EP Business in Hospitality Issue 53 - April 2015

Julian Fris | Opinion
Food vs service
Julian Fris gives a continuing commentary on the NHS
catering experience and asks how we resolve the challenges
presented by the ‘last nine yards’ in patient food delivery
Nick Dawe
It has been a while since I provided
some feedback on catering in the
health service. It was never going
to be an easy challenge but it has a high
media profile and senior NHS leaders
are at last recognising that food can no
longer be ignored.
We have recorded 30% wastage in
many hospitals across England; only 50%
of patients eat their meal when served and
25% of patients get malnutrition during a
hospital stay. You then read that such
and such hospital has scored 90% food
satisfaction. Who are they trying to kid?
There are a number of campaigns –
including Sustain’s Better Hospital Food,
the Soil Association’s Food for Life and the
Hospital Caterers Association (HCA)
The Last Nine Yards – all of which we
support. There is also the Department
of Health’s Hospital Food Standards
Panel guidance, which is little more
than a ‘screen scrape’ of everybody else’s
food and nutrition policies – it is not
a single legally binding policy that sets
out clear and unequivocal requirements,
as exists for schools and prisons.
Many campaigns focus on the
provenance of food, and that is a worthy
cause. In this case, the HCA presents the
most compelling argument. The food is
important – but the service is paramount.
In many hospitals, the control of food is
out of the caterers’ hands as it is delivered by
nurses, healthcare assistants or volunteers.
In a recent study we undertook at an
English regional hospital, only 20% of
ward staff had any food safety training and
only 10% had any customer skills training.
No wonder less than three-quarters of
the patients got what they asked for –
meal ordering was most likely guessed
by nurses or healthcare assistants.
Where caterers serve, patient satisfaction
levels are highly likely to increase.
In hospitals, there is a level of dedication
and skill required from contractors and
in-house teams alike to get the service right
– especially with some of the vast distances
covered and lift availability issues. At a
site in the South Midlands there is such
poor infrastructure that porters have to
wrestle the food trolleys up and down
stairs when the lifts fail – and they often
do – but the patients still get fed on time.
However, again we recorded 26% waste
there, worth an annual value of £ 1 /2m in
food and wasted time. That is not
uncommon. Another health trust
throws away 70 tonnes of food in a year,
which is around 150,000 meals lost.
We have conducted one-to-one patient
interviews at a number of hospitals and
“
In many hospitals, the
control of food is out of
the caterers’ hands as it
is delivered by nurses,
healthcare assistants
or volunteers
”
discovered that a more realistic satisfaction
is around 50% rather than the overinflated
official scores. Many hospitals focus on the
process being carried out within acceptable
parameters rather than actually providing
great service.
How do we resolve this? Clearly training
is a priority, so is a clear service culture that
touches all the people involved in catering
for patients. The real challenge is the ‘last
nine yards’ where the food arrives at the
ward and is then delivered to the patient.
Let patients control their choice (where
they can) and get them around a dining table
for lunch and tea. Whether the meal is
chilled, steam cuisine, frozen or fresh is
secondary to the patient meal experience.
That’s not to say that getting the food
right isn’t important, but that’s something
you work at once you have resolved service.
I strongly believe that a hospital is the heart
of a community it serves and should provide
opportunities for local food producers to
supply fresh, free-range and additive-free
ingredients. But if you cook them and then
there’s a significant delay to delivery, the
quality, food safety risk and nutrition is
obviously going to suffer.
However, it’s evolution, not revolution
– step by step the problem will be resolved
through innovative solutions, technology
and better staff and patient engagement. A
clear Government policy would be a start!
Julian Fris,
Founder and director of Neller Davies
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