With the NHS under enormous strain following the Covid pandemic and the resulting backlog of cases, you could be forgiven for thinking that hospital food is not one of its main priorities. But it certainly should be. When people are in hospital, they need the right and balanced nutrition to have the best chance of recovery. In this article we’ll discover how important nutrition is to a hospital and what measures can be put in place to ensure a great quality of care.
A new NHS hospital food review paper, undertaken between September 2019 and March 2020 (updated with some Covid-relevant observations), and published in October 2020, sets out the challenges faced by the NHS’ catering departments and recommended solutions.
Kafoodle’s patient ordering system puts several of these into practice, easing the burden and streamlining the whole process. The review was commissioned after seven patients died from eating hospital sandwiches infected with Listeria monocytogenes, and this must never be allowed to happen again.
What are the rules & when do they come into effect?
Catering staff support
Catering staff must be given the necessary training and gain a food hygiene certification. The training should be mandatory for anyone who handles food for patients or staff, whether in the catering kitchen or at the ward level providing hot drinks and snacks. They should also be recognised for their efforts and not seen as an afterthought, with pay scales at least at Band C, and incentives like awards.
Nutrition and hydration
Directors of nursing, should be responsible for all food and drink supplied in their hospital. Ensuring it is nutritionally balanced and that patients and staff are kept fully hydrated. To guarantee the needs of everyone are met in a safe environment, food and drink steering groups should be set up containing dieticians, caterers and medical staff.
A food safety specialist should be appointed at each trust, and a designated board member should be made responsible for food safety. With regular food safety audits from an environmental health professional, a robust reporting procedure for concerns needs to be implemented.
Ward facilities should be upgraded to allow for 24/7 catering. Allowing patients and staff to get drinks and snacks whenever required, whether after giving birth in the middle of the night or coming out of an operation after fasting or nursing staff on long shifts with few proper breaks. Hospital new builds need to prioritise fully-equipped kitchens in their plans. The distance from the kitchen to a patient should also be considered, prioritising the ability to deliver sufficiently hot and edible meals.
Patient ordering is already helping the NHS curate food choices, cater for allergies and diets, and reduce waste. Every hospital has been asked to implement a digital ordering system for their meals by 2022.
The hospital food review paper hopes this will lead to:
- ‘Safe ordering and mapping to patients’ care plans.
- The menu offers tailored to patients’ dietary needs and personal preferences.
- Minimum time between ordering and meal service.
- Waste reduction.
The CQC (Care Quality Commission) will undertake regular and in-depth inspections to ensure hospitals and care providers meet essential food procurement standards, safety, and provision.
The Health and Social Care Act (2008) states that: ‘people who use care services need adequate nutrition and hydration to sustain life and good health and reduce the risks of malnutrition and dehydration while they receive treatment.’ The CQC will uphold this.
Sustainability and waste
A 40% cost and 60% quality split is being made mandatory for all catering services throughout the NHS, using the Department of Environment, Food and Rural Affairs’ plan for public procurement: food and catering: the balanced scorecard and the Public Services (Social Value) Act (2012). NHS Trusts need to implement a nationwide system to monitor and record wastage and raise awareness of the problem with a campaign and supporting materials to help minimise it.
‘The Patients Association surveyed 240 patients who had spent at least one night in hospital in England in the past six months. Of these patients, 70% said that the presentation of their food impacted whether they were likely to eat it, with over half (52.1%) saying that poor presentation made it less likely that they would eat their food. Some patients complained that meals were served in microwavable plastic trays.’
A loss of appetite can also be responsible for food waste, so offering balanced smaller portions for patients’ needs should be considered. 14 million kilograms of unserved food was thrown away in hospitals in 2018-2019, which does not include plate wastage, which isn’t currently recorded. Organic food waste should be separated, collected and disposed of at an anaerobic digestion facility. Reducing the amount of food waste sent to landfills and instead being used to generate heat and electricity, allowing the NHS food supply chain to assist the government in its commitment to reduce greenhouse gas emissions to net-zero by 2050.
Allocating resources and keeping information up to date
An expert group should be created to implement all the above recommendations, containing hospital caterers, dieticians and nurses. This group can then apply the advice from infection prevention and control, sustainability experts, and staff wellbeing representatives. It is vital that boards and chief executives regularly eat the same meal as patients and see nutrition as a priority, reflected in their catering budget. There is currently an average spend of £4.56 per patient meal.
A lack of nutritious food available to staff affects mental and physical health and patient care. Hospital staff often work long shifts, which can preclude taking time out for proper meals. A regular supply of drinking water is also necessary to keep them hydrated to work at full strength. It is not just the patients who need to be catered for, and this needs to be at the forefront of all future thinking.
Learning from each other and not working in isolation is critical to the success of the changes being implemented by the hospital food review paper. Hospital catering digital ordering software enables everyone concerned to be kept abreast of developments and valuable feedback, as well as monitoring and measuring progress.
How can Kafoodle help?
Effective change needs two things: ‘data that gives insight for improvement, and a plan or strategy for getting the improvement done.’ This line is taken directly from the hospital food review paper, and neatly sums up exactly how Kafoodle’s digital ordering system can help the NHS to put everything into practice.
Mandatory electronic patient ordering reduces the likelihood of mistakes, especially when people need to eat correctly and may have specific dietary needs.
The patient experience is also improved, with the software including full ingredients, allergen and nutritional information, and pictures of the food so that a more informed choice can be made. It is also quicker and more flexible, with menu updates being made instantly with live data and consumer requests transferred immediately to the people providing the meals. Electronic data can provide insightful reports on recipe popularity or regularly requested nutritional requirements.
It is important that hospitals don’t just feed people but also entice them to eat, providing meals they want. Inclusive dining options for all staff, visitors and patients, providing a range of foods for all religious and dietary requirements whilst setting these out in an easy-to-find format helps make supplying these meals easier.
Kafoodle has adopted the ‘Power of Three’ approach, which empowers dieticians, caterers and nurses to make decisions for patient care, streamlining and collating the process in one simple place for complete ease and total satisfaction from end-to-end. Contact Kafoodle to see how we can help your hospital create digital ordering.
Please credit me with the following author bio:
Sophie Bishop is a medical journalist. Sophie aims to spread awareness through her writing around issues to do with healthcare, wellbeing and sustainability and is looking to connect with an engaged audience. Follow Sophie on Twitter: @SophBishJourno