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Tuesday, 17 September

Hospital Food Standards Leave a Bad Taste in the Mouth - Industry Figures Comment

Yesterday (Thurs Aug 28), Health Secretary Jeremy Hunt MP published hospital food standards and announced that it would now be legally binding for hospitals to apply these standards to food served to patients and sold to staff and visitors on site. Below is what industry stakeholders have said...two of those, from ISS and the Hospital Caterers Association, came in response to our original story which appears first.

 

Campaign for Better Hospital Food

Alex Jackson, Co-ordinator of the Campaign for Better Hospital Food resigned from the Hospital Food Panel in April this year in objection to the government’s refusal to introduce a new law to set hospital food standards in legislation. He responded to Jeremy Hunt’s announcement, saying: “Jeremy Hunt’s announcement that he will introduce legally binding standards for hospital food appear to fulfil what we have always strived for, yet we’re left feeling that he has pulled the wool over our eyes.

 

Legally binding - fib

Jackson continued: "We want to see hospital food standards set down in legislation, similarly to school food standards and therefore universally applied to all hospitals and protected by publicly elected representatives for generations to come. But instead the government has only committed to including the standards in NHS commissioning contracts, which are long documents full of clauses that without proper enforcement and monitoring can be ignored by hospitals.

"In addition, the food standards the government introducing are weak and only reflect basic catering and care standards which are already commonly implemented in the NHS, including that 'tap water is available' to patients. Good things in themselves but not ambitious enough to have a transformative effect on patient meals.

"We’re alarmed to discover that the government is not prepared to put the food standards out for public consultation which means that only the Panel members, including food manufacturers with a commercial interest in hospital food, have had any influence over them. The lack of public involvement in and scrutiny of, the Panel’s recommendations compounds the alarm caused by a Daily Mail article which quoted a government official allegedly undermining the value of nutritious hospital meals and advising that patients be served doughnuts if going hungry."

 

The Campaign for Better Hospital Food is now calling on Jeremy Hunt to:

Put the hospital food standards out for public consultation, so that patients can tell him what changes they would like to see.

Set hospital food standards in legislation so that they cannot be ignored by hospitals or be removed or amended without the consultation or consent of elected members of Parliament and will therefore be protected for generations to come.

Allocate powers to an independent body so that it can review, monitor and support the implementation of the highest standards for hospital food, similar to the role given to Ofsted and the Children’s Food Trust after the original introduction of legislation to set standards for school meals.

 

Comment from ISS

As a major provider of hospital catering ISS Facility Services, Healthcare welcomes the Governments  Hospital Food Standards, which will help to raise the importance of food in the recovery of the Patient.

Unlike Alex Jackson from the Campaign for Better Hospital Food, ISS believed that it was best to remain included in the consultative period because it was at that stage where some influence could be exerted. It is now too late to call for public consultation but the list of bodies that contributed to the report demonstrates how much consultation has already taken place, including many individuals who have personal experience as a patient.

In addition, those who work in the field of hospital catering, both within the NHS and those who support the institution, such as contractors like ISS and food suppliers, continue to strive to provide the best service possible within the budgetary confines placed upon them. The key to success will be an acceptance that every interested group -  caterers, clinicians, dieticians, nursing and other NHS staff - should all work together for a common aim; that of the Patient. It should be noted that there are plenty of examples where patients are more than happy with the food they receive.

ISS also believes that the Campaign is wrong in claiming that patients aren’t being involved. Patients are already being included in local consultations and are at the forefront of the PLACE ( Patient-Led Assessments of the Care Environment) visits, the results of which were also published this week. In addition every patient is approached after they leave the hospital to complete a survey about their stay experience, which is reported independently.

 

HCA response to the government’s hospital food standards plan and patient led hospital inspection audits (place)

This new Hospital Food Plan has involved key stakeholders of which the Hospital Caterers Association (HCA) has been one of the key leads. One area that the HCA was keen to have agreement on from day one was that we did not want any further new processes/procedures to be produced. What was needed was to agree on the key ones that are currently in use and to update and build upon these, removing all others that were unnecessary, and for these to then be embedded into NHS England’s contract.

We also pushed for clarity around catering for the different groups we serve: for patients, eating for good health and for staff and vistors, healthy eating.

It is essential that all Trusts, caterers and clinical teams work together to ensure that the Hospital Food Plan is given full support from the 'top down' and 'down up'. HCA Members will be driving this at their Trusts to ensure that we offer wholesome nutritious food to patients, with the patient and caterers working together to deliver menus they want, within the budgets allowed, and for our dietitians to work with the caterer, as they do now, to ensure the menus are nutritionally correct against the BDA Digest, which is one of the plan's recommendations. This collaborative approach will ensure that the Trust's Food and Drink groups' strategy is truly embedded in the patient’s recovery plan.

 

Andy Jones, National Chair, Hospital Caterers Association (HCA) says: “The HCA warmly welcomes the new Hospital Food Plan and the PLACE inspection system which fully integrates patients in the assessment process. The Plan embeds some of what the HCA has developed, led on and campaigned for i.e. Protected Meal Times to be made compulsory by the Government in all hospitals and for more help to be provided for patients who need assistance to eat. 

"However we have to ensure that the Plan is delivered and communicated correctly firstly, that ALL Chief Executives make the Plan a board issue, which is reported and updated to the board on a minimum of a 3-monthly basis, that ALL caterers deliver the Plan and show that our service is there to meet the needs of the patients, staff and visitors, in all hospital food across NHS Trusts and other health care centres in England.  

“However, whilst I believe that patient involvement is essential to providing a more accurate perspective of views on food, drink and general catering services and to identifying where improvements should be made, we must not allow ourselves to become distracted by overly focusing on scoring and league tables. It is key that our menus and beverage choice meet and are suitable for the patient groups we serve as well as being flexible in both their offering and adaptability. The advantage of the PLACE data is that it enables us to take a step back and explore in-depth patient feedback on specific aspects of the service and to work with the patients on those individual areas that have been identified as weaker."

Jeremy Hunt's report has been published along with the results of the second Patient-Led Assessments of the Care Environment (PLACE) for England 2014.

Andy Jones continues: "PLACE scores should not be used as yet another stick, but 'the carrot' to catalyse continuous, quality improvements. However, in order to achieve that across the board, a view needs to be taken about how some of the catering service is managed in future, such as night time ward snacks and drinks, as these fall under ward budgets and are outside of the caterer’s area of responsibility. In order to improve the quality of all aspects of patient food and drink provision, the caterer should be allowed to take responsibility for the whole of the ward service.

“What the Hospital Food Plan clearly shows is that because of the multi-disciplinary nature of a patient’s nutritional care, we must continue to work across all departments to ensure consistency and support for a patient’s total food and drink provision. For example, we need to encourage Trusts to seek CQUIN payments to help fund improvements to areas where we need to raise standards.

“Consequently there is a need for greater understanding of the wider challenges of producing and delivering food to patients on our hospital wards. In order for nutritional care to be more ‘personalised’ to an individual patient, it is important for all members of the clinical care team as well as caterers to recognise the role that it can make to improving the patient’s clinical outcome and to imbed food and drink as part of the patient’s recovery plan."

The HCA is still calling for  a mandatory minimum expenditure on all patient meals to also be introduced in ALL TRUSTS across the UK. 

The Association has shown by caterers leading that costs need not rise. In fact where the HCA has been involved or led we have seen costs of items reduce and that is not always on food as, for example, with the new NHS jug where a saving of 42p per jug is being made. But that said, the savings were not then given wholly or partially to the caterer!"

Andy continues, "The deployment of ward hostesses on more wards, too, would ensure better monitoring and communication of individual patient food and drink requirements and intake. Improved screening of patients’ nutritional status on admission is called for so that special dietary conditions or needs can also be identified. With a better protocol in place for every single patient which can be followed by all members of the team – from ward to kitchen and throughout a patient’s stay, patients will then receive the optimum nutritional care they expect and deserve.

"The welfare of staff and visitors is essential to the patient’s recovery and that of the community as we must not forget the hospital is the hub of the local community. So ensuring that we offer healthy choices foremost is something that caterers must lead upon, but ensuring we have the balance and choice. Small changes can lead to large lifestyle changes, such as removing full fat mayo and replacing with low fat, reducing sugar in recipes, or not selling duo bars of chocolate."

The HCA Members now have the Plan but the benefits of the Plan are for all, so Jones is asking all caterers to lead and drive the Food Standards Plan to ensure this service is accepted as an integral part of the patient’s recovery plan and staff and visitors' wellbeing. He concludes, "The Plan is the beginning and not the end of the process and we as Caterers have to lead this."

 

To download your copy of the Hospital Food Standards Panel's Report published today, click here

Information ranking the quality of hospital food and can be found here

 

Article written by Brian Shillibeer

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