In the summer of 2019, there was an outbreak of listeriosis in which seven patients tragically died after eating hospital sandwiches contaminated with Listeria monocytogenes. Following this, the Health Secretary, Matt Hancock, announced a “root and branch” review of food served and sold in hospitals.
The scope of the review included the safety, nutrition, quality and production methods of food for patients, staff and visitors in NHS hospitals. In 2018 to 2019, the NHS spent £634 million on hospital food, representing approximately 6.7% of the total costs of running the NHS estate [10] or 0.6% of the total £114 billion 2018 to 2019 NHS budget [11]. It is the second biggest provider of meals in the UK public sector, serving 141 million inpatient meals [10] last year alone, to about 125,000 patients a day. This compares to 602 million school lunches [12] and 93 million prison meals [13].
There is a poor public perception of hospital food; and frequent critical press coverage of problems with both food that is on offer in hospitals to patients, staff and visitors, as well as wider concerns regarding food service. However, the evidence suggests that patients in NHS hospitals are satisfied, overall, with the quality of hospital food, with 22% of patients surveyed in 2019 rating the food they received as very good, and 36% rating it as good [14].
This contrasts with 39% of NHS staff, who felt that food and catering facilities offered in their workplaces were poor [15]. There is clearly scope for improvement. With a median spend of £4.56 per patient meal (including labour costs and overheads) [10], exceeding the budget of meals offered by other UK public services, the NHS should be demonstrating best practice in safely delivering nutritious, quality food to patients, and ensuring the least possible impact on our environment with best possible outcomes.
Better hospital food requires both national focus and leadership, but it is hard to deliver from the centre when power is devolved to individual trusts. We also need trusts to lead the change.
This report makes eight recommendations for system-level change. In Chapter 8 we propose that these are taken forward by an expert group with representation from across the sector and government. These apply mainly to government, NHS England and NHS Improvement, and national regulators.
Hospital food review10However, there are also actions that need to be delivered by trusts themselves. We have included a checklist for catering managers and chief executives which contains key principles of providing a good food service. We urge trust executive teams and boards to consider this list and what they can do to take their catering to the next level. We have tried not to be too prescriptive, as trusts are very diverse and what works in one place may not work in another.
However, these core principles are applicable to every type of service and should be carefully considered. Leadership engagement is key – hospital food is something that all boards we’ve engaged with really care about and are committed to. But commitment is not enough on its own – effective change needs two more things: data that gives insight for improvement, and a plan or strategy for getting the improvement done
