New rules on hospital food announced

Government reveals new standards to enhance nutrition in hospitals, enforced through legally-binding NHS contracts

The Government has announced the introduction of legally-binding standards to improve the quality of patient food and ensure value for money in catering services

NHS trusts will face a new legal obligation to improve food standards as the Government announces tough new legislation that will help to stamp out the significant variations at hospitals across the UK.

The announcement comes after it was revealed that hospital trusts spend, on average £9.77 on food per patient, per day. But there were wide variations and last year 95 hospital trusts cut their spending, according to Department of Health data. One trust spent just 69p on each meal. And, at Ninewells Hospital in Dundee, a takeaway outlet within the concourse sells a ‘fry-up pie’ for just £1.50. The belly-busting meal contains bacon, sausage, black pudding, beans and an egg and contains a whopping 800 calories, a third of the recommended daily intake for an adult male.

Many hospitals do provide high-quality food and drink, but the variation across the country is too great

In a bid to address the problem, the Department of Health commissioned an independent probe into the issue and the subsequent report, entitled Hospital Food Standards Panel report on standards for food and drink in NHS hospitals, includes a number of recommendations that will now be enforced through legally-binding NHS contracts.

Commenting on the release of the document, Jeremy Hunt, Secretary of State for Health; and Diane Jeffrey, chairman of Age UK, warned trust chief executives that they were responsible for ensuring patients were given healthy, nutritional food.

They state: “Every hospital has a responsibility to provide the highest level of care possible for its patients and this, without question, includes the quality and nutritional value of the food that is served and eaten.

“It is important that the quality of food served to patients is nutritious. Many hospitals do provide high-quality food and drink, but the variation across the country is too great.

“As a chief executive you are ultimately responsible for ensuring that patients have a positive experience during their stay, including when it comes to their nutrition. This report will provide you and your team with the guidance and tools to help achieve this.

“As an indication of how serious the Government takes nutrition and hospital food, we are introducing these as legally-binding standards in the NHS Standard Contract.”

As a chief executive you are ultimately responsible for ensuring that patients have a positive experience during their stay, including when it comes to their nutrition. This report will provide you and your team with the guidance and tools to help achieve thisn

The 46-page report explores standards relating to patient nutrition and hydration, healthier eating across hospitals, and sustainable food and catering services.

The changes mean that, in future, hospitals will be ranked according to quality and choice of food, whether the menu is approved by a qualified dietitian, the availability of fresh fruit and food between meals, the variety of options at breakfast, and the cost of the food provided. These rankings will be published on the NHS Choices website.

The new standards will also require hospitals to provide: fish twice a week; seasonal produce; tap water; cooked rice, potatoes and vegetables without salt; fruit for at least half of all desserts, and fair trade tea and coffee at least half of the time.

In addition, patients will be assessed for malnutrition when they are admitted and there will be greater responsibility placed on healthcare staff to ensure patients are well fed.

The publication of the report has been widely welcomed. Stephanie Gibney, ethical and sustainability manager at NHS Supply Chain, said the organisation was involved with putting together the report and already has a commitment to ‘responsible nutrition and responsible food sourcing’. She added: “Following the panel’s recommendations, this will be the first time that there are mandatory food standards for hospitals, which will increase the focus on what hospitals are doing to deliver these standards.

It's very important that the food is attractive, it's appetising, it's palatable, it's nutritious, it meets the cultural and social needs of patients and also meets their clinical needs

“We recognise that, with responsibility for 25% of NHS trust food supplies, we are an important link between food producers, suppliers and NHS hospitals. Our priority is to have a portfolio of framework agreements for food which deliver sustainable value to the NHS and enable ‘eating for good health’, while complying with European regulations. Continuing our work to encourage compliance with Government Buying Standards and stepping up our engagement with suppliers will enable us to drive through the recommendations into our framework agreements.”

Jeffrey added: “When a person is in hospital they are in a very vulnerable state.

“It's very important that the food is attractive, it's appetising, it's palatable, it's nutritious, it meets the cultural and social needs of patients and also meets their clinical needs."

But the Campaign for Better Hospital Food has argued that the standards do not go far enough. Its co-ordinator, Alex Jackson, said: “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 the government still refuses to do this and 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.

"The government may have inserted a new clause in a legal document, but that won't be what most people consider to be legally-binding. It's woefully inadequate." /

Click here to read the report.

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