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NHS targets sale of super-sized chocolate bars in battle against staff obesity


Hospital trusts will face losing funding if they fail to remove super-size chocolate bars and “grab bags” of sugary snacks from shelves in latest moves by NHS leaders to fight obesity and diabetes.

NHS England chief executive Simon Stevens has announced a 250 calorie limit on confectionary sold in hospital canteens, stores, vending machines and other outlets.

“We want to make healthier food an easy option for hospital staff, patients and visitors”

Simon Stevens

Trusts will have to ensure that four out of five items purchased on their premises do not break the limit or risk losing out on funding ring-fenced for improving the health of staff, patients and visitors.

It covers all food and drink sold to staff, visitors and patients on NHS premises such as shops, newsagents, cafes, restaurants, kiosks and coffee carts, vending machines, trolley services, pharmacies and gift shops.

The funding comes under the so-called CQUIN (Commissioning for Quality and Innovation) scheme, which was introduced in 2009 to make a proportion of trust income conditional on demonstrating improvements in quality and innovation in specified areas of patient care.

The 250 limit represents an eighth of a woman’s and a tenth of a man’s recommended daily intake, said in NHS England in a statement announcing the move.

“Hospitals have an important role in addressing obesity”

Alison Tedstone

Unhealthy sandwiches and drinks are also being targeted, with NHS England claiming the health service was taking the “lead in tackling the availability of unhealthy food and drinks”.

The government arm’s-length body noted that nearly 700,000 of the health service’s 1.3million staff were currently estimated to be overweight or obese.

Simon Stevens, NHS England’s chief executive, said: “The NHS is now stepping up action to combat the ‘super-size’ snack culture which is causing an epidemic of obesity, preventable diabetes, tooth decay, heart disease and cancer.

“In place of calorie-laden, sugary snacks we want to make healthier food an easy option for hospital staff, patients and visitors,” he said.

Action has already been taken to end the advertising of sugary drinks and foods high in fat, sugar or salt on NHS premises and ensure healthy options are available at all times, including night shifts.

simon stevens confed 1

simon stevens confed 1

Source: Neil O’Connor

Simon Stevens

In April, NHS England announced that retailers including WH Smith, Marks & Spencer, Greggs, Subway and the Royal Voluntary Service had agreed to continue voluntarily reducing sales of sugary drinks to 10% or less of their total drinks sales within hospitals over the coming year.

Meanwhile, in 2018-19, health services will get financial incentives if they make further efforts, such as ensuring 80% of confectionery and sweets stocked do not exceed 250 kcal.

Other examples to be covered by incentives include that 75% of pre-packed sandwiches and other savoury pre-packed meals contain 400 kcal or less per serving and do not exceed five grams of saturated fat per 100g, and that 80% of drinks line have less than 5g of added sugar per 100ml.

The latest moves come nearly eight years after the seminal Boorman report was published on improving the health and wellbeing of NHS staff.

Dr Alison Tedstone, chief nutritionist at Public Health England, said: “Hospitals have an important role in addressing obesity – not just treating those suffering the consequences, but helping to prevent it in the first place.

“Any plans to offer healthier food are a positive step towards tackling the country’s obesity problem,” she said.

“We look forward to seeing more information on how it will work in practice”

Helen Dickens

Andrew Roberts, business enterprise manager for Royal Voluntary Service, said: “We took an early lead on the NHS workforce healthy agenda by introducing our Healthier Choices programme and it is already having a significant effect on consumer behaviour.

“In the first quarter of 2017, year on year sales of fruit increased by 25%, healthier chilled snacks like salad and sushi by 55% and healthier sweet and savoury snacks like popcorn and dried fruit by 109%,” he said.

Mr Roberts added: “We will be implementing these new guidelines and are hopeful that they will result in healthier food being a more consistent feature in all Hospital retailers.”

Helen Dickens, assistant director of campaigns and mobilisation at Diabetes UK, said: “It’s great to see the NHS taking steps to help make it easy as possible for us all to make healthier choices – particularly for those in hospital.

“We look forward to seeing more information on how it will work in practice,” she said. “However, this is just one piece of the puzzle when it comes to tackling obesity.”

Caroline Moye, head of World Cancer Research Fund, said: “We welcome NHS England’s decision to ban these items from hospital shops. Hospitals are a place of health and should lead by example in creating an environment where it is easier to make a healthy choice.

“Being overweight or obese is linked to 11 common cancers, therefore it is vital that other public places follow this example in creating a retail setting that encourages healthy decision making,” she said.


Readers' comments (7)

  • Re Article on calorific ceiling - Only yesterday I was with my daughter who was admitted to a hospital, Sorry Nurses but I noted the number of over weight nurses - now I am not talking about slightly plump here but morbid obesity, I went to the hospital canteen and it was mainly staff tucking into full cooked breakfasts who were again mostly significantly overweight, Having been in nursing for several decades, I am a strong advocate of practice what you preach, all those in the medical and nursing profession should be counselled and supported to be within a safe range - perhaps ultimately disciplinary process has to be instigated, it's ridiculous to bring in such things as a sugar tax, when healthcare professionals don't set an example, we should be practicing preventative medicine

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  • Doremouse

    Nursing has become a very unhealthy profession. Before the 37.5 hour a week staff were MADE to take their breaks. Hospital breakfasts were available, coffee & tea breakes HAD to be taken in the nurses dining rooms and lunch was a properly served meal also in the nurses dining room. Even night duty staff had their own cook to provide a meal after 12nm.
    Then came the 37.5 hour week. Staff are lucky if they get a break or if they are able to get to the all in canteen, is the que too long or is there anywhere to sit. Its quicker to go to the confectionary machine & get some chocolate or sweets to get through the shift.
    The health service have created the problem & will now make it worse. Staff will get their offending sweets & chocolate from the local newsagents.
    I suggest they should start with the fast food outlets & coffee shops in many hospitals. A frappechino can be 500 calories

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  • Absolutely. Why we should insist that they sign legal documents to say that they carry out at least 40 mins of exercise 5 days a week (overweight or not), don't smoke, drink only the permitted weekly amount of alcohol, always look before crossing the road, limit the amount of caffeine they consume and sleep for a minimum of 8 hours a night.
    Oh and they should give up shift work (especially moving quickly from nights to days or 12 hour shifts where none of the breaks are actually at meal times) and choose careers where the staff shortages and poor conditions do not impact so seriously on their mental health.
    You can't seriously believe that anyone would have the right to discipline a member of staff for being overweight? Personally, I would like to discipline anyone who claims to have been in the nursing profession for decades and still hasn't quite grasped the difference between 'practise' and 'practice'.

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  • Agree with the above comment. Linda Hallett, how is the view from the moral high ground? I clearly remember walking home from my staff nurse job at the Royal London and buying doughnuts as I hadn't had the time to take a break and so had not eaten or drunk anything all day. Shift work is a well documented cause of obesity and other health problems that serve to reduce life expectancy (not just in hospitals.) To all hospital managers - get rid of the vending machines, ensure nurses take all their breaks, ensure an adequate rest period between nights and days (not just one day, as happens where I work), ensure hospital cafeterias serve healthy, subsidized food and get rid of hospital cafe's that serve up doughnuts, croissants, paninis, latte's and other calorie laden goodies. In other words, try having the best interests of your staff uppermost in your minds.

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  • Solution, get rid of unhealthy coffee shops, start serving healthy food and re-introduce canteens and make sure all staff take their breaks that they are entitled to. Linda I don't agree with your take on the situation and you should not make judgements without a clear understanding of the situation.

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  • All those in the medical and healthcare professions should be counseled about healthy eating? Linda dear, what planet are you on? There isn't a Dr or Nurse practicing that isn't aware of what they should be eating and drinking and to suggest they be counseled is nothing short of insulting. Obesity in this particular demographic is not the result of lack of knowledge or education, it is the result of inadequate staffing, resulting in few or no breaks, leading to poor choices brought about by necessity, i.e. keeping your blood sugar up to be able to get to the end of the shift. It is the result of internal rotation to nights, resulting deranged eating and sleeping patterns and the other associated health risks that Health Trusts ignore in favour of fiscal prudence. It is the installation of vending machines serving up crisps, sweets, cakes, chocolates and calorie laden drinks. And no, they don't have to use them but for reasons stated above they often do.
    I would love to live in your world where everything is so black and white. But life is not. And you, as a nurse with 'several decades in the nursing profession' should be ashamed of your judgmental attitude.

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  • If staff can't get a break - sadly... as we are only human our plummeting blood sugar will draw us to the nearest fix (also sometimes thirst can be mistaken for hunger by the body)....when I was a midwife I lived on toast as the hospital canteen was miles away and there was no one to look after my ladies if I left them anyway...'having a break' disappeared from NHS culture a long time ago....even the patients complain if one is seen with a drink 'sitting' at the nurses station - so when staff are all laid with 'occupational' injuries such as AKI, Type 2 Diabetes, Depression and Anxiety no one will give a stuff....

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