I have just finished a clinical swallow evaluation and check off my handy sheet of aspiration precautions and write my diet recommendations. I confidently leave my patient to the care of a well-trained caregiver.

Unfortunately, we know that this is often not the case.

How often do clinicians make recommendations that are not necessarily the best recommendations for the patient but the best recommendations that are most likely to generate the greatest compliance and/or follow-through by a caregiver? Lets face it, dysphagia is not easily understood by many outside the profession and it is our job, as clinicians, to make strides to creatively present dysphagia education to the caregiver, the individual who spends the majority of the time with the patient during meal times.

You can imagine my curiosity when I received a “Twitter Follow” from @dysphagiagame. A game about Dysphagia? I thought this was either going to be really offensive or really interesting. I was so thankful, it was the latter. The Dysphagia Game is a creative and collaborative effort by a consortium of organizations from the UK to increase the awareness of dysphagia among healthcare providers and caregivers. A live board game will be available soon, but you can play an online version of the game at their website. See below for information about the game and a link to the website where you can play the online version. A Round of applause, well-deserved, to our colleagues across the pond! The following information was provided by the game developer, Focus Active Learning.

DysphagiaGame Logo


Dysphagia is a condition that makes swallowing food and drinks difficult. It affects people of all ages and is particularly associated with dementia, Parkinson’s disease, cancer and can also affect people who have had strokes or surgery around the head or neck.

Dysphagia increases the risk of malnutrition, dehydration, aspiration pneumonia and choking. Dysphagia also affects quality of life as a result of malnutrition, dehydration, anxiety and embarrassment.

The most common management strategy for dysphagia is to change the consistency and texture of food and drink to make it easier for people to control their swallow. A range of products is available to thicken food and fluid for a “texture modified diet”.

Dysphagia, however, is poorly understood by healthcare workers, and engaging frontline staff in training is difficult, especially in busy care homes and hospitals. Moreover, good face-to-face or online training tools are not always available or accessible. This lack of understanding and education exposes patients to avoidable discomfort, pain and death.

There is therefore a need for practical frontline education to help improve the detection and management of dysphagia.

The Dysphagia Game

Seeking to address this educational deficit, and inspired by the recent success of “serious” games such as The Nutrition Game, NHS England engaged Focus Active Learning to develop a unique game-based training tool to help improve detection and management of dysphagia. Nutricia Advanced Medical Nutrition agreed to sponsor and actively support the development, manufacture and distribution of The Dysphagia Game.

This partnership identified two main goals for frontline engagement:

  1. Increase awareness of dysphagia among HCPs and carers
  2. Improve the consistency of thickener use to improve safety

Nutricia, NHS England, and Focus Active Learning then collaborated to develop the following:

  1. A board game for face-to-face engagement at the frontline of healthcare
  2. An online version of the board game that can be played on any device, to extend the reach and impact of the programme

A steering group of experts was convened from the following organisations:

  • NHS England
  • Nutricia Advanced Medical Nutrition
  • Focus Active Learning
  • Royal College of Speech and Language Therapists
  • British Dietetic Association
  • National Nurses Nutrition Group
  • National Association of Care Catering
  • BAPEN (British Association of Parenteral and Enteral Nutrition)
  • Barchester Healthcare.

This group defined the aspirations for the game:

  1. Describe the problem in clinical and human terms
  2. Illuminate the size and seriousness of the problem
  3. Explain that players can have direct influence on patient safety
  4. Offer simple risk assessment and management advice that can be put into practice immediately

The game is aimed primarily at frontline healthcare professionals in hospital and community settings, care homes and hospices, and universities.


The programme is still ongoing. Prototypes were extensively tested within the NHS and the game was launched in February. Nutricia is working with NHS England and Focus Active Learning to promote the games to ensure that they reach the frontline where they are most needed. You can play the online version of the game and find more information at http://www.dysphagiagame.com.

DysphagiaGame Logo