Cross Party Group on Food

Do hospitals deliver nutritious food for patients?

Meeting Minutes: 7/2/2018

In attendance:

Jenny Rathbone AM                       Assembly Member (Chair)
Zoë Bateman                                     Jenny Rathbone’s Office (Secretary)
Peter Wong                                        Jenny Rathbone’s Office
Nick Ramsey AM                              Assembly Member
Mark Major                                        Caroline Jones AM’s Office
Ryland Doyle                                      Mike Hedges AM’s Office                                                                       

Kier Warner                                        NHS Shared Services
Hannah Caswell                                                Food for Life Soil Association
Judith Gregory                                  Senior Client Officer Education Catering                   

Judyth Jenkins                                  Head of Nutrition and Dietetic Services, Cardiff and Vale (C&V) UHB                 Joanne Jefford                                 Dietetic Catering Lead & Nutrition Manager, Llandough Hospital, C&V UHB
Judith John                                         Public Health Wales
Rob Daniel                                          ABMM Health Board
Hugh Jones                                         WRAP
Rhianon Urquhart                            C&V Public Health Team
Frances Jacobsen                             Cardiff Resident
Maureen Langan                              Cardiff Resident
Margaret Thomas                            NHS UNISON Rep.
Barbara Moore                                 Cardiff Resident

1. Presentation by Hannah Caswell - Food for Life Development Manager – Soil Association

See presentation and Food For Life Served Here hospital standards guidance attached.

2. Presentation by Keir Warner - Head of Sourcing, NHS Wales Shared Services Partnership - Procurement Services. Presentation below

3. Group Discussion

The group discussed how seasonal and local produce can be included in the standard food service. Kier Warner informed the group that although meals were standardised, individual Health Boards/Hospitals can choose which menus they want to offer. The standards allow for local sourcing as long as the products sourced meet the standard.

Some food was both cooked and re-heated on site.

Some sites rely on food mainly cooked and frozen elsewhere for re-heating when required. Hannah clarified that food frozen and then re-heated can still qualify for Food for Life certification as long as it is cooked and then served within the same area.

Judyth Jenkins said that hydration was just as important as food intake and was being promoted alongside nutrition at C&V UHB. They are putting a lot of effort into training nursing staff and others who interacts with patients to try and increase drinking. Jenny mentioned that the latest PAC report in 2017 flagged de-hydration as one of the challenges. Judyth and Jo Jefford described a specific initiative involving changing the colour of cups to blue, making them easier to hold and making them hold more water. Trials showed this had increased consumption of water, so they were looking to roll this out across all wards.

C&V UHB now have a nutritionist “at the front door” in the Emergency Unit to ensure patients are getting food/drink whilst they are waiting. This initiative has been recognised by the Guardian. (More information at http://www.cardiffandvaleuhb.wales.nhs.uk/news/46298) Margaret said new patients sometimes have to eat the meal ordered the day before by a previous patient.  It was noted that some caterers are using digital technology to allow patients to order the same day and see pictures of what they are ordering. This has been shown to reduce food waste from 14% to 5%.  Unclear whether food left on the plate is counted as waste.

The sort of food needed in Hospital differs depending on the patient, with some elderly patients needing calorie intensive food. Younger patients have different tastes and e.g. maternity units experience more demand for vegan and vegetarian food. Hospital caterers are developing new recipes to keep pace with demand.

There is only a small number of dieticians in any hospital team but they are spreading their knowledge by training up other members of staff, including ward based catering staff. Patients cannot be prevented from bringing in unhealthy food from outside; people prefer to eat what they are used to eating at home and it is challenging to increase healthy eating in hospital. Kier raised cost pressure challenges that hospital caterers are facing. Food costs have risen by 8% and budgets are squeezed leading to real terms cost pressures of 14-15%. This has led to reduced standards in some cases if they could not source a product of the quality they wanted for a price they were able to pay.

4. Agenda for next meeting – date in Summer Term to be confirmed once speakers identified

It was suggested that a future meeting could focus on work being done by some Flying Starts to promote healthy eating in the early years. Alternatively the Food & Fun initiatives during school holidays.