A new white paper addressing dysphagia management has been launched by Care England and OHK, which seeks to transform care practices across the UK, promoting life-changing solutions for a condition that affects approximately 4m people.
It reports that dysphagia, the medical term for swallowing difficulties, is alarmingly prevalent in care homes, with up to 75% of residents affected and up to 52% of these individuals consequently suffering from malnutrition.
The comprehensive report advocates for a sector-wide transformation in dysphagia care through expert-led training, validated frameworks and sustainable practices.
It says that without effective intervention, the risk of choking related fatalities is high. Indeed, mortality rates from choking in care homes are substantially higher than those from diagnosed food allergies and food poisoning in the general population, highlighting a critical gap in the industry’s attention to safe food preparation for individuals with swallowing difficulties.
Complications such as recurrent chest infections and aspiration pneumonia are also a high risk, each with the power to drastically diminish an individual’s quality of life while simultaneously inflating healthcare costs.
Validated Frameworks and Expert-Led Training
The new white paper, which focuses on the Eating, Drinking, Swallowing Competency Framework (EDSCF) and International Dysphagia Diet Standardisation Initiative (IDDSI), highlights the importance of correct texture modification of foods and liquids to improve nutrition, health outcomes, and quality of life for those living with dysphagia.
James Ball, co-founder and director of OHK, a key collaborator on the report, states: “Data from our pilot studies conducted with NHS trusts and private care settings reveals that implementing validated frameworks and training strategies can reduce choking incidents by up to 85%.
“We’ve seen sustained success across a variety of settings, and we feel that it’s now time to push for further action across the whole adult social care sector, so even more individuals can benefit from improved care strategies and lead safer, healthier, happier lives.”
Safety and quality of life can be seriously impacted with high staff attrition in the care sector, with one in three employees leaving their roles annually, leading to a rapid loss of knowledge and skills within teams.
This is made worse when access to Speech and Language Therapy (SALT) teams is limited, which highlights the importance of adopting a whole-team approach to training.
The report says that in many care homes, training is typically provided to only a small subset of the team - such as ‘Champions’, Senior Nurses, Deputy Managers, or Managers - and relies heavily on SALT referrals for advice.
This approach increases the risk of late or misdiagnosis and compounds other safety concerns, emphasising the need for more inclusive and proactive training strategies, which the white paper advocates for.
“Despite its prevalence, dysphagia is often incorrectly, or underdiagnosed due to insufficient training across all staff levels, leading to preventable suffering and increased healthcare costs,” said Professor Martin Green, chief executive of Care England.
“This white paper highlights the urgent need for stronger regulation and a comprehensive, whole-team approach to training and knowledge-sharing to address these gaps and improve patient outcomes.
“Every care team member should be equipped to recognise the symptoms of dysphagia and confidently recommend appropriate next steps. Without empowering entire teams, we risk exacerbating issues like malnutrition and, in some cases, avoidable deaths.”
Validated Solutions:
Building a Workforce for the Future
The white paper says that a well-trained workforce is critical to effective dysphagia care. It emphasises the importance of:
- Leadership development to address high staff turnover and promote team cohesion
- Ensuring consistent and up-to-date knowledge and skills competencies across all roles involved in eating, drinking and swallowing
- Mapping resources to best practice guidelines and maintaining their effectiveness at the point of delivery
- Transparent management systems to ensure quality assurance in dysphagia care
Adds Professor Green: “There is a common but misguided assumption that weight loss and increased frailty are inevitable for those in care due to age or illness. However, this doesn’t have to be the case. Many underlying conditions can exacerbate these symptoms, and it is essential for all staff to recognise the health cues that indicate the need for action and tailored care.
“By providing every team member with expert-led training on validated frameworks such as the EDSCF and IDDSI, we can ensure consistent, high-quality care for individuals with dysphagia. This approach will allow us to help so many more individuals lead healthier, happier and longer lives.”
Transforming Dysphagia Care Together
The white paper offers practical solutions for caregivers across all organisations to understand how to best identify and manage dysphagia within their setting, to improve patient outcomes and quality of life:
- Implement validated frameworks like the EDSCF and IDDSI
- Leverage texture modification to improve nutrition and health outcomes
- Build sustainable strategies for reducing risks and improving the lives of those living with dysphagia
James Ball adds: “As momentum builds to address these challenges, it’s vital that the health and social care industry sustains and amplifies its focus on dysphagia care. This report is both a call to action and a practical guide to improving lives through validated, impactful solutions.”