Comment

Hospitals need to understand that good food is medicine 

Food needs to be an important matter for doctors and nurses as well as caterers, and Covid should not be an excuse to ignore our new report

Prue Leith has advised on the Hospital Food Review
Prue Leith has advised on the Hospital Food Review Credit: Kirsty O'Connor/PA Wire

When I was asked a year ago to be an advisor to the Hospital Food Review, at first I said “No”. I’d seen too many friends (James Martin, Lloyd Grossman and others) do really good work, improving matters in a hospital or Trust, only to find their projects, far from being rolled out, just run into the sand. Official priorities had changed, a new minister was in charge, or the money had run out.

But I was persuaded by Matt Hancock. This time, he said, things would be different. The Review would be backed by the Department of Health, and its members would be NHS dietitians, medics, caterers and administrators, who were committed to change. OK, I said, but what about Downing Street and the Treasury? That led to my meeting the PM for breakfast in the Downing Street garden – a slightly surreal experience – and a promise that he really meant business and that our report would not gather dust on a shelf. I was also assured the chances of getting what money we’d need was high because everyone – public, NHS, staff and the government – want better hospital food.

I believed them. And even if I wasn’t 100 per cent sure, it would have been criminal not to give it a go. If 39 per cent of hospital staff think the food offering is poor, and 42 per cent of patients rate the catering as merely adequate or actually poor, something needs to be done.

We spent six months looking at what works and what doesn’t, and we’ve come up with eight recommendations. I’m proud to say all of them have been accepted by Government. They all point to one general principle: to do a good job you need a whole-hospital approach. Food needs to be an important matter for doctors and nurses as well as caterers. They need to believe that good food is medicine.

There’s no doubt that hospital catering is difficult. For a start, patients don’t want to be there, are not well and many lack appetite or need help to eat. Caterers have to meet hundreds of medical, personal, cultural and religious requirements. Many kitchens are in a sorry state, and haven’t been refurbished for 40 years.

I learnt a lot. I imagined that unless food was freshly cooked on site, it was unlikely to be any good. Wrong – think of Tesco’s Finest. What matters is the quality of the ingredients and the skill of the cooks, wherever the preparation is done. But if a catering contract is all about minimum cost, with nothing in it about quality, nutrition and customer satisfaction, of course the food will be dreadful.

Prue Leith has been tasked with reviewing hospital food and setting out ways NHS trusts can provide healthier meals Credit: Getty Images Europe

One size will never fit all in the NHS. A child with cancer does not need the same diet as a dementia patient in a geriatric ward. Menus need to be tailored to the individual; the service should be flexible and patient-centred.

But we don’t need a lot more money for the day-to-day. Some hospitals are already producing fresh, nutritious and tasty food on less than the average £4.56 per head. Others are producing unappetising food, much of it going in the bin, at well above average cost.

Where we do need money is for refurbishing kitchens and providing facilities for staff on long shifts. At the moment too many night nurses are eating from vending machines which offer nothing hot and nothing healthy. Many hospitals do a great job and, with the right leadership and help, we believe all could. Nurses and caterers should be proud of the food they serve, not ashamed and humiliated by it.

We’ve produced a check list of best practice for hospital executives to measure themselves against. They need to plan how to meet those challenges, and set themselves a time frame to do it. Covid should not be an excuse to ignore this report.

The pandemic has shown us how important good diet is to health and even a busy hospital can start planning now for the future. At the very least, we should expect a cup of tea and a piece of toast served with kindness in the middle of the night to a sleepless patient, a bowl of delicious soup for one who is struggling with swallowing, or an out-of-hours meal for a ravenous new mum. There’s truth in that old adage, where there’s a will there’s a way.