Hospital Food Review – Gail Walker, view from the board

The Hospital Food Review launched on Monday 26th October 2020

#hospitalfoodreview2020 delivers new national standards for improving hospital food. It establishes eight recommendations to improve staff and patient health, and wellbeing through hospital food.

The structure, approach and breadth of the review focuses on NHS Trusts within England and puts food at the heart of the matter.

Debate quickly turned to a question of service type, is one better than another and does one really deliver healthier and more nutritious food.

Debate around in-house versus out of house, and fresh versus frozen is a distraction. The real focus should be, how do we deliver excellent and nutritious food at the point of service, every single time.

The multi-faceted set up of catering operations across Trusts in England, means that without capital investment of an unprecedented manner, not every hospital will be able to cook from scratch in-house. And for me, that’s not really at the heart of the argument. What I wanted to help achieve was a framework for delivering excellence in healthcare catering whatever the delivery method. How can we reach the gold standard, and support every operational type of food delivery, in a way which is diet appropriate, safe, made from good quality ingredients and appetising? I believe only once we deliver this, will we start to see a difference.

The review highlights eight areas to tackle. But to be successful, we first need to take a step back. We need to ask the public to engage with hospital food in a completely different way. It’s become something of a national pastime to attack hospital food, and sadly sometimes with good reason. However, expectations must be managed around what to expect from food upon becoming an inpatient. The NHS simply can’t cater, and nor should it, for every trend or desire. It may not be serving up smashed avocado on toast anytime soon, but the difference goes deeper than that.

Due to rightly enforced nutritional guidelines, patient food in hospital won’t be made with unlimited amounts of flavour enhancers such as salt either. Therefore, hospital food will always taste different to similar dishes experienced at home or in a restaurant. This is not something to whinge about but something to embrace. The NHS should be a global trailblazer for excellence in nutrition and health, and if that means forgoing salt laden food for a few days during a stay, then so be it.

The question of what then the NHS should be serving, continues to be a hot topic, with pressure from many sides. Ban meat, ban sugar, ban frozen food, ban processed food, ban sandwiches, the list goes on. Ultimately the panel reflected that choice, and the patient should be prioritised in deciding what is available to eat.

“It’s entirely within the NHS’s gift to ban ‘junk’ food from all sites. But shouldn’t we recognise that food is more than just health. It’s also a pleasurable, emotional and a sensory experience. In high stress situations, surely we can acknowledge a cup of tea and a slice of cake can work wonders.”

Having worked with the Hospital Caterers Association (HCA) for many years, I was delighted to see the panel adopt so many of its ideas. Chair of the review, Phil Shelley, is not only an industry stalwart but also a previous HCA Chair and we must utilise the depth of experience of this organisation and many like it, such as the BDA, if we are to deliver the panels goals and make a real difference.

Hospital Food Review Recommendations

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.