Thank you all for the comments, both positive and those challenging my view (which might I say is merely that, based on clinical experience in this field). Having been a Nutrition Nurse Lead for a hospital and community Trust, I was responsible for implementing such systems. Some of which worked, others provided the audit results but these could have been achieved without the tray. I do firmly believe that we 'should know' our patients and unfortunately, many nurses do not, because of failings in good supportive leadership to help junior staff work in new and innovative ways, deal with workload and manage the stress that accompanies the job. I have no doubt that many organisations can present audit data on paper, and believe that these systems improve the identification of at risk patients. However I firmly believe that we could have achieved this 'recognition' by actually changing culture, recognising mealtimes as not only an important part of the day for patients but also the nurse to continue to build a relationship with the patient and continue the monitoring of the patient well-being as a whole.