Inability to open packaging is a common difficulty for many people, with the term ‘Wrap Rage’ being coined in 2004 to describe the frustration than people feel when they are unable to get into packaging as intended. Often users resort to strategies such using a relative or partner to open the pack for them, use hot water, rubber gloves and in extreme circumstances, screwdrivers, scissors and knives. As we age there is a natural decline in our strength, our ability to manipulate and handle items (dexterity) and our ability to see and understand information (cognition).  This decline in our capability can make the inability to open packaging even more problematic and can have potential serious consequences for many frail and vulnerable older people.  Work by researchers at the University of Wollongong in Australia, looked at access and use of packaging by patients in hospitals in New South Wales. The work showed that 40% of patients in their study were unable to open some of the packaging they were presented with on a typical meal tray. Further, a similar proportion of were staff also unable to open some of the packaging. Researchers identified unopened packaging as a possible source of malnutrition in older people whilst staying in hospital.

Issues regarding unopened packing and malnutrition was also  identified in the UK. In 2015, the  National Health Service (NHS) established a taskforce to review single portion food and beverage packaging, which has been identified as a potential challenge to users in hospitals. Professor Yoxall as part of the International Standards Organisation (ISO) had been working with other experts on the creation of a series of guidelines for the design and use of accessible packaging. ISO17480 Guidelines for Accessible Packaging, was launched in 2015 and contains information about best practice for the understanding of issues around the inability of accessing packaging and a designer checklist to aid with the development of future packaging designs. Amongst the information within the ISO standard is the use of a user test panel to determine the accessibility o otherwise of a particular pack (ISO 17480 Annex D).

Hence, it was proposed to  undertake a study to determine the suitability and accessibility of the current single portion packs.  The packaging was assessed using ISO 17480 (Guidelines for Accessible Packaging), Annex D.  The standard determines a pass or fail of packaging opening asking a panel 20 older adults to open a pack. A pack is recorded as a failure if within the 20 people cohort there is an example of pack being unable to be opened within the time limit (defined as 1 minute) or the overall satisfaction score ranks below 3 on a 5 point ‘smiley-face’ (Likert) scale.

Ten standard single portion packaging items were randomly selected for testing.  The packs were chosen to reflect a broad range of food and beverage and packaging types.

The results showed that the standard provided useful assessment data, identifying that 70% of packs were so poorly designed that they failed to pass the standard, with 50% of the packs having examples that were unopenable by participants, whilst a further 20% rated poorly for satisfaction.

The project has been funded by the NHS, the University of Wollongong, the Hospital Caterers Association, and contributions from industry suppliers.

"Fundamentally this is about empowering patients to eat and drink well. This in turn could help reduce the risk of malnutrition, supporting nurses, hospital caterers and dieticians be even more effective in their complex and demanding environments.” Caroline Lecko

Research team

• Professor Alaster Yoxall, ADMRC, Sheffield Hallam University
• Dr Alison Bell, School of Health and Society, University of Wollongong, NSW, Australia
• Dr Kate Gee, School of Psychology, Canterbury University
• Ms Caroline Lecko, Patient Safety Lead, NHS Improvement