Speaking at the recent Care Home and Hospital Catering Forum, Emma Brookes, Head of Soft FM, Strategy and Operations at NHS England & NHS Improvement (NHSE/I) outlined how the reporting processes for Trusts may change following the publication of the new National Standards for Healthcare Food and Drink for Patients, Staff and Visitors next year. She also stressed the importance of striving for continual improvement.
When it comes to budget cuts, food, along with other soft services is often an easy target, so it is essential to change people’s attitudes towards food and always remember food is medicine. There is some really good work going on, but it isn’t consistent and with various standards, guidelines and targets already out there and work being done by different organisations and stakeholders, such as the Department of Health and Social Care, Public Health England and agencies such as Defra, it's a 'mix and match' scenario. The new standards will unite all of this good work to create a 'joined-up' approach so caterers can see what they should be doing for the best and provide a framework against which to measure and improve performance.
A new reporting process would aim to put food high on the agenda at Board level, by requiring compliance to a certain standard, Boards will not be able to argue that they didn’t realise they were under-performing.
A new Maturity Matrix will set targets for continual improvement against which organisations will have to report their progress - initially after six months and then on a year-on-year basis. Any organisations that are not demonstrating improvement will have to report to NHSE/I with an action plan.
Unannounced visits/inspections will form part of the procedure for checking compliance because NHSE/I does not want Trusts saying they are doing something when actually they aren't. "We don't want tick boxes," Emma confirmed, adding she would rather know the true picture and work with Trusts to help with them to achieve compliance.
Four workstreams
There are four workstreams within the new standards, each with a Lead and input from a wide cohort of participants (no Ministers) who will all remain in place after publication to continue to look at food strategy, and review and update as necessary, responding to changes in the sector.
Patient Experience. This refers to the Last 9 Yards and topics under discussion include encouraging pop-up dining areas in bays to get patients up and out of bed, moving around and being more sociable. Becoming less institutionalised is another priority, for instance, over the presentation of meals because if the food looks horrible and is presented badly, the patient decides not to eat, and then it doesn’t matter how nutritious the meal is, the service has failed.
Patient Nutrition, Hydration & Safety. This is looking at the food service in the context of the BDA guidelines and the Government Buying Standards, and how the discrete needs of patients who are nutritionally well as opposed to nutritionally vulnerable are catered for, as well as staff.
Procurement, Sustainability and Food Waste. These are very high on the agenda at the moment. There is obviously money to be saved from reducing food waste that can be invested back into services. At the same time, the procurement process is being examined and how sustainable it is.
Staff, Visitor and Retail. This offer is being scrutinised in terms of availability, choice and safety. Emma cautioned that it is not acceptable to believe that if space is contracted to other high street brands it negates responsibility for the hospital - if they are on your site, you are responsible, she said. There is also the opportunity to look at the retail services provided by the catering teams in a different way, for instance, if a site has fabulous fresh cook services, why not package products for sale through the vending machines rather than getting another company in to do this?
Workforce
There are other considerations as well, notably the workforce - the health of the workforce and attracting new talent into it. We need to establish the NHS as a space where people believe they can innovate, do something different, but most of all help patients to get better.
We also need to look after the workforce, who may be working long shifts, night shifts, with little time to source food and eat. The health service relies on its staff and needs to look after them.
