A major review of hospital food has called for on-site kitchens to be upgraded and suggested that innovative new equipment be installed to support a move to digital menus and tailored service. FEJ caught up with Philip Shelley, who chaired the review, to learn more.
A root and branch review of hospital food has provided the NHS with a new blueprint for kitchens and catering services.
The Hospital Food Review could lead to significant project work for the catering equipment supply chain over the coming years as hospitals upgrade kitchens to follow the recommendations set out in the report.
It has also prompted the government to state that 40 new hospitals being built during the next decade as part of a £3.7 billion investment programme will include “21st century” CPUs and ward kitchens.
The review, which was led by TV chef and restaurateur Prue Leith was carried out in the six months prior to lockdown, but the conclusions have only just been made public. It makes a series of recommendations on how NHS trusts can prioritise food safety and provide more nutritious meals to both staff and patients.
This includes upgrading hospital kitchens so a 24/7 service can be provided to everyone, from a hot drink and a snack in the middle of the night to a cooked meal for new mums in a maternity ward. It calls for funding to equip and enhance hospital kitchens, and prioritise providing health-enhancing meals.
Philip Shelley, soft FM operational management at NHS Improvement, chaired the review and he revealed that visits were carried out to more than 30 NHS Trusts in England as part of the process. He says the exercise confirmed that one size certainly doesn’t fit all when it comes to foodservice.
“What we saw were lots of fantastic hospitals doing great work, real exemplar sites throughout England, and also some sites that were struggling. And often the ones that were struggling had the same type of foodservice as exemplar sites. So is it down to the funding? Is it the skills? Is it the equipment? I think there’s a blend of all those things, which is why we formed the eight recommendations (below).
“There is also a chief exec checklist because we want chief execs to be closer to food and understand where they get things right and where the challenges are, so at least they can measure them. And obviously going forward we want to support those Trusts to get them to a point where they feel much happier about their services.”
The age of some hospital buildings naturally poses structural challenges for future kitchen design, says Shelley, but perhaps the more pertinent issue is making sure sufficient funding is available for new equipment.
Suppliers have got an opportunity to make a real difference by working with hospital sites to improve the equipment and the structure of the kitchen builds”
“There is so much equipment out there now that you can cook so differently,” he says. “It is about thinking more in terms of energy use and the quality of food, so we really believe there is a great opportunity to change the way that Trusts actually cook food and serve food. And also, at this point in time, I hope it allows suppliers to think that they’ve got an opportunity to make a real difference by working with hospital sites to improve the equipment and the structure of those builds.”
Shelley says it is vital for Trusts to look ahead and consider future models of delivery in order to be able to adapt. This will have a major impact on equipment purchasing.
“We’ve seen instances where people have just continually replaced what they’ve got and their model of delivery then changes, which means they’ve got to have a massive turnaround of what they have already purchased.”
The review suggests that every hospital should also implement a digital meal ordering system by 2022 to collate food choices, manage allergies and diets, and minimise waste. Shelley believes that food ordering needs to be brought as close to the point of service as possible for the patient.
“If you want to go out for a meal tomorrow night, you want to choose your meal when you’re at the table, you don’t want to choose it in advance. We should be in that scenario here for our patients. We feel that digital has a part to play, we know that the government is very strong around digital and therefore is happy to support the possible financial implications around that, so there will be a bidding process for us to set up around the review and we believe that digital will play an important role in that.”
Additionally, the report recommends that NHS Trusts agree a common method of monitoring food waste and proposes that national professional standards for NHS chefs should be introduced with mandatory professional development, including appropriate compulsory food hygiene and allergen training.
We need to know what our patients are eating and, as importantly, what are they not eating and the reason for that”
Food waste is an area where hospitals need to build up a better idea of practices, says Shelley. “When you serve one ward with 30 patients in, we should be able to understand how much of that food is getting to the patient in as best quality as possible and how much food is either being left on the trolley or left on the plate.
“We need to know what our patients are eating and, as importantly, what are they not eating and the reason for that. Is it because they are on medication, they have had a real change in their physical and their mental health while they’ve been in bed? Or is it because the food is not of the right quality? That will give us a story and we need to understand the story from each hospital and from each Trust.
“We are working with WRAP and with the Hospital Caterers Association to bring in a consistent template so everybody can actually link into that and we can start to measure across the country what people are doing well, what their challenges are and how we can help them.”
Median spend per NHS patient meal currently stands at £4.56, exceeding the budget of meals offered by other public services. The government said it will establish an expert group of NHS caterers, dieticians and nurses to take forward the recommendations made in the report and decide on next steps.
An NHS England survey shows that while 58% of patients rate hospital food as ‘good’ or ‘very good’, 39% of hospital staff feel that food and catering facilities offered in their workplaces are poor. More than 140 million meals are served to patients every year, as well as a further 1.25 million to members of staff on shift.
The government has created a £3.7 billion fund to deliver 40 hospitals across England by 2030, which will include a focus on new catering facilities such as restaurants, central kitchens, patient dining spaces and ward kitchens.
Ensuring the dial moves on healthcare foodservice will command the very best support from the catering equipment supply chain.