New blueprint for better hospital food

Millions of NHS patients and staff will benefit from tastier, healthier and better-quality meals following an independent review of hospital food

A review of hospital food was ordered by the Government following an outbreak of listeriosis in 2019 and has made recommendations for widespread improvements

  • New blueprint for hospital food launched by food and health professionals following a review led by chef and restaurateur, Prue Leith
  • Expert group of NHS caterers, dietitians, and nurses will lead on reviewing recommendations for tastier, more-nutritious food for patients and staff, some of which can be adopted immediately
  • The 40 new hospitals built by 2030 will include 21st-century catering facilities including restaurants, central kitchens, patient dining spaces, and ward kitchens

Millions of NHS patients and staff will benefit from tastier, healthier and better-quality meals following an independent review of hospital food, led by a panel of advisers including TV chef and restaurateur, Prue Leith.

Published last week, the review makes recommendations on how NHS trusts can prioritise food safety and provide more-nutritious meals to both staff and patients.

This pandemic has demonstrated, more than ever, the importance of good food and proper nutrition

And, following the release of the report, the Government has announced it will establish an expert group of NHS caterers, dietitians, and nurses to take forward the recommendations and decide on next steps. These include:

  • Upgrading hospital kitchens so a 24/7 service can be provided to everyone; from a hot drink and a snack in the middle of the night to a hot meal for new mums in a maternity ward or for patients hungry after a long fast due to surgery, plus facilities for staff to store, prepare, and eat food at any time during the day or night
  • Introducing digital menus and food ordering systems which can factor in a patient’s dietary and cultural requirements and nutritional needs. This will improve communication between dietitians and caterers; reduce food waste; and provide patients with the right food for recovery
  • Agreeing national professional standards for NHS chefs with mandatory professional development, including appropriate compulsory food hygiene and allergen training
  • Increase the role of nurses, dietitians, caterers, and staff wellbeing leads in overseeing food services so that nutritious meals are part of a patient’s recovery plan

Matt Hancock, Secretary of State for Health and Social Care, said: “This pandemic has demonstrated, more than ever, the importance of good food and proper nutrition.

“We must all prioritise our health and be empowered to eat well, whether we’re at home or in hospital.

“This impressive report shows the way to good hospital food for all - patients, staff and visitors.

“Across the NHS, and in the 40 new hospitals we are set to build, I want to ensure - with Prue’s help - that we deliver really-good hospital food.

Just as our staff need the right tools to do their job, we also need to ensure that they have the nutrition and hydration they require to perform their crucial roles

“Alongside our new obesity strategy to improve the nation’s diet, the NHS is leading by example when it comes to public health.”

Leith added: “The review provides best-in-class examples of how hospitals can serve delicious, nutritious, and nicely-presented meals on a budget.

“Food is not only important to health, but to morale and hospital mealtimes should be a moment of enjoyment and a pleasure to serve.

“They should inspire staff, patients and visitors to eat well at home.”

Recruitment has now begun for the expert group led by the review’s chairman, former head of the Hospital Caterers Association and catering lead for Taunton and Somerset NHS Foundation Trust, Philip Shelley.

He said: “Just as our staff need the right tools to do their job, we also need to ensure that they have the nutrition and hydration they require to perform their crucial roles.

“The wellbeing of our NHS staff is vital because it affects their mental and physical health as well as the quality of care they deliver for patients.

“A lack of nutritious food and drink can contribute to feelings of stress and lack of control in the workplace.”

In putting together the report, Shelley and Leith visited catering managers, staff, and patients across the country, looking at best practice from those leading the way in NHS food quality and innovation.

And their findings echo many of the themes in both the Government’s recently-published Obesity Strategy and part one of the National Food Strategy.

This includes the importance of healthy, nutritious and tasty food for physical health and wellbeing; how COVID-19 has highlighted the need to improve the nation’s dietary health; and the need to also focus on the culture around food, not just on the food itself.

We urgently need to get to grips with the slow-motion disaster that is the British diet. And, if we are to succeed, hospitals must be a guiding light

The National NHS Staff Survey in England for 2019 revealed that while 58% of patients rate hospital food as ‘very good’ or ‘good’, 39% of hospital staff feel that food and catering facilities offered in their workplaces is poor.

And, with over 140 million meals served to NHS patients every year, and a further 1.25 million members of staff that require nourishing food and drink on their shifts, the review highlights the importance of improving both patient and staff satisfaction even further.

Henry Dimbleby, co-founder of Leon Restaurants and independent lead on the National Food Strategy, said: “We urgently need to get to grips with the slow-motion disaster that is the British diet. And, if we are to succeed, hospitals must be a guiding light.

“This is a refreshingly-innovative review which, not only offers solutions for hospitals; but offers three principles that any institution could use to improve their food: realise that leadership, not decree, is what creates change; put in place a ‘whole-institution’ approach, and focus not just on the food, but on the food culture; and ensure we put love, care, and humanity at the centre of any solution.”

The review was ordered by the Government following an outbreak of listeriosis in 2019.

And the report makes recommendations for system-level change, covering staff, nutrition and hydration, food safety, facilities, technology, sustainability, and enforcing standards.

The recommendations aim to ensure every NHS catering supplier, worker and contractor is meeting the highest standards to prevent foodborne infection and keep patients safe.

This includes training hospital workers, including ‘non-catering’ staff such as nurses, on food hygiene matters relevant to their work; and ensuring suppliers uphold Food Safety Association and Public Health England standards.

The review also contains a checklist for catering managers and chief executives with the key principles of providing a good food service.

And many of the recommendations can be implemented now, at no additional cost.

The Government also recently announced a £3.7billion fund to deliver 40 hospitals across England by 2030, which will include a focus on 21st-century catering facilities including restaurants, central kitchens, patient dining spaces and ward kitchens.

The call for food to be available to patients 24/7, even if just a snack and hot drink outside mealtimes, is just one example that we know, from what patients told us, will make a positive difference if implemented

Rachel Power, chief executive of The Patients Association, said: “When a patient stays in hospital, they are strongly conscious of the importance of the food they are served – most patients told us it has a direct bearing on their experience, and that the presentation of it affects how much they will eat.

“We therefore welcome the strong ambition for hospital food shown in the report’s recommendations.

“The call for food to be available to patients 24/7, even if just a snack and hot drink outside mealtimes, is just one example that we know, from what patients told us, will make a positive difference if implemented.”

The background

The hospital food review panel completed its research, fieldwork and report between September 2019 and March 2020.

The median spend per NHS patient meal was found to be £4.56, exceeding the budget of meals offered by other public services.

The review makes the following eight recommendations to improve staff and patient health and wellbeing through hospital food:

1. Catering staff support: Introduce professional qualifications and standards for hospital caterers, provide more training and reward excellence with pay progressions.

2. Nutrition and hydration: Ensure importance of food services is understood and integrated within patient recovery, hospital governance and staff training.

3. Food safety: Ensure food safety through open communication channels to address safety concerns, by appointing food safety specialists and upholding standards.

4. Facilities: Provide funding to equip and upgrade hospital kitchens, provide 24/7 services for staff and patients, prioritise providing health-enhancing meals.

5. Technology: Every hospital should implement a digital meal ordering system by 2022 to collate food choices, manage allergies and diets, and minimise waste.

6. Enforcing standards: Food and drinks standards should be statutory and inspected by the CQC, a forum should be established to share exemplary best practice.

7. Sustainability and waste: Ensure government food procurement standards are upheld, NHS trusts should agree a common method of monitoring food waste.

8. Going forward: Establish an expert group of hospital caterers, dietitians and nurses to monitor progress, accountable to the Secretary of State for Health and Social Care.

Learn from the best

St Bernard’s Hospital in Southall has developed tailored sessions for dietitians to teach patients the principles of good nutrition so they can apply them to their own diet.

Many of its patients did not have much nutritional knowledge and a high proportion were at risk of obesity-related health problems.

Broadmoor Hospital has staff kitchens on each ward with a microwave and toaster.

The staff restaurant is also very popular and serves mostly the same food as is served to patients, but on a different menu cycle.

And Frimley Park Hospital runs teams of ‘dinnertime companions’ who are there to provide social companionship to long-stay patients as well as to support patients who may need a little bit of help with eating.

Other best-practice examples include Musgrove Park Hospital which uses seasonal menus as they have the added benefit of promoting local procurement, along with reducing food miles and air pollution.

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