New blueprint for better hospital food

• 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 chef and restaurateur Prue Leith.

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

The government has today announced it will establish an expert group of NHS caterers, dietitians and nurses to take forward the recommendations made in the report 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. Alongside our new obesity strategy to improve the nation’s diet, the NHS is leading by example when it comes to public health.

Restaurateur, celebrity chef and television presenter Prue Leith CBE, said:

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. 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 chair, former head of the Hospital Caterers Association and catering lead for Taunton and Somerset NHS Foundation Trust, Philip Shelley.

Philip Shelley, chair of the hospital food review, 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.

Philip Shelley and Prue 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. The findings of the hospital food review 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 our culture around food, not just on the food itself.

High-quality hospital food can improve staff wellbeing and speed up patient recovery.

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 were poor. (Source: NHS England, 2018 National NHS Staff Survey in England, 2019.)

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 shift, 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. 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 3 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, ensuring that everyone from the board members to the patients are eating from the same kitchen. But most of all – with its Power of 3 approach – it puts love, care, and humanity at the centre of any solution.

Following an outbreak of listeriosis in 2019, the Health Secretary of State announced this ‘root and branch’ review of food served and sold in hospitals.

Today’s 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.

Many of the recommendations can be implemented now, at no additional cost. The government also recently announced a £3.7 billion 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.

Rob Percival, Head of Food Policy at the Soil Association, said:

Good food could be game-changing in turning the tide on poor-quality food being served across English hospitals, but only if the recommendations are implemented in full.

It’s time food standards were regulated with monitoring and inspections to ensure good practice. It will be brilliant to see hospital trusts using their buying power to support British farmers and enable environmentally sustainable food production.

Chief Executive, Rachel Power, The Patients Association, said:

Good food is essential for patient recovery so this review could be game-changing in turning the tide on poor-quality food being served across English hospitals. But only if the recommendations are implemented in full.

It’s time food standards were regulated with monitoring and inspections to ensure good practice. It will be brilliant to see hospital trusts using their buying power to support British farmers and enable environmentally sustainable food production.

Background information

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

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

Recommendations

The review makes the following 8 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.

Case studies

St Bernard’s Hospital (West London NHS Trust) has developed tailored sessions for dietitians to teach patients the principles of good nutrition so that 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 (West London NHS Trust) has staff kitchens on each ward with a microwave and toaster. The staff restaurant is very popular and serves mostly the same food as is served to patients, but on a different menu cycle. They have been trying to make staff options healthier, while still giving people choice.

Frimley Park Hospital (Frimley Health NHS Foundation Trust) 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.

Musgrove Park Hospital (Taunton and Somerset NHS Foundation Trust) have seasonal menus as they have the added benefit of promoting local procurement, along with reducing food miles and air pollution. Local and seasonal food can have substantial environmental benefits, while local procurement and employment provide social and economic benefits.

The Chest Pain Unit at County Durham and Darlington NHS Foundation Trust is very well set out, providing food for several community sites at an excellent standard. Safety standards are high and the standard operating procedures and processes onsite are ingrained into the food safety management system.