Fast food companies service millions of meals to satisifed customers every day. The NHS should tap into their expertise and take a new approach to catering, Susan Holmes
The problems of hospital food and malnutrition have been known since Florence Nightingale first stated that hundreds of patients were “annually starved in the midst of plenty” for “want of a good diet”.
How little has changed. Patients consistently complain about their food, I know of one hospital where 6,500 meals are thrown away each year. However, evidence suggests that even if patients eat all the food provided, nutrient intake remains inadequate. Little wonder then that under-nutrition persists. It should not be difficult to draw links between these factors.
I and others like me have been drawing attention to this situation for over 25 years and yet it remains an intractable problem. Perhaps it reflects the low importance placed on food, which often seems to seen as an opportunity for trusts to make savings. Perhaps the significance of adequate nutrition remains unrecognised in practice and the savings that this could achieve are not acknowledged. Or is it that the NHS as a whole has failed to explore what has gone wrong and what could be done?
In referring to the differences between patients and customers and between pleasing people and helping them, Mark Radcliffe makes an important point. He questions whether we wantpatients “to love the food they are given”. Surely they should at least like the food if we want them to eat at all? He also asks whether it is the responsibility of hospital food to provide nutrition. What else should it do? There is no good reason why hospital food should not both please and help patients - or customers - at the same time. This surely is not beyond the wit of hospital managers and caterers.
That patients should need good food to promote recovery and prevent malnutrition is beyond doubt. That they eat something – even a burger - is surely better than nothing? Food that is not eaten has no nutritional value. The patient population has changed over recent years and many stay only a few hours or days - a few stay for longer. Does it really matter that the lasagne they are served is high in fat and salt?Short-term consumption of an “unhealthy” diet will do little harm and may even meet their needs more effectively than so-called “healthy diets”. It is the overall dietary balance that is important, not a short-term aberration.
Applying conventional approaches to solving the problem has clearly failed. What is needed is new and radical thinking if a different solution to food problems in hospitals is to be found. In practice, this may have been compromised by nutritionists or dieticians attempting to impose long-term dietary considerations on to a largely short-term problem. Misguided attempts by TV chefs to impose haute cuisine were unhelpful and taken up by less than 25% of hospitals nationally – patients did not recognise the food they were offered. Good home cooking and familiar, comforting foods are needed, rather than fancy restaurant meals.
Mr Radcliffe ironically suggested that we could franchise catering to McDonald’s - but is that such a bad idea? I can hear the shouts of horror from here. I am not advocating that patients should be fed on burgers and chips, nor that a McDonald’s McFlurry dessert is suitably nutritious, although the occasional treat will do no harm.
What I am suggesting is that we look to companies such as these for a new approach to hospital catering. They successfully serve millions of palatable meals at any time of day or night, to happy, satisfied customers. They provide food of a consistent standard and a known nutritional content - exactly what is needed formost short stay patients. Of course, the menus would need adjusting to appropriate nutritional and quality standards suitable for patients and their conditions.
To meet these needs we need the knowledge, skills and expertise of those who make their living by producing food to given nutritional standards that daily supply millions of people. McDonald’s and the like are good examples of such skills and they may have much to teach the NHS. So, why not suggest they are given an NHS contract?
SUSAN HOLMES,BSc nutrition, PhD, SRN, CMS, FRSPH, is director of research and development, Faculty of Health and Social Care, Canterbury Christ Church University, Canterbury