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 project is an exciting collaboration between the Ageing and Dementia Research Centre at Bournemouth University, Wessex Academic Health Sciences Network (AHSN)Southern Health NHS Foundation Trust, and the Centre for Implementation Science (CIS) at the University of Southampton.
  • The INSCCOPe project focuses on how best to implement service improvements for screening and treatment for malnutrition in older people. A new model of nutritional 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 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.

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. 
Professor Jane Murphy

Our approach

The new model for screening and treatment of malnutrition 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, we aim to understand the 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 – normalizationprocess.org)
  • Study design, data collection, and analysis have been led by Dr Mike Bracher (for the baseline and the phase 1) and by Dr Daria Tkacz (for phase 2)

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.
​– Dr Mike Bracher



Murphy JL, Bracher M,  Tkacz D,  Aburrow A,  Allmark A, Steward K,  Wallis K, May CR. Malnutrition in community-dwelling older people: lessons learnt using a new procedure. British Journal of Community Nursing  2020: 25 https://doi.org/10.12968/bjcn.2020.25.4.193

Bracher M, Murphy JL, Steward K,  Wallis K, May CR. Implementing professional behaviour change in teams under pressure – results from phase one of a prospective process evaluation of a new procedure for screening and treatment of malnutrition in community care for older people (INSCCOPe). BMJ Open 2019;9:e025966. doi:10.1136/bmjopen-2018-025966

Bracher M, Murphy J,Steward K, Wallis K, May CR. What factors promote or inhibit implementation of a new procedure for screening and treatment of malnutrition in community settings? A prospective process evaluation of the Implementing Nutrition Screening in Community Care for Older People (INSCCOPe) project (UK). BMJ Open 2019;9:e023362. doi:10.1136/bmjopen-2018-023362

Murphy J, Mayor A & Forde E Identifying and treating older patients with malnutrition in primary care: the MUST screening Tool. British Journal of General Practice 2018; 68 (672): 344-345. DOI: https://doi.org/10.3399/bjgp18X697853

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