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”
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”
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
Source: Neil O’Connor
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”
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.