Against the backdrop of the UK’s dynamically changing population demographic, its National Health Service (NHS) is faced with a number of ‘wicked problems’, i.e. problems that are difficult to resolve and resistant to resolution. An attempt to resolve just one aspect of a problem often results in the creation of further problems. ‘Solutions’ tend to be addressed using a reductionist approach and imposed through hierarchical management structures. Consequently there can be a lack of collective contribution to potential solutions from - and engagement with - those who are both delivering and receiving the service. This compounds problems through the introduction of solutions that are unworkable or ineffective due to a lack of acknowledgement or poor understanding of complex interdependencies and relationships. This paper discusses the value of introducing design approaches to a particularly wicked NHS problem, that of how to address the issue of chronic malnutrition in vulnerable older UK hospital patients.

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