interviews

Improving hospital food

Health secretary Jeremy Hunt has announced a new initiative intended to improve the quality, availability and choice of hospital food to patients. Niall Gray talks to national chair of the Hospital Caterers Association, Janice Gillan.

Following a countrywide pilot review of hospital food across the country, figures suggest that two-thirds of hospital staff wouldn’t eat food served to patients and over 30 million hospital meals go uneaten each year.

With the quality of food and service of hospital food under question, NHE talked to Janice Gillan, national chair of the Hospital Caterers Association, to get an inside perspective on the difficulties of delivering high quality food under tight budgets, while looking at some of the implications of the new initiative from the Department of Health, announced on October 15.

Gillan told us: “Anything to raise the importance and the value of food is wonderful.”

She was, however, realistic about the challenges that must be faced in implementing some of the principles under the initiative.

The finances of food

In light of the considerable savings already being implemented throughout the NHS, we asked Gillan about the challenges of delivering high quality food at low costs. She said: “Caterers are not seen as a frontline service and they’re often at the mercy of efficiency savings, and you’re fighting against the tide all the time. I’d have to say a lot of people only have about £3 per day per patient for all food and drink.”

At less than the price of a supermarket ready meal, this daily quota displays the difficulties faced by NHS caterers in feeding patients to strict budgets.

She continued: “We all work for different NHS trusts and boards, where the priority for food costs [vary]. For example, the staffing: you may find that a trust running a 250-bed hospital, has a manager, three assistant managers and clerical staff, but along the road there’s a 1,000-bed acute hospital that’s lucky if it’s got one catering manager. Because they are trusts, you’re not on the same playing field, so anything to get on a similar stance is good.”

Quality of service

One of the major principles of the DH initiative was concerned with improving the taste and nutritional content of patients’ food, but Gillan also raised the issue of the way food is served within hospitals. She said: “One of my mantras, is that ‘food is the simplest form of medicine’ – and we need to get the food to the patient, and that can often be where the blockages perhaps are.”

Referring to the findings of the pilot, she added: “A lot of those reports are saying it’s not the quality of the food, it’s getting the food to the patients”.

She continued: “Hospital catering must be one of the only catering establishments which doesn’t always serve direct to its customer. If you think about prisons, or restaurants, or care settings, then the caterer will serve direct to the customer, whereas [in hospitals] there’s various numbers of people in the food chain: the food can be produced to the standard, but then if the trolley is then handed to a porter, that’s then handed over to a domestic, that’s then handed over to a nurse…So, these new standards can be a baseline for all, but the service side is of equal importance.”

Local sourcing issues

Another principle of the initiative states hospitals should act in accordance with the Government Buying Standards, which encourage more environmentally friendly food sourcing and waste management.

Gillan explained some of the difficulties and misconceptions around locally sourced food, saying: “I’m all for local sourcing. I come from a dairy farming background, so I know how difficult it is for them on that side.”

But she said it would be a real challenge to get the majority of NHS food locally sourced.

She broached the ambiguities associated with local sourcing, given it carries different specifications and regulation between companies: in certain instances, for example, food classed as ‘locally’ sourced can refer to food sourced anywhere within Europe. Gillan also explained problems arising from public procurement legislation, stating: “If you work for a public body, you cannot specify local sourcing, so that’s another challenge.”

When asked about the viability of placing a higher emphasis on organic products for NHS meals, she was sceptical: “I think if we could get local sourcing done, then we’d be going a whole lot of steps. I think organic is too far a step. Plus organic cannot, and will never be able, to produce the quality and quantity of produce all year round.”

But she was ultimately positive about the new standards, saying: “It’s a new platform and something to aim towards and it’s raising the profile of how important food is.”