'Nutritious meals count for nothing if they are cold'
Yet again TV programmes and reports are lamenting the state of hospital food.
Soil Association research says more than a third of people thought hospital meals unacceptable, while two-thirds took in their own food as that provided was inedible. Despite 17 government initiatives costing more than £54m, the association says meals are generally no more palatable or nutritious than a decade ago. Chefs Jamie Oliver and Heston Blumenthal think they can succeed where others have failed.
Malnutrition “almost always becomes worse during a hospital stay” claims the Council of Europe. This contravenes Regulation 14 of the Health and Social Care Act 2008 (Regulated Activities), which states: “Where food and hydration are provided… as a component of the carrying on of the regulated activity, the registered person must ensure that service users are protected from the risks of inadequate nutrition…”
Figures from the NHS Information Centre show 13,500 patients became malnourished while in hospital last year and the Department of Health suggested more than 50,000 patients in England could be suffering from malnutrition or conditions complicated by it. All this even though evidence shows good nutrition leads to healthier patients who recover more quickly.
The DH claims £500m is spent on food (£1.67 per meal) in England each year; this contrasts with hospital food budgets, which vary from £1.60 to £2.40 per day – and about 43% of hospitals have reduced their budgets this year. This is a false economy as malnourished patients are in hospital for longer, are three times more likely to develop complications and have higher mortality rates. Effectively treating malnutrition has been estimated to save the average American hospital $1m each year – this cannot be achieved with inadequate hospital food.
This is a long-standing problem but it is important to realise food provision is increasingly outsourced to commercial companies. Meals are mass produced off site and “regenerated” using steam or reheated in trolleys or individual containers. Such is the reliance on this, some hospitals have no kitchens at all.
This method of food preparation can deliver high-quality meals – after all it’s no different from chilled foods available in supermarkets. What is needed is the right specification, good-quality control and proper training of staff responsible for reheating or regeneration. “Service” is equally important; the most nutritious meal counts for nothing if it is served cold, unattractive and left uneaten.
The NHS has a duty to feed its patients properly and should ensure the health gains available from investing in food are realised. But food is not only about nutrition but also about patient experiences. So all health professionals need to ensure that patients can access their food and, where necessary, are helped to eat it.
Susan Holmes is director of research and development, Faculty of Health and Social Care, Canterbury Christ Church University