Patient recovery

02/01/2014 - 15:08
News the Government has launched a review of hospital food, with plans to report back in autumn 2014, has been broadly welcomed. But Foodservice Consultants Society International (FCSI) members Andrew Etherington and Peter Pitham, who’ve worked in the healthcare sector, sound a warning

Plans by the government to set up a Hospital Food Standards Panel to review the quality of food for patients and then report back by autumn 2014 sound like the answer to a long-expressed demand for action in this area. It will be led by Age UK’s chairman Dianne Jeffrey and has the support of Health Minister Dr Dan Poulter MP.

The panel’s findings will be used as the basis for new government and NHS England guidance and regulations.

But two catering consultants with a background in the healthcare sector say they remain to be convinced any good will come of it.

FCSI UK & Ireland vice chairman Andrew Etherington, owner of Andrew Etherington Associates, has worked in and consulted on hospital catering throughout his 40-year career in the foodservice industry, which means he’s well placed to comment on the latest plans for a food review in this sector.

“The issue of poor standards in hospital food is still happening because there’s no UK wide standard for the catering provision. The main problem is that there is a mixture of in-house and outsourced services that are operating with different degrees of success.

“This means there is a huge variation in standards between the different NHS trusts in all aspects of the service from menus and methods of food production, to portion sizes. There are examples of trusts that are doing great things, but unfortunately it can’t be said across the board.

“There’ve been several previous attempts to improve the overall standard, such as The Better Hospital Food Programme with Loyd Grossman, that I was involved in. This campaign made a good attempt to address key issues, but fell apart over time as there was no policing or benchmarking to ensure that trusts stuck to their recommendations.

“This again, comes down to the fragmented nature of the NHS.”

Peter Pitham, managing director of Catering Consultancy Bureau, has a similar view: “All the time that the powers-that-be pay lip-service to the hospital food issue the problem is still going to be there.

“What is required to address the problem of a very fragmented NHS is a concentrated, sustained effort with serious investment and resource.

“We need a central resource to enable individual trusts and catering managers to share best practice. At the moment there is no communication, no shared strategy and the trusts are isolated.

“There isn’t a straightforward solution, but an area that could be quite easily addressed is the service of food to patients on the ward.

“For example, many patients are served a regenerated meal, which is never going to be in prime condition. A solution to this would be to have ward-level kitchens to deliver freshly cooked meals of a better standard.

“Also lacking is attention to the service of meals - in many hospitals it is down to the nurses to serve meals, however, they have so many other priorities.

“Lack of time means that those patients who need help to eat don’t receive it and their plate is often whipped away before they’ve had a chance.

“Food hosts or dedicated porters who are part of the catering team and responsible for delivering meals and offering assistance to patients, work well and ensure that each patient receives a personal service and help when needed.

“There are examples where this has already worked really well and it is something I would like to see enforced.”

Etherington adds: “If I could change one thing, which I believe would improve the standard of catering, it would be to remove dietitians from the equation.

“This may be controversial, but I believe that they currently have too much say over what goes on the plate and it’s not always what our patients want to eat.

“The average stay in hospital is only two to three days, so it’s not enough time to educate patients on following a healthy lifestyle, so why not give something familiar and tasty which is still nutritious without alienating them from their food.

“The reality is that the majority of patients fall into the older age demographic, and aren’t familiar with a lot of the items currently on hospital menus.

“When it comes to the recommendations to Government, it’s important that whatever is concluded comes with clear, accessible guidelines.

“But, at the end of the day it’s up to the individual trust to put it into practice – this won’t change. So, if the management doesn’t like it, it simply won’t happen.

“To make a real difference, I believe the programme needs a champion to galvanise change. This has to be someone with credibility, experience and they need to be involved from the off.

“It can’t be just a celebrity chef who gives their name; we need to learn from the School Food Plan where John Vincent and Henry Dimbleby did all the groundwork and are seeing a degree of success as a result.

“This approach would mean it’s seen as sensible and, by its very nature, more likely to be delivered.”

Pitham concludes: “There is a huge job for the Government to do, but they need the resources and knowledge from within the foodservice industry to help them solve it.

“There is also the wider issue of the fragmented system and budget constraints, which need to be reviewed in order to facilitate long-term change.

“If this isn’t addressed then three years down the line exactly the same problems will be coming up again.”

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