Background It is well known that swallowing problems are a common symptom in palliative care patients (Bogaardt et al., 2015). The emotional, physiological and psychological impact of swallowing problems cannot be underestimated on the patient, their families and carers.

Aims To reduce the impact of swallowing difficulties by ensuring patients can eat and drink safely, efficiently and nutritiously.

To develop and roll out a training programme for healthcare professionals involved in the preparation, formation and delivery of modified diets/fluids.

Method A collaborative working party including Speech and Language Therapy(SLT), Dietetics, Catering and Housekeeping was set up to review and improve the modified diets and fluids that are offered to our patients with swallowing difficulties. The review included patient and staff feedback and focused on consistency, appearance, taste and texture. As a multi-disciplinary team, each discipline provided a different knowledge base: SLT focusing on swallowing safety, Dietician focusing on nutritional content, Catering with the preparation and cooking of the food and Housekeeping with food presentation.

Results A new puree menu has been developed with standardised texture and consistency with the use of puree moulds to improve appearance. A daily smoothie round is now offered to our inpatients and day hospice. A formal evaluation is in progress. Initial feedback from patients and staff has been positive. ‘It looked like chicken and even tasted like chicken. This is the first puree meal I have actually enjoyed!’

A training programme on modified diets was developed and is being delivered on a rolling basis.

Conclusions We believe by evaluating and improving our modified diets and fluids that are offered to patients with swallowing difficulties, these patients can continue to eat and drink safely and nutritiously through the development of an innovative new modified diet menu thus reducing the distress that can be caused by the impact of these difficulties.