A multidisciplinary team, funded by the UK cross-council New Dynamics of Ageing programme, is developing and prototyping a new food service for older patients (stroke, dementia and hip fracture) vulnerable to in-hospital nutritional problems. Designers, food scientists, dietitians, medical sociologists, ergonomists, and technologists are working together with key stakeholders and a ‘food family’ to understand the needs of the food provision from patients’ perspectives, to ‘map’ the food service and to identify opportunities for improving the service for all. Major opportunities for service redesign guided by a set of service principles have been generated through an inclusive design methodology. This is leading the team towards a new prototype food service that considers new food products, the design of tableware, the patient eating environment including furniture, food service provision, and a responsive information management system which monitors nutrition consumption and responds to individual nutritional needs. This paper discusses the results of the inclusive, participative and co-design methodology deployed in the initial phases of the project to engage the food family, stakeholders and the separate discipline specialists within the research team.