Improving hospital food project - rewarding excellence
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A presentation by Jane Crossley outlining some fundamental principles for hospital food and drink at the Department of Health Improving Hospital Food event.
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3. The Paediatric Yorkhill Malnutrition Score (PYMS) evaluates 4 risk factors within 24 hours including weight and height measurements.
4. The Screening Tool for Assessment of Malnutrition in Paediatrics (STAMP) identifies malnutrition risk based on diagnoses, intake, and anthropometrics.
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Hospital Food Case Study
Introduction
Hospital food is an emotive subject and engenders headlines, usually negative, in the national newspapers. The NHS spends around £500 million on food to serve 300 million meals in 1,200 hospitals every year. For example, it buys 1.3 million chicken legs, 12.3 million loaves of bread, 13.5 million kgs of potatoes and 250,000 litres of orange juice a year. In 2000, a newspaper article estimated hospital food wastage at £144 million per year – almost three times the Department of Health estimate of £45 million. One of the main reasons being cited for the wastage was the poor quality of the food, although a definition of quality was not offered. Hospitals can deliver their catering services in-house; however, the NHS tendering process allows hospital trusts to outsource their catering processes if they want. Experts in food nutrition are concerned about the low priority given to the nutritional value of the food, with many patients becoming undernourished during their stay in hospital. Food is viewed by medical staff as part of the recovery process.
With regards to food quality hospitals do survey patients’ attitudes to the meals provided, some hold focus groups and generally ask about overall quality, temperature and how they were served at the bedside. Most patients have low expectations but meals are often the highlight of the day, especially for long stay patients.
Food Services
Over the years, the need to improve efficiency has resulted in reductions in staff numbers involved in the hospital catering service, along with centralisation of skills and equipment to produce economies of scale.
There are now many possible variations in food service and either an in-house operator or a contract operator could manage the food service.
The following are simplified overviews of the different systems (although every hospital can have a different variation according to local circumstances):
(a) The food can be produced on-site using a cook-serve system
A cook-serve system is a “traditional” catering operation where food is prepared on-site and distributed at the appropriate temperature to the wards, either plated or in bulk. This system allows for batch cooking which minimises hot-holding and nutrient losses and optimises the food’s sensory characteristics as it can be prepared close to the time required. However, in practice there can be a substantial time delay between production and consumption as wards are often situated a long way from the kitchens. The result is that many of the potential advantages are not realised. It is important that the food is served at 63ºC or above to control the multiplication of bacteria in the food.
Cooked on the day
Immediate service
Raw Ingredients
Figure 1: A Simplified ...
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Know what functional food is and be aware of common misconceptions
Recognize what types of foods are marketed as functional foods and how they play a role in consumer trends
Understand the regulation of functional foods
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No standard definition of functional foods
Provide health benefits beyond basic nutrition
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