Hospital food has never had the greatest reputation, but caterers are striving hard to alter that with a more nutritious and diversified approach to food provision. And it all starts with the right kitchen equipment, as FEJ finds out.
When the government published a report last year recommending a set of food standards that should become routine practice across NHS Hospitals, it was hoped that it would be seen as a major step in addressing the core problems facing the hospital catering industry.
But there were many who felt that it simply didn’t go far enough, including the UK and Ireland branch of the Foodservice Consultants Society International (FCSI). The chapter’s then chairman, Niccola Boyd-Stevenson, said the new benchmarks that hospitals would be required to meet were simply too basic, such as providing tap water, and didn’t take into account the bigger picture.
“They address patient nutrition and hydration but regrettably not the quality of overall catering and there have been no minimum standards set. If we can enforce national nutritional standards for schools, why can’t we do the same for hospitals?” she argued.
Nutrition is by no means the only challenge the healthcare sector faces when it comes to catering. The demands put on caterers are high and budgets, particularly in the public arena, are constantly under review. Caterers require equipment that enhances meal presentation, while maintaining quality and safe-serving temperatures. There is a growing focus on reducing waste and optimising portion control, all while endeavouring to increase patient satisfaction.
One man with an unparalleled view of hospital catering is Andy Jones, service development director for innovation and product at catering services specialist ISS and a recent chairman of the Hospital Caterers Association (HCA), which today boasts more than 400 members. He says that closer collaboration between kitchen buyers and planners will be needed if the healthcare sector is to drive towards its goals.
“We are seeing more focus on ‘sustainability’ via the Government Buying standards and DEFRA’s ‘Plan for Public Procurement: balanced scorecard for public food procurement’, as well as carbon neutral products, all of which caterers in the NHS are well-equipped to deliver, but we need the supply chain to be in place and work with us on the information and products required to meet this, and this is where the gap is.
“Waste is a focus for us all, but for caterers in the NHS it’s not just about production waste. We have to focus more — and rightly so — on plate waste, which is not always easy with the complexity of the NHS — or is it? We have to understand why we have plate waste, the portion sizes, and whether the menus are what patients want.”
Although the industry struggles to meet demand for more seasonal products, such as strawberries in the summer and satsumas in the winter, due to red tape, the NHS is no different to the wider foodservice sector in the sense that patients are demanding good quality food and menus made up of fewer choices. Customers are demanding us to deliver more healthy options in our restaurants and we need to work better in this area and take the lead,” says Jones.
“We also have to stop looking at the cost of equipment in the short term and going with the cheapest option, and instead look at the need, the whole lifecycle and whether it saves time and delivers better results.” In much the same way that other public sector departments have seen a funding reduction, those in the healthcare sector are also facing substantial pressure on budgets across the board.
Trusts are still buying equipment on the basis of ‘is it really needed’ and ‘cheapest is best’”
Jon Usher, head of UK sales and marketing at GDPA, says it is having an impact on spend on healthcare foodservice provisions, with catering managers still required to produce a varied daily menu to exacting standards and strict nutritional guidelines, yet often working with outdated appliances.
“A focus primarily on affordability and reliability has led operators to carefully select any new appliances based on brand reputation, associated costs and the added value of the after-sales service packages available. In addition to this we are also seeing more and more of the catering provisions within healthcare trusts being outsourced to more specialist contract catering teams. This has led to a much more fragmented industry where equipment manufacturers are required to work very differently with each independent Trust.”
Healthcare Trusts employ a variety of systems and have their own preferences in terms of production model, but centralised production units (CPUs) feature heavily in the sector. Here, the use of cook-chill systems, which involve blast chilling or blast freezing on a large scale for onward regeneration at a satellite hospital, remain prevalent.
Peter Stansfield, managing director of Burlodge UK, agrees that when you look at the sector it is generally a mix of single-plated frozen meals and traditional catering using CPUs.
“There are still many hospitals preferring to offer multi-portion, either chilled or frozen. There is not a single ‘trend’, it all depends on the location of the hospital and the level of skill available. In terms of the delivered meal service sector, we haven’t seen a drop in sales of our equipment; equally we haven’t seen an increase. The single frozen-plated meal is the only change we have seen in the past few years.”
Where hospitals are modifying their equipment infrastructure and are committed to cooking fresh, BGL Rieber’s managing director Gareth Newton sees a transition from ovens and ranges to more “flexible” options such as cooking kettles and bratt pans. “There is also continuing maximum emphasis on ensuring that correct temperatures are maintained while transporting and serving hot, chilled and frozen food to patients,” he adds.
Hospital kitchens are high productivity environments and, as such, the ability to create a variety of different dishes on a large scale takes priority, as does the economy at which this can be achieved. Stuart Flint, regional training and development manager at Electrolux Professional, agrees that equipment such as braising pans are proving extremely popular to assist with the bulk cooking that is carried out daily.
“Where the food is centrally produced, investors are always looking for new, innovative ways to produce good quality food which retains nutrients, and one of the most popular ways this can be achieved is through pressure cooking. The result of this is more nutritious and tasty food, cooked in a more energy- and time-efficient way — the perfect combination for those establishments looking to achieve quality and increase their margins.”
It is not only patient catering where changes are evident, as Newton from BGL Rieber notes: “Front or theatre cooking equipment with the added bonus of self-ventilation is being selected for public and staff restaurants to offer ‘fresh cooked’ appeal. The drive to achieve higher standards is increasing the demand and desire for more versatile forms of cooking equipment.”
Equipment that offers the opportunity to reduce cleaning times and manual handling is a real bonus in a tough and busy kitchen environment”
ISS’ Jones acknowledges that investment in the healthcare sector is still “very slow”, but suggests that where developments are taking place the emphasis has to be firmly on meeting patients’ needs and producing food that is of a consistent standard and quality.
“The focus needs to be at the ward end and that last nine yards,” he says. “However, I do add caution to the suppliers in the sector to assist us in making this change by helping us show the ‘whole costs’, including operating costs over, say, five and 10 years. This includes lifecycle costs and energy costs based on the current rates. That said, Trusts are still buying equipment on the basis of ‘is it really needed’ and ‘cheapest is best’, without looking at the lifecycles, sustainability and running costs and suitability to ensure we can offer the service going forward to capture any changes in trends.”
The healthcare sector clearly needs equipment that is functional and energy efficient, but above all uncomplicated to use. And because hospitals are feeding high-risk patients, food safety records need to be meticulous, says Graham Kille, boss of Frima UK.
The HACCP facilities on its multifunctional cooking units are being used to help caterers monitor and manage records. “The flexibility of the smaller 112 units make them especially useful for diet kitchens where they help speed up production of purees and the many different meals being prepared,” he comments. “Hospital kitchens require robust and easy-to-use equipment. Equipment that offers the opportunity to reduce cleaning times and manual handling is a real bonus in a tough and busy kitchen environment.”
It is a view that GDPA’s Usher agrees with given that chefs in the healthcare sector will always have a need to produce large quantities of meals on a daily basis. “We are predicting that with budgets remaining tight for the foreseeable future, the healthcare sector will be looking for equipment that is multi-functional and versatile, rather than having many different appliances for the many different roles in a busy professional kitchen,” he says.
Hygiene requirements extend across all kitchen platforms, including warewashing. Hygiene security is a primary concern for hospital caterers, for washing at ward level using undercounter machines and in the main kitchen, where rack or flight transport machines capable of handling large volumes are preferred.
Winterhalter’s marketing manager, Paul Crowley, says that although he sees a culture of repair and an emphasis on budget purchases within the healthcare sector, the company is being asked for more compact and flexible warewashing equipment. He comments: “Caterers are looking for solutions that enable strict hygiene standards to be met or assist with keeping items cleaner longer, for example thermal disinfection and easy-to-clean machines, preferably with a self-cleaning cycle.”
Bill Downie, managing director of Meiko, says the highest level of security is provided by thermal disinfection warewashers. “Thermo label testing also ensures that a recommended temperature of 71°C has been achieved on the surface of washed ware, using labels which can be attached to glassware or directly to a dishwasher rack. The label changes colour when the correct temperature has been achieved.
“For ward level warewashing, the elimination of water softening apparatus and the consequent issues of operator training and lack of salt is achieved by using integral reverse osmosis water treatment, incorporated within the body of the dishwasher itself.”
One critical aspect of healthcare catering is food delivery and this continues to be a core area of spend. Burlodge, for instance, is a significant player in this category with its Multigen, RTS and Multicook systems, while catering equipment distributor FEM has introduced a non-electric ‘healthcare meal delivery cart’ from Cambro that provides insulated transport for 10 trays.
“It’s intended for use in the healthcare industry to improve patient satisfaction with high quality, room-service style meals served quietly and efficiently,” explains FEM’s marketing and sales manager Mark Hogan.
The company also supplies Cambro’s Shoreline collection, which can be used alongside the meal delivery cart to keep food hot until it gets to the patients or residents. “The collection includes mugs, bowls and insulated dome lids and maintains top quality care and presentation for safe transportation and heat maintenance,” says Hogan.
Equipment utilisation within the healthcare sector is an evolving topic, with caterers working hard to ensure that once food reaches the ward, it meets the type of patient groups required. As Jones at ISS says, the food offer has to dictate the kind of equipment specified, not the other way round.
“We need suppliers to understand the complexity of how a hospital works — and patients’ needs can be diverse depending on the type of patient. Elderly wards, for instance, will have a different need and approach to, say, maternity or surgical patients. One size does not fit all.”
Allergen safety is a major focus in the healthcare sector, with caterers looking at ways to raise staff awareness and implement procedures to minimise the chance of allergens reaching diners with food allergies.
The risk of contamination during food preparation has led catering equipment supplier FEM to launch a range of utensils based on the San Jamar Saf-T-Zone system. The utensils are an eye-catching purple colour to distinguish them from other utensils and provide a simple yet effective approach to creating an allergen-safe preparation area.
The range includes a chopping board, a 25cm chef’s knife, tongs, a turner and a digital thermometer. All items use the same distinctive purple plastic handles.