The issue

More than 15 million adults in England live with care and support needs due to a long-term condition or disability. Many of these adults need help with shopping for food and preparing meals. In addition, approximately 300,000 older adults, particularly those living in deprived areas, need support with food shopping and meal preparation. Meals on Wheels services can be essential to these individuals, who wish to continue living in their communities but need support to do so.

Meals on Wheels have been traditionally provided by local authorities, which deliver a daily hot meal, but also chilled and/or frozen meals, either in addition to the hot meal provision, or as a substitute. Cuts in social care budgets have seen an increased number of local authorities closing their Meals on Wheels services in the last decade. Although the gap in service provision has often been filled by social enterprises, and organisations in the private and non-profit sector, many individuals are purportedly not aware that Meals on Wheels still exist. This could contribute to poor service referral rates. Our research has also suggested that ‘Meals on Wheels’ is a generally well-known concept, but that people do not register what the service is about, until they actually need to enquire about, or use the service. This might hinder uptake of Meals on Wheels by adults with care and support needs who could benefit from the service.

About our research

We conducted interviews with 28 recipients of Meals on Wheels services and family members of users of Meals on Wheels who referred them to the service, recruited via four service providers across England. The aim of this study was to explore participants’ experiences with accessing Meals on Wheels, and their perceptions of the service.

We then worked with a group of six people with lived experience of Meals on Wheels (users of services and their family referrers). This group identified five key themes from the aforementioned interviews, which they considered as high-priority to be highlighted in knowledge translation resources, in order to raise awareness of the service:

1. The importance of a tasty and nutritious meal that requires little to no preparation
2. The importance of interactions in reducing social isolation
3. The importance of wellbeing checks in highlighting any concerns
4. The reliability and consistency of the service
5. The importance of the service in promoting independence

Our response to the issue

Through four co-production workshops with people with lived experience of Meals on Wheels, and identification of the high-priority themes that emerged from the aforementioned interviews, we designed two infographics, and produced a film, to raise awareness of Meals on Wheels services.

The infographics (in both jpeg and pdf format), and the short version of the film (2 minutes, good for disseminating), can be found and downloaded from:

https://express-licences.bristol.ac.uk/product/meals-on-wheels-awareness-raising-aids

We have also produced a policy briefing that presents key findings, and policy recommendations, arising from our research. This can also be downloaded from the link above.

Meals on Wheels film (long version, 7 minutes):

https://www.youtube.com/watch?v=mO3GtnPO4E4

The benefits of these resources

Our co-produced knowledge translation resources can be used by:

1. Healthcare professionals (e.g., general practitioners, hospital discharge and enablement teams, district nurses), and social work, social care, and community carers and workers, as resources to inform referral decisions to Meals on Wheels services.
2. Service providers, as resources to raise awareness of Meals on Wheels services on their websites and publicity materials (in order to help anyone considering commencing the service make an informed decision), and/ or as evidence-based resources when they seek funding for the continuation or enhancement of their services.
3. Commissioners and policy makers, as resources to inform decisions about reintroducing, continuing to fund, or enhancing, Meals on Wheels services.

Further information

1. Papadaki A et al (2023) ‘The service, I could not do without it…’: A qualitative study exploring the significance of Meals on Wheels among service users and people who refer them to the service. Health and Social Care in the Community
2. Papadaki et al (2023) Accessing Meals on Wheels: a qualitative study exploring the experiences of service users and people who refer them to the service. Preprints 2023, 2023090310.

Lead researcher

Dr Angeliki Papadaki, Associate Professor in Public Health Nutrition, Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol: angeliki.papadaki@bristol.ac.uk

Co-investigators (University of Bristol)

Dr Paul Willis, Centre for Research in Health and Social Care, School for Policy Studies

Dr Miranda Armstrong, Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies

Professor Ailsa Cameron, Centre for Research in Health and Social Care, School for Policy Studies

Funder

National Institute for Health and Care Research (NIHR) School for Social Care Research