Implementing Nutrition Screening in Community Care for Older People

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Funded by the Burdett Trust for nursing, the INSCCOPe project aims to improve nutritional health of older people in the community, by supporting implementation of a new procedure for screening and treatment of malnutrition.

Who we are, and what we do.

  • We are a research team (led by Professor Jane Murphy), who are part of a project to improve screening and treatment of malnutrition for older people in the community.
  • The INSCCOPe project focuses on how best to implement service improvements for nutrition screening and treatment for malnutrition in older people. A new model of nutritional care (screening and care) has been developed in order to enable integrated community teams to better identify and support older people considered at-risk. This is currently being implemented within one area of Southern Health NHS Foundation Trust, alongside associated training for healthcare staff.
  • Our aim is to maximise scalability and cost effectiveness of this new procedure,by providing an evidence base to support implementation across wider settings in the health service.

The problem.

  • Malnutrition is a significant health problem for older people living in the community, with around 3 million older adults estimated to be at risk of undernutrition.
  • The health consequences can be quite far reaching and include slower recovery from illnesses and an increased need for healthcare, whether at home or in a hospital setting.
  • The cost of providing that care can be high, but could easily be prevented by screening and early intervention.

Our approach.

  • Professor Jane Murphy (Chief Investigator), and Dr. Mike Bracher (Post-doctoral Research Fellow) explain what the team hope to achieve;

[Prof. Murphy] “The cost of under nutrition in the UK is estimated to be around £19.6 billion, around half of this being spent on older people. We’ll be working with a number of different community and mental health teams within the Southern NHS Trust, representing both rural and urban areas, rehabilitation and hospital admission prevention.  We hope this mix will give us a real insight into the different issues faced by a number of different touch points older people may have with the health system.”

[Dr. Bracher] “By understanding factors that influence implementation of new procedures, we can maximise their efficiency and effectiveness. Informed by Normalization Process Theory, the INSCCOPe project explores how best to do this in community settings, and thereby improve nutritional care for older people.”

  • The new procedure is currently being implemented by Intergrated Community (ICTs) and Older People’s Mental Health (OPMH) Teams in Andover, Winchester and Basingstoke, with plans to further roll out across Hampshire, and then further afield across England.
  • In addition to understanding the effectiveness of the model with respect to staff knowledge and patient outcomes, it will also understand factors that may help or hinder implementation of the new model, and embedding it as a routine aspect of care.
  • The project is informed by Normalization Process Theory (NPT –

Project highlights.

  • T0 data collection completed (07/2017)
  • T1 data collection completed (09/2017)
  • T0-T1 results presented to Southern Health NHS Trust Nutrition and Hydration Committee (10/2017)
  • INSCCOPe project poster accepted for presentation at the BAPEN 2017 conference (to be presented 11/2017)
  • INSCCOPe presents at Wessex AHSN seminar: ‘Normalization Process Theory and it’s application by Wessex AHSN’ (05/2017)

Further information.

Links to other resources.





Tagged:dementiahealth services researchimplementation sciencemalnutritionnutritionprocess evaluation. service developmentundernutrition

Latest news from this project:

Project updates:


Dr. Mike Bracher presented findings from T0 to the BAPEN 2017 Annual Conference poster session.

(click here to download/view the poster).


T0 & T1 interim findings presented to the Southern Health NHS Foundation Trust Nutrition and Hydration Committee.


T1 questionnaire data collection was completed today


INSCCOPe project accepted for presentation at the BAPEN Annual Conference 2017 poster session.


T1 data collection begins today – drawing on findings from interviews at T0, we have expanded the questionnaire to explore some emerging issues, within the wider sample.  These include: access to dietetic services; reasons for non-completion of training; factors mitigating engagement in non-mandatory training.


T0 data collection was completed today – interim results were presented to the Procedure Design and Delivery Group (PDDG)


INSCCOPe team presented today at the Wessex AHSN seminar: ‘Normalization Process Theory and it’s application by Wessex AHSN’


T0 data collection begins today


Letter of access granted by NHS Research and Development


Approval for study granted by Bournemouth University Research Ethics Committee panel


  • Professor Jane Murphy,
    • Professor of Nutrition / co-lead, Ageing and Dementia Research Centre (ADRC), Bournemouth University
  • Dr. Mike Bracher
    • Post-doctoral Research Fellow, Ageing and Dementia Research Centre (ADRC) Bournemouth University