Appendix 9: Methods for providing blended diet in hospital

Five methods in use in UK hospitals. The choice often depends on catering facilities, systems and staffing, and several may be used in the same hospital.

Method

Method	Description	Advantages	Limitations	Considerations for practice
Hospital-prepared blended diet	A dietitian develops a recipe with the person and family. The feed is prepared in the hospital kitchen, labelled, stored and given according to the regimen. Standardised recipes may be nutritionally analysed and produced through existing catering systems	Tailored to individual nutritional, cultural and dietary requirements Greater control over ingredients and preparation Can use foods available through existing catering Supports continuity of care for patients already receiving blended diets at home Standardised recipes can improve governance, staff confidence and consistency of practice	Resource intensive for dietetic and catering teams Needs recipe development, analysis and review Hard to replicate the volume and consistency of home blends Risk of inadequacy if standard recipes are used without individualisation	Appropriate where the organisation has an established pathway, suitable equipment, trained staff and food safety processes in place. Standardised recipes reduce workload but should be reviewed for adequacy. Consider blending time, staff training and flushing protocols to reduce blockage. Consider catering capacity, approval processes, infection prevention requirements and ongoing service evaluation when implementing a hospital-prepared blended diet service.
Puréed hospital meals, further blended	Food from the hospital puréed menu, blended further to a consistency suitable for the tube.	Nutritional and allergen data may be available from the caterer Often a variety of meal options Uses existing hospital food services	Some foods contain fibres, husks or textures that can block tubes Hard to cater to specific dietary requirements Regenerated meals may dehydrate, affecting consistency	Assess individual menu items for suitability before use. Guidance on dilution and consistency helps standardise practice.
Family-prepared blended diet	Blends prepared at home by the person, parent or carer and brought into hospital for administration.	Continues the established home plan Improves satisfaction for the person and family Less preparation burden for hospital staff	Relies on blends being prepared and brought in from home Nutritional composition hard to verify Safe transport and storage needed Difficult where the person lives a long way from the hospital or has no kitchen access	Local policy should define labelling, storage, transport and administration requirements. Plan for the situation where blends cannot be brought in or given and agree an alternative feed.
Commercial baby food	Stage 1 baby food jars or pouches mixed with formula, milk or water to the required consistency. Additional ingredients, such as baby rice, may be added.	Known nutritional content Consistent texture, lower risk of tube blockage No high-powered blender required Often readily available in hospitals Less labour intensive than preparing blended meals	May not provide adequate nutrition long term Limited product range may be available May not match the person’s preferences about processed food	Useful when initiating or trialling blended diet. More suitable as a short-term option than as a nutritionally complete long-term feed.

On admission

Establish whether the individual is receiving a blended diet
Review the existing feeding plan and nutritional goals
Discuss how the feeding plan regimen will be supported during admission
Involve the dietitian, nutrition nurse and relevant medical team at an early stage, to confirm how the established plan will be delivered and whether any of the clinical exceptions in Part 11 apply
Agree who will give the blends on the ward. Where nursing staff are not yet trained to do so, the family may give them in the interim, but provision should not depend on a family member always being present
Agree, document and communicate any temporary changes with the individual and their family
Where blends cannot be given, a prescribed commercial formula with real food ingredients may be an acceptable alternative for some people
Review feeding plans regularly throughout admission, particularly if clinical status changes
Plan discharge so that blended diet continues on leaving hospital

Developed for the 2026 Practice Toolkit from work led by Ruth Stanley on blended diet in settings other than the home. Part 11 sets out the position on continuation and the clinical exceptions.