Greater Glasgow and Clyde Medicines

IDDSI Update

International Dysphagia Diet Standardisation Initiative (IDDSI) Update

Following assessment by a speech and language therapist, modification of fluids and diet may be recommended for people with swallowing difficulties.  In 2018, NHSGGC published information (available here) on the proposed transition towards the International Dysphagia Diet Standardisation Initiative (IDDSI). This global standard uses terminology and definitions to describe texture modified foods and thickened liquids. IDDSI can be used for individuals with dysphagia of all ages, in all care settings and for all cultures. The IDDSI framework consists of a continuum of 8 levels (0-7).  Levels are identified by text labels, numbers, and colour codes to improve safety and ease of identification. For more information access

All patients prescribed thickeners across NHSGGC required prescription review as the manufacturers of available thickeners introduced new product labelling in line with IDDSI descriptors.

Phase I – Transition to IDDSI for patients prescribed fluid thickeners

a) All patients prescribed the preferred list thickener Nutilis® Clear were given new dosage instructions in accordance with IDDSI descriptors.  This work was completed in May 2018.

b) Patients prescribed non-preferred list thickeners will now be reviewed with the help of prescribing support teams. Where possible, patients will be switched to Nutilis® Clear early in financial year 2019/20.  Patients unsuitable for a switch will be reviewed by a healthcare professional.

Phase II –Foods

Transition of patients on texture modified foods to align with IDDSI requirements will take place towards the end of April 2019 in both acute and community settings. Previous descriptors (letters A-E) will be replaced with the new IDDSI levels (3,4,5,6,7). 

Please note, no thickener should be added to any oral nutritional supplements. For queries, please contact


Published 13/05/19. Medicines Update blogs are correct at the time of publication.