Background Good nutritional care is essential to the delivery of excellent palliative care. In addition to our bodies’ physical needs, nutrition can have social, psychological and spiritual importance to patients. Despite this historically nutrition has not always been well supported in palliative care organisations (Help the Hospices Food and Nutrition Group, 2009).

Aim(s) To examine the current nutritional care provision within our organisation; to compare this to national standards; to explore where deficiencies existed and how these could be overcome.

Methods A full review of nutritional care was undertaken in 2017 across the organisation. Five key functional areas relating to nutrition were explored: catering management; patients’ nutrition; communication; governance; and others’ nutrition. Tools used included direct observation of catering processes, talking to key members of staff, seeking feedback from patients, completing the Hospice UK Nutrition and Hydration Audit Tool and visiting other local hospices delivering excellent nutritional care.

Results The review produced a number of recommendations for improvement across the five key functional areas. A Nutritional Care Steering Group was set up to ensure recommendations were delivered in a coordinated way and that strong governance structures underpinned this. Changes being implemented are already directly impacting positively on patient care.

Conclusions Delivery of excellent nutritional care requires a whole system approach where each aspect of the service is explored and improved cohesively.