Press Releases
The Hospital Caterers Association’s Response to the Which? Survey on Hospital Food
In response to the findings of the Which? Survey on hospital food which looked at both hygiene standards in hospital kitchens and patient satisfaction with hospital food announced today (Thursday 2 November 2006), Alison McCree, Chairman of the Hospital Caterers Association (HCA) comments as follows:
“The Survey gave a distorted impression of current hygiene standards in hospital kitchens because many of the findings relate to incidences of poor standards of cleanliness from three years ago. A good deal has been done in the intervening time at those sites to address and put right the problems. We were pleased, therefore, to see that Which? did also draw attention to the high levels of good practice today because hygiene and safety issues are a paramount priority for hospital catering managers.
Patients should be reassured to know that catering managers observe a strict code of practice for cleaning standards within their kitchens and conduct daily - often twice daily - checks to ensure patient health and safety at all times. These take place before and after food service every day with a full weekly self-imposed audit of all facilities, equipment and processes. All kitchen catering staff are expected to take individual responsibility for maintaining health and safety as part of their employment contracts. Any failings can result in the severest disciplinary action. In addition to this all hospital kitchens are bound by Government hygiene legislation and depending on the food production method used by a particular hospital, catering managers can expect vigorous six monthly or annual inspections by Environmental Health Inspectors.
The HCA was, of course, disappointed by many of the Which? survey findings in relation to patient satisfaction with food which appear to contradict recent Government PEAT surveys that had indicated a more positive picture. It is absolutely imperative that we continue to strive to maintain or improve the standard of food and food services to patients, staff and visitors in our hospitals.
The Better Hospital Food Programme did much to raise the status of hospital food on Trust boardroom agendas, to catalyse change and to encourage significant improvements. Whilst the Government may have stood down the Better Hospital Food Panel, it is important to note that the objectives of the Better Hospital Food Programme still need to be met and now become the responsibility of individual NHS Trusts. As food standards will continue to be monitored by the Health Care Commission using the PEAT process, NHS Trust Boards just simply cannot afford to allow food and food service standards to slip.
The HCA has always stressed that improving hospital food is much more than just about improving ingredients and menus. Unless we have a system that ensures a patient can receive and consume his or her food to the best possible standard, in the best possible environment then there will be a variable success rate with regard to the positive or negative impact on patients’ perceptions of their meals and mealtimes as well as their nutritional intake, status, wellbeing and recovery rates.
Many of the complaints in the Which? Survey that relate to issues such as the wrong or inappropriate meals, could be dramatically reduced by increasing the number of ward housekeepers or ‘hostesses’ who should be more widely deployed to work alongside nursing staff on every ward. This was a target of the Government’s 2000 NHS Plan but not many hospitals have them stationed on all wards.
Caterers would like to feel that the ward food service was in a safe pair of hands and they can play a valuable role in observing patients eating patterns and ensuring they receive the correct food. They can greatly relieve the pressure on nursing staff by acting as an early warning system and raising concerns over patients who need nutritional attention and support. It is the duty and responsibility of nursing staff to attend to the nutritional status of patients and to take the necessary action such as a through a ‘red tray’ system, mentioned in the Which? report, to ensure they are not allowed to become malnourished.
We need to turn our attention towards the issues associated with creating a joined-up delivery and service process. Food is without doubt the cheapest form of medicine but what is the point of improving the food on the plate if the food on the plate is subsequently wrong, inappropriate or cannot be eaten for whatever reason? Currently, hospital caterers work on a per patient budget of £2 for breakfast, lunch, evening meal and two snacks per day. Without greater investment by the Government in hospital food and a serious focus on the issues relating to food service at ward level, a ‘cure’ for improving hospital food may still be a very long way off”.
Download a copy of the Which press release and survey.
Patient and Public Involvement (PPI) Forums’ “Food Watch” Survey
Download a full copy of the report.
The Hospital Caterers Association’s Response to Age Concern’s ‘Hungry To Be Heard’ Report
The Hospital Caterers Association (HCA) shares the concerns and wholeheartedly supports the findings of Age Concern’s ‘Hungry to be Heard’ Report launched today (Tuesday 29 August 2006).
The HCA has been actively raising its concerns over the unacceptable levels of malnutrition and under-nourishment amongst elderly patients for some time. With 40% of patients malnourished upon entry to hospital, there is clearly an urgent need for a more effective screening system on admission and a vigilant monitoring process throughout their stay. Screening is still not universally undertaken and many vulnerable patients slip through the net. The HCA believes that all hospitals should adopt the NICE guidelines issued in February 2006 and testing for malnutrition should be mandatory in England and Wales as it is in Scotland. These are in line with the requirements called for in the Council of Europe Resolution on Food and Nutritional Care in Hospitals_, published in November 2002.
Hospital caterers are dependent upon close co-operation with dietitians and nursing teams to ensure that at risk patients are identified. Under direction from dietitians and nursing staff, caterers are often able to tailor meals and provide foods to meet individual dietary requirements.
Before the surprise decision was made in May of this year to conclude the Better Hospital Food Programme, the HCA had been calling on the Government to instigate a Better Hospital Food Service Programme. The Association believes that the key to achieving greater nutritional intake is by establishing higher levels of food service at ward level.
As responsibility for hospital food has now been returned to individual NHS Trusts, it is imperative that food services do not slip down Board agendas. It is also time for the previous focus on ‘cuisine’ and ‘menus’ to turn towards the issues associated with creating a joined-up delivery and service process. This will increase the opportunity for patients to receive the appropriate meals and assistance to eat where necessary.
The HCA launched its Good Practice Guide for Healthcare Food and Beverage Service Standards in April 2006. The Guide sets out the standards that patients should expect and is a ‘how to’ manual for hospitals to achieve the delivery of improved services at ward level. It is aimed at all those involved in food services including doctors, nurses and dietitians. It points out that food is as integral to patient care as any of their treatment. By adopting the principles of this Guide, all hospitals have at their fingertips the solution to transforming their food and beverage services so that patients improved mealtimes experiences will have a positive effect on their nutritional intake as well as their mental and physical wellbeing.
The Guide won praise and endorsement from a number of high profile organisations including the RCN, the NPSA and the Patients Association. Clare Rayner, President of the Patients Association said: “If all hospitals in Britain ran their food service to their patients according to this Guide, they would be doing more than some of them realise to ensure their patients’ wellbeing’.
The HCA Guide concurs with many of the key points raised by Age Concern in their Report including the adoption as a priority of a Protected Mealtimes policy on all wards. It also states that at risk patients should have access to food outside of the prescribed service times where necessary and all wards should have a nominated Nutritional Link Nurse. All ward staff should be familiar with and aware of the alternative menus available to ensure a patient does not miss a meal. All patients should be given the opportunity to prepare or be prepared for a meal such as by replacing removed dentures and being provided with appropriate feeding aids.
The HCA also believes that the way in which food and beverages are presented at ward level and the attitude of all staff who are involved with serving it, can have a significant influence on the volume of food consumed. There is therefore an urgent need to examine on a wider and more in depth basis how patients receive their food.
To relieve the pressure on nurses, the HCA believes that ward housekeepers or ‘hostesses’ should be more widely deployed to work alongside nursing staff on every ward. The introduction of ward housekeepers was a fundamental target of the Government’s 2000 NHS Plan but not many hospitals have them stationed on all wards. Where ward housekeepers are employed, they greatly assist with monitoring patients’ consumption patterns as well as keeping their dietary progress under observation.
Commenting on Age Concern’s ‘Hungry to be Heard’ Campaign, Sandra Roberts, National Secretary, Hospital Caterers Association says: “We cannot continue to treat malnutrition with apathy. Nor can we continue to make excuses or blame the system. No patient should go hungry whilst in hospital and malnutrition has no place in a modernised National Health Service. We must identify the failings and inconsistencies that exist within current NHS policies, procedures and systems by whichever means possible now, to prevent the incidence of malnutrition spiralling out of control with dire consequences for our elderly vulnerable patients. The HCA measures recommended are not rocket science, they’re just plain common sense. We don’t need any new ideas, we just need to change outdated NHS culture and practice”.
“Only by catalyzing greater cross-team collaboration, communication and co-operation will be in a position to address the issue. However, food is still not being fully recognised by all members of the clinical team as important to patients as their medical care. Normal food has always been and continues to be the cheapest form of medicine and its therapeutic role within the healing process should never be under-estimated. One thing remains sure, the nutritional value of uneaten meals to an elderly patient is absolute zero”.
Download a copy of the Age Concern media statement and Report.
Lady Waldegrave takes on role as President of the HCA
The HCA is delighted to welcome our new President, Lady Caroline Waldegrave of North Hill OBE. She officially took on her new role during the HCA’s AGM, which followed the National Conference in Birmingham.
Lady Waldegrave has had a long and distinguished career in catering and attributes the inspiration for her interest in food and cookery to her mother. In 1971, she joined the catering company, Leiths Good Food, as a cook after training at the Cordon Bleu Cookery School in London. Four years later, when Leiths School of Food and Wine was established, Lady Waldegrave was appointed Principal. She is now co-owner and Managing Director of Leiths School of Food and Wine. In June 2000 she was awarded an OBE in recognition of her services to the UK’s catering industry.
Lady Waldegrave is also a cookery writer and health food expert and currently contributes recipes to the Daily Mail. She has conducted numerous television and radio broadcasts, including a ‘Tricks of the Trade’ series on BBC2 in 1994. She has appeared as a judge on Masterchef, and is a qualified wine instructor. She has recently finished working on an updated version of Leiths Fish Bible, originally published in October 2005, and other published titles include: The Healthy Gourmet, Low Fat Gourmet for Sainsbury’s and Leiths Daily Mail Cookbook.
Lady Waldegrave recently joined the Editorial Advisory Board of the BBC, is a former member of the Health Education Authority (1983-1987) and a past chair of the Guild of Food Writers.
She lives in London and Somerset with her husband and their four children, and enjoys adventure holidays, gardening and playing tennis.
Commenting on her new position, Lady Waldegrave said, “I am honoured to have been asked to be the President of the Hospital Caterers Association. It is essential that hospital catering and good quality food continues to be given priority within government and the NHS and that it is seen as an integral part of patient care. As the incoming President, I am keen to enhance the status of health service catering and facilities management and hope that I can help to achieve greater recognition for the profession.”
HCA National Chairman, Alison McCree, added, “I warmly welcome and extend our best wishes to Lady Waldegrave as she takes over the Presidency of the Association and I look forward to working with her. Her in-depth knowledge and experience in the world of food and cookery will be invaluable as we turn our attention to making changes to the way food and beverage provision is operated at ward level in our hospitals. Raising service standards is, we believe, the key to ensuring that patients receive the optimum nutritional benefit and enjoyment they need from mealtimes.”
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