There’s a balance to be struck – somewhere!

In an age of austerity, how has hospital catering been affected and how has the industry reacted to change? Richard Piper went out into the industry to find out more

It is not uncommon to hear a joke or two flying around making fun of hospital food, and many an end-of-the-pier style comedian has relied on the subject to bolster their mother-in-law routines I am sure!

At a guess, however, I would say that these individuals have not ventured out and done a bit of research into the bigger picture – so, in an attempt to find out more, I armed myself with a series of questions and strode forth with an open mind into the world of hospital catering.

The first thing I wanted to know, naturally, is what the industry professionals see as the biggest issue affecting hospital catering at the moment. Is there a common thread running through it, or are there several issues that are raising their heads right now?

Rosemarie Hoyle, healthcare divisional manager at apetito, said: “Pressure to reduce costs remains the single biggest issue facing NHS Trusts. While the NHS is not having its yearly budget reduced year on year, as is the case in other areas of the public sector, inflation in the NHS is currently running at 6%, which means that catering managers are typically being asked to reduce their costs by this amount each year, without of course compromising patient service.”

To do this is no easy task I am certain, and the mention of not compromising patient service is a very important factor in my opinion. If you are unwell, have had an accident, or are for any reason spending any amount of time as a resident in hospital, mealtimes may be the points in the day that you really look forward to. They restore an element of normality and routine to your day, and to be served a meal that is below par could affect your mood quite dramatically. Indeed, there are those who believe that meals are fundamental to a patient’s recovery and I have to say I agree.

John McKears, foodservice sales manager at Jus-Rol Professional, has a passion for pastry – and asked the same question commented: “Budgets are a key theme in the sector, but there are still ways for hospital caterers in which to enliven menus, do more with less and create memorable food in the process.

“Creating simple and wholesome pastry dishes is a great way to help keep the kitchen costs down. Jus-Rol’s range of pastry blocks, sheets and shapes work with the caterer, allowing them to make dishes that will go further and feed more people. Jus-Rol sheets, especially, are a must-have for catering on a larger scale.

“Using pre-rolled Jus-Rol pastry means no off cuts and less waste, as you only use as much as you need. Also, Jus-Rol allows you to create consistent, delicious dishes with the minimum of fuss – in minutes, rather than hours.”

So, budget is a common answer so far it would seem. Coincidence? I think not. To rule this out, I also contacted an equipment supplier to the healthcare sector and a separate manufacturer, to get their views for balance.

Glen Crossland, marketing manager at dawson foodservice equipment, had this to say: “Budget is a big constraint issue that affects the hospital kitchen today. From the point of view of catering equipment, hospital caterers need to have full confidence in the products they choose and have clear sustainable benefits of choosing one manufacturer from the next. Budget is a key factor that will not go away! So, purchasing managers need to consider heavily their manufacturing partners. Case studies and site references are a good indicator for this.

“Reduced and tighter budgets have also seen an increased focus on the investment into greener equipment, as this can claw back new benefit to the end user. Both reduced water and power consumption can save the end user funds on their energy bills in quite a dramatic fashion. A point not to be ignored in today’s modern kitchen environment.”

Keith Broadway, country sales manager for GRANULDISK in the UK, said that aside from funding, the high street is an issue due to people bringing fast food to hospital bedsides. From an equipment point of view he said: “Managers are being more prudent - looking for ways to save, not just by getting the best price, but looking at saving water and energies. They are looking for equipment that can add real worth into their kitchen. Saving time and allowing them to use their workforce efficiently.”

So there you have it. It is certain, as far as I can see, that budget is the main issue affecting healthcare catering, and it is also clear from the comments above that people are thinking hard about ways to offer savings without compromising on quality. So, in a time when budgets are limited, where do hospital caterers choose to prioritise?

“There’s no one size fits all solution as priorities vary from site to site.  Some hospitals are limiting choice in a bid to reduce wastage or simply removing more expensive menu choices, while others have resorted to cutting the number of hot meals served each day from two to one.  The latter can however have a negative impact on both patient and ultimately budgets, as it reduces the opportunity for patients to eat a hot meal, which can lead to increased incidences of malnutrition, leading to longer stays in hospitals.

“We’re also increasingly seeing hospitals take a more commercial approach to the catering operation, with several hospitals now reaping the benefits of generating more income from their staff and visitor dining offer by investing in and improving their existing facilities.  Nottingham University Hospitals NHS Trust’s example is well-documented and demonstrates how, if done well, this can relieve pressure on the patient catering budget,” said Hoyle.

The answer from John McKears was more along the lines of where caterers should be prioritising, rather than where they are doing so at present. He said: “With the pressures of budgets and menu planning, the priority for hospital caterers should lie in simplicity. Providing a selection of simple dishes, made well, should prove to be much cheaper than buying in readymade products.

“For instance, using Jus-Rol’s pastry sheets, caterers can feed 6-10 people for just a few pence each. Not only does this make sense from a budgetary point of view, it also means caterers can supply quality, hearty ‘homemade’ food to patients.

Sounds simple doesn’t it? But then things often have a way of sounding simple, when the reality is quite the opposite. Often it is the quicker fixes that are employed, such as reducing the number of hot meals per day as mentioned above, which will ultimately have a detrimental effect on your operation. If by reducing your hot meal offering you are increasing the risk of malnutrition in patients, eventually you will be paying more for the care of those patients, thus wiping out any so-called savings and costing your facility even more money. You are robbing Peter to pay Paul and then paying Paul again!

So how, I ask next, can hospital caterers improve their offering?

“Tackling the issue of food waste is a good starting point to help caterers improve their offering.  Finding ways of reducing wastage can ultimately help reduce costs, freeing up cash to spend on developing and improving their service,” said Hoyle.

“Service quality is as much a driver as cost so when it comes to plate waste, the first step is to serve patients food that they want to eat; when they want to eat it.  Extending patient choice is a proven way of helping achieve this. Our team at apetito works with healthcare catering professionals to deliver delicious, nutritious dishes that offer patients a range of meals including choices suitable for special dietary needs.

“While wards with a lower patient turnover tend to be catered for using multi or twin portion ranges, apetito has recently launched a new option, ideal for high patient turnaround wards – plated, individual portions.  The new system will not only revolutionise the way in which patients’ food is served, but will mean greater flexibility for busy wards.  And, because our meals are frozen, and can be cooked and served within half an hour, hospital caterers can significantly reduce levels of ‘order’ waste.”

Following the example of others could be the way forward according to Crossland at dawson foodservice equipment. He said:  “Hospital caterers can improve their offering by adhering to the structures set by the most prestigious hospital caterers where success stories are a plenty. These cases can strive to set the bar for the catering facilities in the UK. Ingredients, menus and catering equipment forums within this sector can also be of great benefit.”

And so we come down to perhaps the most important part of hospital catering – patient feeding.

Hoyle, of apetito, had this to offer: “There’s real truth in the adage that food is the best medicine. Ensuring that patients are eating is the single most important aspect of hospital catering.  For more infirm patients, the issue is physically making sure that the food gets eaten.  The wider challenge is to meet the individual demands of all patients; providing an appealing menu of choices that not only tastes good but smells delicious and is delivered piping hot.

“apetito understands the issues of hospital feeding, which is why we work with hospitals across the country to provide systems that address these issues.  Our range of more than 200 main meals and desserts not only provides the variety and nutrients patients want, but importantly, can be heated at ward level, ensuring the meals are hot when served, making it more likely that patients will eat.  Our new plated range is also designed to increase the appeal of the food and has been proved to reduce wastage on short-stay, high turnover wards by as much as 30%.”

When it comes down to it, I believe that reducing food wastage will lead to greater cost reductions in this area and could be the key to improving the offering to patients at the same time. As far as I can see, it would only take a small increase in the average cost per meal to improve the quality and variety exponentially - which in turn should lead to a reduction in plate waste, therefore offsetting the increase and potentially leading to marked savings. If your facility is experiencing above average wastage with regard to food, it may be time to look at your offering and ask yourself why this is and what you can do in order to fix the problem. There is a balance to be struck in all of this somewhere I am certain, and it is up to you to work together to strike it.