Implementation of the Patient Association Nutrition Checklist by the Food Train charity’s Eat Well Age Well project in the Scottish Borders

Evaluation completed March 2023


Eat Well Age Well Policy Briefing

Watch a webinar about the evaluation hosted by Food Train Eat Well Age Well

What does the research mean for Local Authorities?

Addressing malnutrition is a key Scottish Government priority. A Fairer Scotland for Older People recognised malnutrition as a risk to healthy ageing and committed to action to tackle the problem. The findings of the evaluation will provide Scottish Borders with insights to inform future implementation of the Patients Association Nutrition Checklist in the region for addressing malnutrition. Findings will include the potential impacts of using the Checklist and recommendations for how it could be rolled out more widely in different service provider contexts.

What does the research evaluation mean for the Public?

The information gathered in the project will inform further roll-out of the Checklist in Scotland and in the UK. Use of the Checklist may allow early identification of older adults, living in the community, who may be at risk of malnutrition. This is important for the older population, as well as their families and those that care for older adults. Malnutrition has adverse effects on health and wellbeing outcomes for older adults; early identification and subsequent treatment, can improve outcomes for these individuals.

How are the public involved in the evaluation?

Public and practitioner involvement in the development of the project has been undertaken following a variety of methods. The Patients Association Nutrition Checklist was co-produced in collaboration with members of the public and several health, social care and voluntary sector providers. To develop the research protocol, the team consulted with organisations responsible for implementing the Checklist, who advised on appropriate methodology for participant identification, recruitment and data collection processes. One to one consultation with public representatives, recruited from NIHR’s People in Research initiative has ensured that all participant facing documents have been collaboratively produced with members of the public, including data collection materials and outcome measures. Ongoing and meaningful public involvement throughout the project has been considered and guided by the public involvement representatives. This will involve collaborative decision making with the research team into project design, all participant-facing materials, project reports and dissemination materials. This will be achieved via focused public involvement meetings with public representatives, as well as membership of public involvement representatives at project management meetings, to ensure shared decision making at project management level. In addition, the project team will support opportunities for development for all public representative team members. Participant questionnaires and interview topic guides will be developed in collaboration with public and practice stakeholders and also piloted with public representatives prior to use.

Lay summary of research

Malnutrition has been shown to affect over 1.3 million older people (over the age of 65) in the UK and this figure may be worse following the COVID-19 pandemic. Malnutrition, in the form of undernutrition (i.e. not consuming enough nutrients or food), has adverse effects on health and wellbeing outcomes, including increased risk of hospitalisation. Furthermore, the levels of malnutrition in the community are largely undetected and untreated. The Patients Association Nutrition Checklist (referred to as the Checklist) is a simple tool used to identify whether older adults may be at risk of under-nutrition (in need of nutritional support). The Checklist is currently being rolled out by the Food Train Charity's Eat Well Age Well project in the Scottish Borders region and this project aims to find out whether using the Checklist in the community is beneficial for older people and the staff/volunteers in the community who use the Checklist.

In this project, we will work closely with organisations that are using the Checklist (in voluntary, housing and social care sectors), and the staff/volunteers who work for them. We will interview up to 15 staff/ volunteers who use the Checklist and up to 15 relevant managerial staff at the organisations to explore their experiences of using the Checklist and any potential benefits/ disadvantages of using the Checklist. The project has been developed in collaboration with key stakeholders who are involved in supporting the roll-out of the Checklist including the Eat Well Age Well project of the Food Train Charity, NHS Borders, Scottish Borders Council, the Patients Association, the University of Glasgow, Bournemouth University and older adult representatives. The information gathered in the project will help assist with further roll-out of the Checklist in Scotland and in the UK.

Local Authority/Partner(s)

Michael Curran, NHS Borders and Scottish Borders Council

Nichola Sewell, NHS Borders Joint Health Improvement Team

Jen Grant, Food Train Eat Well Age Well (EWAW)


PHIRST Insight Research Team

Cardiff University
Dr Jemma Hawkins
Dr Elinor Coulman
Dr Sarah MacDonald
Professor Simon Murphy