Recognising progress in healthy NHS catering

Stewart McKenzie, the new national chair of the Hospital Caterers Association, looks at the role that healthy catering in the NHS has to play in the fight against obesity and diabetes

As chair of the Hospital Caterers Association (HCA), I am keen to build on the strong foundations to ensure that the patient is at the heart of everything we do. The HCA and its members understand the key role nutritious food can play in supporting patients with their recovery and we are actively promoting that message with our hospital colleagues.

I want to make sure the collective voice of hospital caterers is heard loud and clear, not just within hospitals but on the wider political platform. The Lead Association for Catering in Education (LACA), the HCA’s counterpart in education catering, recently demonstrated how powerful lobbying can be, with the government reversing its decision to remove Universal Infant Free School Meals in England.

Well done to all involved for their fight to keep such a vital service. Just as it’s important for patients to receive a hot nutritious and tasty meal, it’s equally important for children to be provided with one. The health of children will ultimately have an impact on the NHS now and in the years to come. We should ensure children are taught valuable lessons about food and good nutrition, so they become well-informed adults.

Obesity crisis
An obesity crisis is in full swing in the UK and childhood obesity is becoming a major problem. Research has shown that obese children are more likely to become obese adults, with a higher risk of developing type 2 diabetes and heart disease. Such health problems will put even greater strain on an already suffering NHS. In the UK, we now have 700 amputations per year from diabetes alone. Furthermore, worldwide obesity rates have more than doubled since 1980, according to the World Health Organisation (WHO), who suggest that 40 per cent of all adults are now overweight or obese, and the figure is rising.

Fat used to be enemy number one but now we’re fighting a raging war on sugar. Caterers can be the ones to kick-start a nutrition revolution and the public sector is already at the forefront. We have seen several initiatives introduced in our hospitals and schools to improve the health of the nation. In doing so, we are likely to reduce the pressure on our services in the future.

A couple of weeks into my chairmanship, NHS England announced its intention to limit sugary drinks sales in hospital shops. The HCA welcomed the news that several suppliers had already pledged to cut sales of sugary drinks to 10 per cent or less within hospitals over the coming year. It’s great to see initiatives being introduced to help fight against obesity, diabetes and tooth decay across the country, with the NHS leading the way. We hope more suppliers follow suit and introduce measures voluntarily, rather than having an outright ban forced on them in April 2018.

In the last year, we have seen progress being made with hospitals removing price promotions on sugary drinks and snacks and making sure healthy options are available to patients, staff and visitors. It will be interesting to see how retailers also respond to the further targets imposed by NHS England for confectionery and pre-packed sandwiches and meals.

Combating obesity isn’t easy and it can’t be solved with one simple solution. We need to make sure we are addressing matters and taking steps in the right direction and that also includes making the health and well-being of NHS staff a priority. Our role as hospital caterers is particularly important for the patients we serve, however, we need to ensure our staff also have access to healthy and nutritious meals and snacks, so they are best placed to carry out their role.

Nutritional and healthcare campaigns
The HCA believes a multi-disciplinary approach is pivotal in ensuring patients are at the heart of hospital services. In recent years, we have sought greater collaboration between caterers, nurses and dietitians as part of our ‘Power of 3’ campaign. This important initiative of working together to help improve nutritional outcomes for patients overarches much of what we are aiming to achieve as an association.

Stemming from this, the HCA has been working hard to increase awareness of malnutrition, which affects around one in three people admitted to hospital. The association has delivered a national campaign to improve patient screening on hospital admission to ensure early identification of malnutrition. Our efforts have secured media coverage and support from key stakeholders including NHS England, which has resulted in an increased awareness of the need to create bespoke nutrition plans for patients.

We have also launched our 24-7/365-day nutrition and hydration awareness campaign to highlight the importance of good nutrition every day of the year. It aims to raise awareness of food and hydration being an important part of quality care, the risks of malnutrition and what can be done to prevent the condition in health and social care environments.

The HCA will continue to campaign to improve hospital catering at ward level, with its ‘Last 9 Yards’ initiative that aims to deliver an excellent mealtime experience for every patient, every time. The ‘Last 9 Yards’ taskforce addresses failings identified at the point of service for patients including issues with meal presentation, food being out of reach from patients, crockery, water jugs, glasses and packaging. It has led to a wide range of improvements being introduced at several hospitals, such as blue plates and finger food for patients with dementia, as well as initiatives such as ‘little and often’, extended choice for long-stay patients and 24/7 availability. The campaign presents the case for food quality and enjoyment, arguing that food must form part of the patient’s recovery plan. It highlights if food is not eaten it can do no nutritional good and food waste is money wasted.

I plan to build on the work of my predecessor Phil Shelley to ensure national prominence for the organisation in what continues to be a challenging time for hospital caterers. The HCA is proud to have forged closer working relationships with other public sector catering bodies such as the National Association of Care Catering (NACC), LACA and The University Caterers Organisation (TUCO). I believe that if we take a more joined up approach we are likely to have a better chance of getting our messages heard and in turn will have greater influence on the political stage. This could prove vital in light of the uncertainty facing the public sector and the UK as a whole.

The association has also brokered alliances with several clinical and auxiliary agencies, by the signing of a memorandum of understanding or the forming of strategic partnerships. Organisations include NHS England; the British Dietetic Association (BDA); the Health Estates & Facilities Management Association (HEFMA); the Association for Healthcare Cleaning (ahcp) and the Soil Association.

Fundamentally, everything we do is about the patients in our care and a desire to deliver service excellence. Every year our Leadership and Development Forum plays a significant role in supporting the continuing professional development of members and the sharing of best practice. Additionally, branch activities take place throughout the year, including formal meetings, seminars and study days with guest speakers, supplier demonstrations, exhibitions and social events.

In our bid to deliver service excellence we recognise the need to sometimes look to others for advice, encouragement and support and that’s why our collaborations are important to us. The partnerships and collaborations the HCA has already formed make us collectively stronger and it’s important we continue to strengthen these. Although this will be a focus of the HCA, the association will remain independent and will not be afraid to say when we disagree with something.

The NHS and the HCA
With 15 branches across the UK and more than 250 hospitals represented in its membership, the HCA network is the single largest group of healthcare catering providers within the NHS and is recognised as the sector’s lead voice. Next year will mark the 70th anniversary of the NHS and the HCA is looking forward to celebrating its coinciding milestone. Throughout its history, the NHS has evolved and overcome many challenges and no doubt it will continue to do so.

Hospital catering also presents its own challenges and obstacles and often hospital caterers have been faced with the daunting task of trying to do more with less. It’s certainly a complex area and there are many factors to take into consideration at each individual site. Financial constraints and pressures continue to be a big challenge and on top of that there are inequalities in catering funding across the country. I have real concerns regarding the fragmented nature of the service in England with individual Trusts operating in isolation.

Then we have issues relating to recruitment and staff retention, promoting a healthy workforce and the introduction of compliance standards, and that’s before we assess the impact Brexit is likely to have on our services.

Whatever the service model, we need to make sure we go the extra mile to support patients and their needs. I strongly believe people who work in the NHS tend to do so because they care and that’s no different for caterers. Seeking excellence in service delivery and knowing we are aiding patients in their recovery is immensely rewarding.

Being chair of the HCA is a significant role and I look forward to helping drive up standards to improve hospital catering for the most vulnerable people we serve.

Stewart McKenzie is the new national chair of the Hospital Caterers Association (HCA). He took over from Phil Shelley at the HCA’s Leadership and Development Forum, held in Belfast in April. McKenzie has more than 35 years’ experience in the NHS and currently works as site facilities manager at NHS Greater Glasgow & Clyde. He is also a Fellow of the Institute of Hospitality.

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