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Challenge & opportunity

The catering team at the Hillingdon Hospitals NHS Foundation Trust was a finalist in the Team of the Year category* in the 2019 HEFMA Awards for the achievements made since bringing the service back in-house in 2012. HEFMA finds out more.


The Hillingdon Hospitals NHS Foundation Trust has 465 beds at Hillingdon Hospital, its major acute facility, and a further 37 beds at Mount Vernon Hospital. Located eight miles away from Hillingdon, the Mount Vernon site is shared with a neighbouring Trust. The catering team provide almost 700,000 patient meals every year, including meals to patients of the neighbouring Trust at Mount Vernon. Over 1,200 restaurant meals are served daily to staff, patients and visitors. 


Steve Wedgwood, Assistant Director of Facilities at the Trust, is a strong advocate for in-house services wherever possible. When he joined, around eight years ago, the catering service had been allowed to drift, with staff/visitor restaurants at the Trust’s two main sites that were drab and uninspiring and a patient meal service that was going through the motions. He put together a case to reinvigorate the restaurants and improve patient dining by bringing the service in-house.


The bid was successful and work began to transform the catering provision, with a softly-softly approach ensuring staff engagement from the beginning, carefully examining and continuing to re-examine the needs of all site users, and a keenness to embrace innovation.


The biggest challenge was also the biggest opportunity – reducing costs whilst providing a wide choice of good quality, nutritious and tasty food, meeting the needs of patients, visitors and staff and maintaining retail revenues. Taking the service back in-house brought the flexibility and control necessary to find solutions that would work, and at the same time enabled the introduction of innovative ideas and a closer working relationship between facilities and nursing staff. 


The softly-softly approach to change gave staff time to adjust from outsourced to in-house and allowed the process to be managed and controlled in a business-like way, protecting retail incomes and maintaining services whilst important and informed decisions were made for the future. 


The rosters were streamlined to meet the business needs through a flexible approach and a standard uniform was introduced for all catering staff. Changing mindsets was a challenge at first, which was overcome by demonstrating the benefits and treating everyone fairly and as an individual.


From the beginning of the new service, the catering team wanted to ensure innovation in everything they did. They joined the Soil Association’s Food for Life Hospital Leaders Circle and now hold Food for Life Bronze Accreditation – an initiative that was led by Catering Operations Manager, David Blackman. The Trust subsequently became one of two chosen to work with the Soil Association to develop a blueprint for a good food hospital that will support staff health and wellbeing and demonstrate caring for the community through food.


Patient services

The Soil Association was also involved in the specification for the new patient food contract, which was the first aspect of the service to be addressed. The Trust does not have extensive kitchen facilities, so whilst the restaurant meals are prepared freshly on site, main meals for patients are bought-in, supplemented by cold dishes including salads that are made on site. The contract was put out to tender and a cook-off was organised at which each supplier’s food was put to a taste test, rated and scored by 60 people. 


The contract was awarded to apetito, which marked the beginning of a journey at the heart of which was the requirement for continued innovation. For example, the Trust worked with apetito on the development of a new finger food menu. Dietitians and Speech and Language Therapists were also involved with this initiative, to ensure food is nutritionally balanced and suitable.


Offering a wide choice across the patient menus was also a priority. A three-week menu cycle has been developed, which offers patients a choice of starter, main course and dessert for lunch and supper with three main courses on offer for each mealtime occasion plus sides. Salads and sandwiches are available as an alternative to the hot option for both lunch and supper. The menu is so diverse it allows for a different selection every day for three weeks. There is also a wide choice in specialist diets, including allergen-free meals, energy-dense meals, cultural choices, vegan and vegetarian, gluten-free, easier to chew and IDDSI (International Dysphagia Diet Standardisation Initiative) meals.  


The IDDSI menus have been developed with considerable forethought and planning. Not all meals from bought-in ranges are available for all descriptors, so it can be difficult to present an IDDSI menu that shows patients clearly what dishes are available in the particular texture they require. Hillingdon's approach has been to develop dedicated menus for each of the key descriptors for catered meals - 4 (puréed), 5 (minced & moist) and 6 (Soft & Bite-Sized). 


The catering team also worked with a local children's charity to provide bedside meals for parents with children on the paediatric wards who might not be able to leave the child's bedside to eat. This scheme is administered at ward level, with ward staff identifying the families that might benefit from this service. 


The desire to improve on the style of food service led to The Hillingdon Hospitals pioneering a new trolley system that would allow for the personalisation of individual patient trays that are loaded into a fixed insulated dividing wall inside the trolley, separating the space into hot and cold. The patient's full meal is loaded onto the tray with dishes chilled or re-heated to the desired temperature for service.


The Trust is now able to offer patients a slick dining service. Meal service time has been reduced, food ordering is closer to service, more meals are being fully consumed, plate wastage has been reduced and there is less food handling. The feedback from wards has been excellent.


Retail services

Two mundane restaurants - one on each site - have been transformed into two good restaurants which are more in-tune with consumer taste trends and which continue to evolve. In 2016 Facilities Manager Anne Byrne used the introduction of CQUIN targets as a reason to give the restaurants a healthy overhaul, introducing a salad bar, healthier snacks and giving customers more choice, which, in addition to the hot meal options, includes paninis and toasties. Special days include roast dinners, fish and chips, curry, pizza, and omelettes cooked freshly to order. The work to encourage healthy eating options resulted in the team winning the Trust Chairman's Award for 'Promoting Healthier Lifestyles'.


The design of the restaurant space has also been addressed with special access areas for wheelchair users introduced. At Hillingdon, a disused exterior courtyard space adjacent to the restaurant has been converted into outdoor seating for over 100 people, which is often used for staff meetings on warm, sunny days and for barbecues. 


The high street has been brought into the hospital at two cafes and the new Bevans coffee shop, which opened earlier this year. Here the catering team have taken over a facility previously run by the RVS, opposite a Costa Coffee immediately inside the main entrance to Hillingdon Hospital. Bevans has been a huge success for the team. It offers high quality Lavazza coffee and Tea Pigs teas with a seating area, as well as newspapers, books and other retail items.


Vending across the Trust meets CQUIN targets, with drinks and snack vending provided by The Rude Food Company and hot meals through Ooft.


In 2017 the team also won the Health Business Award for Hospital Catering.


The outcome

The catering team at The Hillingdon Hospitals NHS Foundation Trust have driven change to support a good food culture and achieve high customer satisfaction, by embracing change and innovation, making the most of available space and resources and selecting the best service solutions for the Trust, its patients, staff and visitors. 


* This award was won by the In-house Bed Maintenance Team at the Trust – read the full story in the September/October issue of HEFMA Pulse Magazine.


The Hillingdon Hospitals catering service is also featured in more detail in the September/October issue of Hospital Food + Service Magazine.