Health and Independent Living Support (HILS) Meals on Wheels

01/09/2026 by Angeliki Papadaki

Provider in Focus | Health and Independent Living Support (HILS)

Discussion took place on 8th May 2026

This month, we’re speaking with Tom Cottam, Deputy CEO of HILS (Health and Independent Living Support), a charitable social enterprise delivering Meals on Wheels and wider wellbeing services across Hertfordshire, Hampshire, and West Sussex.

Delivering more than 1,000,000 hot lunches, breakfast and tea packs each year, alongside wellbeing checks, and wider preventative support, like exercise support programmes, HILS combines large-scale operations with a strong focus on human connection, flexibility and innovation.

“I think the social enterprise model is a brilliant model of delivery for Meals on Wheels. We’re not for profit, which means we don’t have to make margins for our shareholders. We can focus on meeting client needs, the innovation and our aspiration about the value of Meals on Wheels, not just to individuals, but to the wider health and social care system. We’re really ambitious and aspirational about that.”

More than a meal

Tom is clear that Meals on Wheels should never be viewed simply as a food delivery.

For HILS, the service combines:

Nutrition and hydration support
Daily wellbeing checks
Safeguarding and escalation pathways
Reassurance for families
Trusted human contact for people living independently at home

“Meals on Wheels is not just drop-and-go delivery. It is a holistic service around the client’s needs.”

Meals are delivered hot every day of the year, alongside breakfast and tea packs for later use.

The organisation also employs nutritionists who support menu development and provide specialist dietary advice.

Tom believes the preventative role of Meals on Wheels is often underestimated.

“It’s important to recognise that nutrition and hydration are key markers for lots of things, not just malnutrition, but also frailty, which costs the NHS billions of pounds a year… a huge national issue. Meals on Wheels as a preventative service can support in those areas too.”

He also reflects on the service’s wider value:

“If we signpost and refer into other support mechanisms, we can have a huge impact on wider social and economic determinants of health. There’s lots of policy around how housing affects someone’s health. If we are in and supporting somebody in their own home, Meals on Wheels services can play a huge part in that.”

A Meals on Wheels delivery driver bringing a cup of tea to a client to have with his meal

“The service is not an optional, fluffy, charitable extra. It’s vital, it’s necessary. It’s a service that holds things together on a daily basis, quite often invisibly. We see it as an additional emergency service – and we think others should too.”

Image: One of the HILS Community Team Members delivering meals and a caring wellbeing check, a standard addition to the HILS meals service

Reliability, reassurance and rapid response

HILS supports primarily older adults, particularly people aged over 85, alongside people living with frailty, physical and learning disabilities, long-term conditions, social isolation and mental health challenges.

Tom explains that what people often value most is the consistency and reliability of the service, as well as the compassion the service brings.

“Accessing food can be quite challenging for our client base, and there’s also the worry about falling and having nobody there to help. In some cases, the meal service is the only regular contact someone has.”

“That regular, trusted human contact is such a huge part of the service.”

Families also gain reassurance from knowing somebody is checking in regularly and escalating concerns if something is wrong.

“… that reassurance that if someone’s worried about their family member or the person in their care, the Meals on Wheels service is there reliably supporting them, and can help them connect to wider support.”

HILS operates rigorous wellbeing-check and “no reply” procedures, including contacting families, checking with hospitals or GPs, and escalating safeguarding concerns where needed.

Tom also highlights the speed at which Meals on Wheels can respond to emerging need.

“If someone contacts us before we start cooking in the morning, we can get food and support to them that same day.”

This flexibility is particularly important to help people remain independent.

“Think about the value to people coming out of hospitals, trying to get back on their feet, returning home to empty cupboards… There aren’t many services out there that can respond so quickly to need in a flexible way.”

A Meals on Wheels driver delivers a meal to a client

HILS Meals on Wheels are more than a delivery – they are a familiar face and a friendly check in

Innovation with a human face

Although HILS operates at significant scale, Tom repeatedly returns to the importance of maintaining a personal approach.

“We want our clients to see us as a service with a human face. Our people are the service.”

The organisation uses a wide range of systems and digital tools to support operational resilience.

“From referral platforms to our own database systems, to how we design our telephone systems, all of that’s really important. Having those centralised client records, where you can record details about a client that are important so you can personalise the service, ensure it’s safe, recognise any safeguarding practices, is vital.”

But Tom stresses that technology should support – not replace – human relationships.

One of the HILS Community Team Members, working as part of the team to make a difference every day

“It’s always digital as a complement to that human face.”

Keeping a flexible approach is also important.

“We are always learning. We don’t have all the answers. We are a learning organisation. We want to keep refining what we do.”

HILS also places strong emphasis on workforce development. All staff receive training covering safeguarding, lone working, wellbeing checks, escalation procedures and recognising changes in clients’ wellbeing.

Importantly, Tom believes staff need to understand not just what to do, but why it matters.

“Meals on Wheels, logistically, is more complicated than many people might think on the face of it.”

Managing quality, costs and uncertainty

Like many providers, HILS has faced rising pressures around staffing and food costs, fuel, utilities, increasing client complexity, and changing commissioning priorities in health and social care.

“Our response is: listen to our clients, be honest about pricing, listen to our staff and involve them in solutions, and listen to our wider stakeholders to design services that meet their needs.”

Tom believes maintaining quality must remain central, even under pressure.

“Our investment in our freezers, our ovens, our vehicles, the way we cook our food and keep it safe throughout delivery, is really important. Sometimes there’s a false economy. If you cut your costs too far, your quality will dip. Put your quality first, you build your reputation on the back of that. You’ll get new clients, you’ll retain existing clients. You can build that scale. With that comes economies of scale and it helps you manage your costs.”

One lesson HILS has learned through expansion and growth is the importance of agility and preparedness.

“We live in a volatile world. Things happen and will continue to happen. Building the capability to act quickly and decisively if there are shocks is vital to survival.”

At the same time, Tom strongly advocates for partnership-based approaches with local authorities, NHS partners, suppliers, and wider community stakeholders. Long-term thinking is essential.

“Building those long-term relationships with your partners, rather than chasing short-term gains… mobilising and convening around the outcome for the long term and influencing the picture towards that really helps realise the change within the pressures that we’re all under.”

Where each meal begins, prepared with care and attention to ensure our clients receive meals that are right for them

Where each meal begins, prepared with care and attention to ensure HILS’ clients receive meals that are right for them

Why Meals on Wheels matters to the wider system

Tom believes Meals on Wheels services play a vital role not only for individuals, but across health and social care systems more broadly.

He highlights the importance of the service in preventing malnutrition, frailty, deterioration in health, and avoidable escalation of need.

“Fundamentally, for any commissioner and policy maker, Meals on Wheels should represent affordable prevention that’s delivered by people who know their communities well, and can support a whole host of national health and care challenges.”

The service also acts as an early warning system, identifying concerns before crisis intervention becomes necessary.

“We help prevent deterioration, prevent crisis, and reduce avoidable escalation into statutory health and care support. But we also help people avoid having excess GP visits, hospital admissions…”

Tom believes Meals on Wheels services remain under-recognised nationally, despite the scale of their contribution.

“It intuitively makes sense. It’s a win-win for commissioners and for individuals themselves in the outcomes that the service achieves. But it’s difficult to measure prevention as a concept. We have to prove it – and prove it more than ever in a system that has reduced funding. But we can do that, and we should, and we will.”

Hot, nutritious, food delivered with care

Building the evidence base

HILS has developed its own methodology for measuring social return on investment and social value, supported by independently verified approaches and client outcome data.

But Tom believes the sector would benefit greatly from:

Stronger independent research
Shared evidence frameworks
Collaboration between providers

“It’s still probably under-evidenced nationally. That’s a weakness of the system, not necessarily individual providers.”

He also emphasises the importance of providers working together to strengthen the collective evidence base around prevention and impact.

Part of the dedicated HILS team supporting people across the community 365 days a year

Looking ahead

Reflecting on the future of Meals on Wheels, Tom believes there is enormous opportunity for the sector to become more embedded within health and social care systems.

“The local signposting referral frameworks are really valuable. So how we look at connecting into the wider system practically, I think we, as Meals on Wheels providers, could share best practice in that space so that we absolutely maximise the value of the Meals on Wheels service locally.”

He argues that Meals on Wheels should ultimately be recognised as a statutory service.

“Meals on Wheels adds so much value to individuals, but also to health and social care in terms of health outcomes and costs avoided… If it was more widespread commissioned, the funding and the contract models would be longer term. It could allow for more innovation within the service.”

Tom also highlights the importance of having a network forum of providers to:

Share learning, failures and successes
Exchange operational practice
Discuss risks and opportunities
Share and strengthen the evidence on Meals on Wheels outcomes
Jointly work on sustainability

“That will be really powerful to helping us work collectively to support local need, but also to influence that national picture and build Meals on Wheels to be more part of the fabric of local commissioned health and social care. There’s a sense of solidarity there. We’re not in it alone.”

He believes stronger collaboration could help providers influence national policy discussions.

“The health and social care system won’t put things on a plate for you. As a Meals on Wheels provider, you need to be proactive in spotting and meeting the need, in building that evidence base, in mobilising to achieve things in partnership, in leading the dialogue and in influencing the local environment. You can’t sit on your hands and be passive. You have to be out there actively championing Meals on Wheels as a solution.”

Advice for other providers

For organisations considering developing a new Meals on Wheels service, Tom advises thinking beyond catering.

“Don’t treat Meals on Wheels as a catering service. It’s more than just a meal. The preventative service approach is where the value is. Meals are almost the entry point, not the end product. It’s that daily contact and support that gives us that preventative impact.”

Tom also stresses the importance of investing in people, building resilience and designing a service deliberately for scale and sustainability.

“Understanding that your demand, your staffing, your referrals, your costs all move quickly and how you manage them is vital.”

And if an existing provider came to Tom for advice, he would encourage them to stay confident in the value of what they provide.

“I think a lot of Meals on Wheels providers see the market and may be struggling alone. But you’re not in it alone. Stick to your guns because you know the value of the service. I know the value of the service. It’s how we work together to evidence that to others and build from where we are. That’s important.”

Tom’s question to other Meals on Wheels providers

“How have other organisations balanced route efficiency with the time needed for meaningful interaction with clients, while balancing meeting the need, quality and costs?”

This reflects one of the key tensions discussed throughout our conversation: maintaining the human value of Meals on Wheels services while operating under increasing financial and operational pressure.

Learn more about the HILS Meals on Wheels service
Contact: info@hils-uk.org | 03302 000 103

Do you run a Meals on Wheels service and have thoughts or experience to share? Join the conversation with other Meals on Wheels providers via our WhatsApp Community.