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Trust asks nurses to pick up slack after catering cut back


A leading London hospital has cut back on its catering contract and asked nursing staff to pick up the slack, Nursing Times has learnt.

Under a new system being trialled across eight wards at Imperial College Healthcare Trust, nurses and healthcare assistants are doing the jobs previously carried out by contract staff.

It follows a cut in the trust’s contract with catering and facilities supplier ISS, and the replacement of food cooked on site with food cooked off site.

Rather than food being delivered to patients by “hostesses” employed by ISS, the food is being delivered to the ward by an ISS employee and then distributed to patients by nursing staff.

However, Nursing Times understands no extra nursing staff have been employed on the wards to carry out the additional duties or cover for staff that are doing them.

The union Unison branded the move another attempt to save money, potentially at the expense of patient care.

Michael Walker, Unison’s London nursing officer, said: “We are aware that across London, attempts are being made to force nurses to carry out more and more non nursing duties.

“We fear that distractions from core nursing duties could result in serious implications for patient care.”

A trust spokesman said: “In order to better meet the needs of our patients, Imperial College Healthcare NHS Trust is exploring different types of food, and different ways of delivering them on the wards.

“We have trialled a variety of different options and will review the results of these trials with patients and staff.”

Whereas in the past nurses have been responsible for feeding patients, most trusts have now introduced hostesses to take over the role, as it is time consuming and easily disrupted by clinical incidents on the ward. Many trusts also make use of volunteers to help feed patients.

Nursing Times understands the use of nurses to carry out hostess roles is unlikely to be continued at Imperial.


Readers' comments (27)

  • why dont they stick a know the rest!!!!

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  • we have no hostess any more where I work so an HCA is allocated each day to serve breakfast, teas and lunch. We used to have a hostess but they were re-located to another ward.

    we have never had an evening or weekend hostess so nurses have always had to serve evening hot drinks, the evening meal and all food at the weekends.

    it usually takes at least 2 nurses to serve the food and yes it is time-consuming and we don't think it's very hygienic.

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  • In some cases it might be the most positive thing they can do for some patients as malnourishment is a serious problem for many patients. Some leave hospital weighing less than when they came in.

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  • The HCA give the food out in our Trust, but that doesnt always mean that vunerable patients get more attention at mealtimes, often the HCA is taken away from patients that already need attention to serve the food, leaving one less member of the team to care for patients, nursing numbers are strained enough as it is!
    I have been on shift when patients food has gotten cold even when a HCA is serving, they still dont have time to stop and help patients with thier meals!

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  • Do you know, I am amazed. I have only ever worked in one Trust where there was a hostess who served the main lunch time meal. Every other meal I have seen over the past 22 years of working in the NHS has been served by HCA's, students and qualified nurses. I did not realise that there were Trusts out there who employed people to do such things.

    I used to serve dinners and the such but then when I noticed HCA's having coffee breaks whilst I was handing out meals instead of caring for patients and providing medications I am afraid I refused to do any more. I did not get time for extra breaks and if there was work to be done it was done. These days I get told "You can't ask me to clean them up, I have been working hard all morning, I am reporting you". Similar situation with the meals.

    I say bring in staff in all trusts to give out the meals and let nursing staff give out care.

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  • nurses obviously play a vital role in monitoring patients food and fluid intake but there are not enough nurses to go round.
    Hostesses should serve the meals 7/7, nurses can help feed patients and monitor what they eat, refer to dietician etc.

    all we need to do is employ more nurses. what a surprise.

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  • Well I too have worked in the NHS for a long time and have handed out food, done tea rounds both as a student and as a SN. Where I work the food is given out by the domestic staff (they also clean so again not really hygenic is it??).
    As it is a busy MAU if we had to do it I know the patients wouldn't get fed as are too busy trying to do every scrap of admin, plus the actual care that is required. Also they reguarly want us to move the patients even though supposed to have 'protected meal time'!!!!
    The important thing it is a really important thing nutrition, but lets face it none of us have enough staff or the time to, feed, toilet, dress wounds, drug rounds, answer phones, talk to relatives, board rounds....etc, not forgetting the mountain of paperwork.
    So there will probably be more Panarama programmes bemoaning uncaring, uncompassionate nurses etc. Well I say to anyone outside of nursing come and spend a week in our shoes and see if can give all the care that we want to be able to deliver to our patients.

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  • wouldn't you just love it if journalists and tv companies came and worked on a ward for a month and did the job of an hca.

    should nurses be serving meals? I've seen patients asking for commodes/bedpans in the middle of meals being served and every day I have to remove urine bottles from patients tables (patients who are able to walk to the loo but don't want to), gross.

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  • Many years ago, when hospitals cooked patients food 'on-site' it was delivered to wards in large heated 'trolleys'. Patients had soup to start with then a selection of fresh vegetables/meats/gravy and desserts and was plated/served by the staff nurse or ward sister from the trolley. Patients were individually asked what they would like and how much (portions served according to the needs of the patient). This included special diets such as diabetic or 'soft diets' for patients unable to chew food. The food was taken to the patients by student nurses/ HCA's who would ensure patients unable to feed themselves were fed. We also ensured they had fluids with their meals and that this was recorded on their fluid balance charts! Meal times were an important part of the ward routine, overseen by senior nurses. I dont ever recall elderly/infirm patients being left to fend for themselves plus the food served was more palatable and attractive than todays rubbish served by outside caterers. This is a positive step in the right direction with regards nursing staff serving the food. Meal times are protected, so all nursing staff on the ward should be available to assist at meal times. At least nursing staff could monitor what food was being eaten and that it was appropriate to the needs of the patient. However, its a backwards step to have food cooked 'off site'. In my days you could always obtain food from the hospital kitchen anytime of the day for patients admitted later in the day. Now, patients have to make do with a dry sandwich (if they are lucky), cos they hadnt ordered their food the day before!

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  • Tinkerbell

    i don't understand nursing anymore, i don't recognise it as nursing anymore. Which bit don't i get, any of it. It's all gone completely bonkers. I am in a regular state of befuddlement where i can barely remember my own name. I use to think the 'impossible we do at once, miracles take a little longer', now i am not even that optimistic.

    Please somebody tell me what it is i don't do rather than all the new things i am expected to do on top of what i am already doing.

    I am losing the plot!

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