Putting healthier food on the hospital menu

In August 2014, the Better Hospital Food campaign urged the government to set hospital food standards in England. Consequently, The Hospital Food Standards Panel, led by Dianne Jeffrey, chair of Age UK, recommended five legally‑binding food standards for the NHS. The government’s standards included requirements that: hospitals should screen patients for malnutrition and patients should have a food plan; hospitals must take steps to ensure patients get the help they need to eat and drink, including initiatives such as protected meal times where appropriate; hospital canteens must promote healthy diets for staff and visitors – the food offered will need to comply with government recommendations on salt, saturated fats and sugar; and that food must be sourced in a sustainable way so that it is healthy, good for individuals and for our food industry.

Following the standards publication, Secretary of State for Health Jeremy Hunt announced that hospitals would, for the first time, be ranked on the NHS Choices website for the quality of their food. This looks at how hospitals perform on the quality and choice of food, readily available fresh fruit, dietitian approved menus, food availability between meals and the cost of food services per patient per day.

Speaking after the announcement, Hunt said: “We are making the NHS more transparent, giving patients the power to compare food on wards and incentivising hospitals to raise their game. Many hospitals are already offering excellent food to their patients and staff. But we want to know that all patients have nourishing and appetising food to help them get well faster and stay healthy, which is why we’re introducing tough new mandatory standards for the first time ever.”

Food from the outside
However, despite some initial progress, the standards that apply to hospital food remain hopelessly weak, are not being properly monitored and are likely to be ignored. The campaign urges Westminster to set new, higher standards, and to place them into law. It is also essential that the standards are checked by an independent organisation trusted by both patients and staff.

The hospital food problem is not a new one. In a major indictment of the state of hospital food in this country, a 2011 survey for the Soil Association revealed that nearly two thirds (63 per cent) of people bring in food from outside hospitals because the meals they were served were unappetising. Over a third (35 per cent) said that they think hospital food is unacceptable and over half (53 per cent) claimed that they would not be happy serving the meals they were given to a child.

Nearly every independent survey of hospital food since 1963 has concluded that NHS food is neither appetising nor nutritious.

The Soil Association found a significant number of examples of strikingly good practice: well-run hospitals, where those in charge, and their skilled and committed catering staff, understand the importance of good quality, nutritious and satisfying food. In these hospitals, the food makes a positive contribution to patients’ well-being and staff morale. Those running hospital trusts with unhealthy food say they cannot afford better quality, but the hospitals that are doing a brilliant job are not necessarily those spending the most on their food service. It reports how one hospital saved £6 million a year by cooking with fresh, local ingredients; another sources yoghurt from a local supplier for two thirds of the price of the nationally-approved supplier.

In 2002, the Audit Commission noted that higher cost hospital food did not necessarily equate with better food – hospitals spending half as much as the highest were often able to provide better quality food than those spending more. More than a decade has passed since then, and much of the same discussion is played out. The NHS is vividly searching for new ways to make savings, especially given the aims of NHS England and the findings of the Carter report, but why enforce cuts on hospital food when the quality of the food is risked?

Over the last few years, in Cornwall, hospital spending of over £1 million with Cornwall suppliers generated an additional £900,000 for the local economy. Hospitals may resist changing their food because they claim it is all too complicated, as they are being asked to make food healthier, source it locally and reduce their climate impact all at once. In fact, these priorities can go hand in hand. Moving to healthier diets means moving to more environmentally-friendly food. The best hospitals’ food is good for patients, good for NHS staff, good for British farmers and food businesses – good for Britain. But the majority
of hospitals are delivering hospital food that is bad for patients, bad for staff and bad for Britain.

The Oxford Health NHS Foundation Trust closed its hospital kitchen doors for the last time this autumn as, despite best efforts from campaigners, the Trust moved its community hospitals to a cook-chill food system. The kitchens at Wantage, Didcot, Wallingford and Witney hospitals have all been shut down in order to save around £300,000 a year.

The Trust never said how many staff posts were at risk from the changes, but said it was ‘working to redeploy staff to other posts within the trust’. Opposition to the closure gained support from celebrity chef Raymond Blanc and a petition against the decision gained 474 signatures, but ultimately proved unsuccessful. The Better Hospital Food campaign also revealed that the closure of hospital kitchens at Oxford Health NHS Foundation Trust will mean that more than £1 million of food which can currently be spent on fresh food will now be spent instead on ready meals, creating a loss of more than £3 million in economic benefits for Oxfordshire communities. This includes the loss of local jobs and withdrawal of vital business for local businesses.

Katherine Button, of the Campaign for Better Hospital Food, said: “Most people prefer a home-cooked dinner to a ready meal and the same principle applies with hospital food. When a hospital kitchen closes, patients, staff and hospital visitors are more than likely to end up eating reheated frozen food, or chilled food delivered by van, sometimes transported for miles, topped up by unhealthy snacks from coffee shops and vending machines.

“If we care about the health and well‑being of patients and their families, then they need to be served good, fresh food to meet their needs. Food is also a vital opportunity for a hospital’s money to be invested in the local economy, with hospital chefs buying fresh ingredients from local farmers and other suppliers. When a hospital kitchen is lost, all these benefits are lost as well.”

Alex Meredith, Faringdon town councillor, said: “We still believe fresh food is the best way to make people better and give them a good experience in hospital. And because of the way the government is supporting healthy eating, there is a chance this sort of decision might be reconsidered in future and hospitals would have to reopen their kitchens, which would be a very costly process, but we have got to keep asking them to do that.

“These community hospitals are so small, patients got to know the cooks and knew what was going on the menu each weekend I was talking to people they got really excited about it, and part of a hospital’s care should be keeping people’s spirits up, but that has been lost.”

About Sustain
Sustain: The alliance for better food and farming advocates food and agriculture policies and practices that enhance the health and welfare of people and animals, improve the working and living environment, enrich society and culture and promote equity.

Representing around 100 national public interest organisations working at international, national, regional and local level, the Alliance was launched at the UNED-UK hosted Healthy Planet Forum on 17 June 1999. It was formed by merging The National Food Alliance and the Sustainable Agriculture Food and Environment (SAFE) Alliance, both of which had been established for over 10 years.

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