Hospital Caterers Association national chair, Ian Robertson, looks at the importance of healthy and sustainably sourced food for hospital patients.

It was Hippocrates who allegedly said around 400 BC, “Let food be thy medicine and medicine be thy food.” This is as relevant today as it was then, even more so if you are a hospital patient, relying on others to provide you with that ‘medicine’. However, food can only be medicine, if it’s actually eaten, and that applies to us all.

UK’s largest diverse caterer

With over 300 million meals served every year to patients, staff and visitors and around £634 million spent on food annually by around 300 NHS Trusts/Boards across approximately 1200 hospitals, the NHS is one of the UK catering industry’s largest providers of meals and the service represents a significant spend from the public purse.

Feeding patients in hospital is not the same as in a restaurant, or even at home. By their nature, patient groups have vastly diverse needs – children need a quite different diet from the elderly and pregnant mothers’ requirements are totally different to someone, say suffering from kidney disease. 

The hospital caterer has to consider a myriad of different diets, including ethnic diversities, and try to have something suitable three times every single day for every individual.

Sustainability – NHS towards zero

In October 2020, the NHS became the world’s first national health system to commit to becoming net zero carbon, this was in response to the threat to health posed by climate change.

It is estimated that food and catering services in the NHS produces 1,543 ktCO2e each year, equating to approximately six per cent of total emissions. This places a huge responsibility on the hospital caterer to look at ways of reducing that footprint.

What and how much we eat directly affect what is produced and in what quantities. If we are to achieve our environmental targets, we need to consume a more’ sustainable diet’ – diets that have lower environmental impacts and are healthier.

Sustainable nutrition

In recent years, there has been a growing recognition of the interconnectedness between our dietary choices and the health of the planet.

Sustainability in nutrition involves making food choices that consider the environmental, social, and economic impacts of the food we eat. 

These choices may include the environmental impact of food production, the role of dietary patterns in promoting health and well-being, and the importance of considering social and economic factors in shaping sustainable food systems.

Healthier, seasonal and locally sourced food can improve wellbeing while cutting emissions and wider environmental impacts related to agriculture, transport, storage and waste across the NHS supply chain, as well as supporting the local economy.

These choices emphasise a balance between meeting current nutritional needs of our patients, staff and those that visit our hospitals, without compromising the ability of future generations to meet their own needs. This includes supporting local and seasonal foods, reducing food waste, and promoting environmentally friendly farming practices.

As already mentioned, a key aspect of sustainability in nutrition is the environmental impact of food production. 

Agriculture, including livestock farming and crop cultivation, contributes significantly to greenhouse gas emissions, deforestation, and depletion of natural resources. As the global population continues to rise, there is a pressing need to develop more sustainable and resource-efficient farming practices.

This includes exploring alternative protein sources, promoting regenerative agriculture, and reducing food waste throughout the supply chain.

Eatwell plate 

The government’s EatWell plate recommends a diet with reduced processed foods high in sugar, salt and fats as part of a healthy balance. Analysis makes clear that this diet is also a low-carbon diet, with seasonally and locally sourced fruits and vegetables greatly decreasing emissions, as well as one for which rates of colorectal cancer and heart disease are lower compared to average diets across the country.

NHS England is working on a recipe range of low-carbon dishes that can be adopted across the country and large food producers are also following suit, actively signposting their low-carbon menu dishes to their customers.

Plant-based diets

There is an increasing proportion of the population who are now opting for a plant-based diet, either permanently or on a regular basis.

There is evidence that the environmental and health benefits of an increased consumption of plants and a reduction in consumption of highly processed foods can include significant reductions in carbon emissions, water consumption, land-use needed for food production and a reduced risk of cardiovascular disease, stroke and obesity.

By reducing reliance on animal products, individuals can decrease their carbon footprint, minimise land use, and mitigate environmental degradation associated with livestock farming. Incorporating plant-based dishes aligns with the principles of sustainable nutrition. 

Balancing the nutritional needs with environmental choices is something we must all make but the hospital caterer has to consider a broader audience than most. Sustainability in nutrition is not solely about eliminating specific food groups; it also involves promoting diversity and promoting more sustainable farming practices.

There is a campaign within the public sector that calls for a reduction in meat on the menus but using better quality cuts and looking at alternative sources.

For example, venison is gaining popularity as it represents a lower carbon impact, it is not intensively farmed, is higher in protein compared to conventional beef alternatives and is lower in cost. 

Food miles 

For many, food miles are a perceived indicator of sustainability, despite there being no shared definition of food miles. There are great reasons for buying locally, as demand for British products supports our own farmers and businesses, and in many cases, animal welfare and traceability is typically higher.

However, seasonality is a far greater indicator of sustainability. To give a simple example: A 250g punnet of strawberries grown locally and in season takes approximately 490g CO2e, but when grown in a hot house out of season the carbon footprint grows to approximately seven times that figure.

Hospital caterers who operate fresh food production traditionally change their menu cycle four times per year to reflect the seasons.

National standards for healthcare food and drink 

Each of the Four Nations of the UK have their own national standards relating to healthcare food and drink. They are all broadly similar, reflecting their own communities and national strategies. 

These, combined with the hospital caterer’s commitment to meet the Net-Zero targets are helping us all eat more healthily and, perhaps, save the planet at the same time.

The Hospital Caterers Association

The Hospital Caterers Association encompasses the single largest group of healthcare catering providers within the NHS and is the recognised voice of hospital catering. 

It represents catering managers who provide a wide range of food and other services for patients, visitors and staff in NHS hospitals and healthcare facilities. 

The HCA is a national organisation, with fifteen branches throughout England, Wales, Scotland and Northern Ireland, and more than 250 hospitals represented in its membership.

For further information, contact Craig Smith at journaleditor@hospitalcaterers.org or call 07774 759 558.