HCA Response to the Government’s Hospital Food Standards Plan and Patient-Led Hospital Inspection Audits

Health Secretary Jeremy Hunt MP has published Hospital Food Standards for England 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. This report has been published along with the results of the second Patient-Led Assessments of the Care Environment (PLACE) for England 2014.

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 visitors, 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.

But 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 click here.

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