Better hospital food

09/01/2015 - 10:33
The recent publication of the Hospital Food Standards Panel’s Report on standards of food and drink in NHS hospitals generated a lot of interest. Panel member and Apetito chief executive Paul Freeston believes the recommendations will improve hospital meals.

We’ve all seen the photos of unappetising meals snapped at patient bedsides that typically appear across the media whenever a story on hospital food hits the headlines. Despite the negative perceptions this undoubtedly fuels, let’s not forget that there are, of course, many hospitals across England that are providing consistently high-quality food and drink that we would all be pleased to eat.

The Hospital Food Standards Panel was set up by the Department of Health to help all hospitals across the country to achieve this level of quality.

With more than 50 potentially relevant standards covering hospital food, the aim of the panel was to examine them all and recommend a small number that should be enshrined in the NHS Standard Contract.

This contract is used by commissioners to purchase healthcare from healthcare providers, including catering companies and suppliers, and the inclusion of these standards means that all providers will be legally obliged to adhere to the requirements set out within.

The five identified have been selected for their potential to make the biggest difference to patients, staff and visitors, while improving the sustainability of hospital catering services.

The role good nutrition plays in patient recovery is well documented, and high-quality food has a major impact on a patient’s stay.

At the heart of the three required standards for patient catering is the fact that their needs should be properly identified and met at all times. Not only may patients have specific dietary needs relating to the reason they have been admitted to hospital in the first place, but there’s also their individual appetites and cultural influences to consider, plus the potential impact that being unwell is likely to have on their appetites.

This means it’s vitally important to offer patients a broad choice of food – in more than one portion size – to encourage them to eat and therefore receive the nutrition they need to recover.

Services such as pre-prepared meals that can be heated at ward level are particularly useful for wards with a high patient turnaround, where flexibility is important.

However, the ability to serve patients across any ward at any time will go a long way towards ensuring they receive the nutritional intake they need to recover as quickly as possible – rather than forcing them to eat at set mealtimes.

Since more than half of all the food provided in NHS hospitals is served to staff and visitors, hospitals therefore have an important role to play in promoting good health in the wider community.

The needs of staff and visitors are often very different to those of patients, and it is therefore more appropriate to promote ‘healthy eating’ rather than taking the ‘eating for health’ approach recommended for patients, although those in need of extra calories, such as patients undergoing chemotherapy, will of course need more than an average healthy diet would tend to provide.

Again, flexibility is key, as there is an important role to play in encouraging and supporting diners in hospital canteens and cafes to make healthier choices by making sure they have access to a variety of healthy food and drink at all times, including staff working shifts during unsocial hours.

To guide caterers in putting this into practice, Public Health England’s Healthier and More Sustainable Catering Principles use the government’s ‘eatwell plate’ on how best to achieve a healthy balanced diet.

Based on the five food groups, the plate is a simple visual representation of how much of what we eat should come from each group – it may sound obvious, but it’s a useful guide to bear in mind when devising menus.

The Government Buying Standard for Food and Catering Services (published by the Defra), includes a call for practical strategies aimed at reducing salt, saturated fat and sugar intake. Caterers able to clearly demonstrate the salt, fat and sugar content of each meal, snack and drink on their menus will not only reassure hospital managers, but also encourage staff and visitors to make healthier choices.

As well as meeting all these challenges, hospital food should also support the economy and protect the environment. As major purchasers and providers of food and catering services, hospitals have the opportunity to put sustainability at the heart of their work.

The Government Buying Standards for Food and Catering Services also include provisions such as procurement of catering operations to higher sustainability standards.

It’s therefore important for caterers and suppliers to be able to account for all aspects of their own supply chain, demonstrating elements such as where and how their food has been sourced, as well as measures taken to reduce waste, embed high standards of farm and food production, and reduce their carbon footprint.

The implementation of these standards will be monitored using the annual Patient-led Assessments of the Care Environment (PLACE) system. First introduced in April last year, the system assesses the overall quality of the patient environment, including food served during their stay in hospital, and will now be updated to include a detailed evaluation of the taste, flavour and presentation of hospital meals and snacks – all important elements of a quality food provision.

To help ensure they are meeting the standards, the panel recommended that all NHS hospitals should develop a food and drink strategy covering the three core elements of patient nutrition and hydration, healthier eating for the whole hospital community, and the sustainable procurement of food and catering services. Caterers and suppliers have an important role to play in working with hospitals as they formulate their strategies.

What does the future hold? Among the panel’s recommendations on how the standard of hospital food can be improved in the future is that further work is needed to deliver excellence in texture-modified foods.

Therefore, caterers and suppliers that are not only able to help hospitals meet what’s required of them by the report, but are willing to innovate and provide solutions that go beyond the elements set out within as well, will be well placed to help raise the quality of food served in hospitals across the country for years to come – and gradually address the poor reputation it currently endures.

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