which sets the expectation 
that “Staff (working in psychiatric hospitals) are equipped to support people with their 
physical health needs, and understand the higher risk of premature mortality and co-
morbidities ...”. NHS England also delivered a two year Culture of Care Improvement 
Programme  which  all  NHS  and  major  independent  mental  health  providers 
participated in.  

Access  to  wider  Multi-disciplinary  Team  (MDT)  members  in  core  mental  health 
services  has  been  shown  to  be  highly  variable  in  recent  evidence,  which  includes 
dieticians. A recent rapid review of learning from quality and safety incidents  found 
that  the  understanding  and  recognition  of  Allied  Health  Professional  (AHP)  roles, 
which would include dieticians, is lacking at all levels of healthcare organisations. It 
highlighted  the  need  to  raise  awareness  of  the  essential  roles  of  AHPs  to  improve 
quality and safety in inpatient mental health, learning disability and autism services. 

In  response  to  this  paper  the  Royal  College  of  Psychiatry  have  updated  their  core 
standards  for  inpatient  and  community  mental  services  to  include  the  following 
“desirable” standards:   

                                                                                                                       
 
 
 
 
 
 
 
 
  
 
 
 
 •  Community:   

5.4.  The  team  has  access  to  Allied  Health  Professionals  to  meet  a  range  of 
patient  needs  that  may  be  identified  as  part  of  care  and  treatment  planning. 
There is sufficient sessional time and/or a pathway/shared care arrangements 
in place to draw on these staff on an as needed basis. 

Guidance:  As  a  minimum,  this  includes  dietetics,  physiotherapy  and  speech 
and language therapy with appropriate experience in mental health. 

• 

Inpatient: 

6.3.  The  ward  has  access  to  Allied  Health  Professionals  to  meet  a  range  of 
patient needs as identified in their care plan. There is sufficient sessional time 
and/or pathway arrangements in place to draw on these staff on an as needed 
basis. 

Guidance:  This  includes  dietetics,  physiotherapy,  speech  and  language 
therapy. The ward monitors its demand for and access to these services, the 
response  time  when  input  is  needed  and  any  delays  in  accessing  input  on 
patient progression through the inpatient pathway 

There are currently no AHP safer staffing standards, but these are being developed 
by NHS England. They will be considered by NHS England’s National Quality Board 
in September 2026. This guidance will include principles that would apply to mental 
health services. 

Workforce  models  and  local  arrangements  for  dietetic  provision  are  determined  by 
providers and commissioners. NHS England will continue to support multidisciplinary 
and integrated approaches to care through its published specifications and guidance. 

NHS England would advise that any further enquiries as to the specific arrangements 
for nutrition assessment and support for inpatients for psychiatric care in SPFT should 
be sent to the ICB directly for a response as they are the most appropriate organisation 
to respond.    

I  would  also  like  to  provide  further  assurances  on  the  national  NHS  England  work 
taking  place around  the  Reports  to  Prevent Future  Deaths.  All  reports received  are 
discussed  by  the  Regulation  28  Working  Group,  comprising  Regional  Medical 
Directors,  and  other  clinical  and  quality  colleagues  from  across  the  regions.  This 
ensures  that  key  learnings  and  insights  around  events,  such  as  the  sad  death  of 
Neeshat’s, are shared across the NHS at both a national and regional level and helps 
us to pay close attention to any emerging trends that may require further review and 
action.   

Thank you for bringing these important patient safety issues to my attention and please 
do not hesitate to contact me should you need any further information.  

Yours sincerely,  

 
  
 
 National Medical Director  
NHS England