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Hospital food: The chef that hopes to improve standards

 
Nurse trying to feed sick child in hospital bed

A new report has criticised government efforts, which involved celebrity chefs, to improve hospital food. But James Martin believes expert chefs can still help raise standards.

You are ill, in hospital and might not feel like eating anything.

Maybe you could stomach chicken soup. But the odds are you won't be served it.

Some hospitals are serving locally sourced, sustainable, nutritious food, and receiving accolades for it, as they are saving money, food waste and jobs.

James Martin makes it better:

Madeira cake

Mend wounds with Madeira cake

Heal with butternut squash and lime soup

Soothe with roast parsnip and rosemary soup

Restore with cauliflower and apple soup

However, according to a report produced by The Campaign for Better Hospital Food, the UK government has wasted more than £54m of taxpayers' money on failed attempts to improve patient meals since 1992.

There have been 21 failed initiatives, it says, many involving celebrity chefs such as Albert Roux, Heston Blumenthal or broadcaster and gastronome Loyd Grossman.

But one chef has recently been working to make a difference.

In the BBC Two series Operation Hospital Food, James Martin went in to the Royal Orthopaedic Hospital in Birmingham to give things a shake-up. Previously he had done similar at Scarborough General Hospital, North Yorkshire.

"Every hospital has its own particular problems," he says. "With only three months to complete the transformation it has seemed like an impossible task."

Sample dinner menu:

James Martin stirring custard
  • Fruit juice
  • Moroccan chicken tagine
  • Tabbouleh with lemon and mint
  • Green beans
  • Chips
  • Madeira cake

Watch Operation Hospital Food at 09:15 on BBC One weekdays starting Monday 25 February

He was shocked to find 40% of food being thrown away, the catering department crippled by a huge overspend and facing the threat of closure, and no system to assess how many people they were cooking for - or what they would like to eat.

"At times I have actually sat at home thinking, 'Is it worth it?', because I simply wasn't getting anywhere," says the chef.

"But I passionately believe that patients deserve the best standard of food available and I'm determined not to fail."

He introduced a new seven-day menu helping the head chef take control of stock management and ordering, and combining the restaurant menu and patient menu to save costs.

His new lunch and dinner menu featured healthy, nutritional classics, including cauliflower cheese with leeks, slow roast shoulder of pork, and a range of soups such as roast parsnip, or carrot and coriander - made with fresh not packet ingredients.

Go behind the scenes

Start Quote

Why wouldn't they be wary of a film crew descending on their hospital and exposing their flaws?”

End Quote Series producer Lucy McLennan on the TV blog

Desserts, which could be swapped for fruit salad, included pancakes with orange sauce, steamed treacle sponge, and baked rice pudding with raspberries.

James Martin is perhaps best known for presenting the weekend food show Saturday Kitchen on BBC One.

So could a Saturday Kitchen-style menu save the day?

"I have tasted some of his dishes like the soup for the starter and they are really good," says Lucy Jones, consultant dietician and co-director of Nutrifit Health Ltd, based in Purley, Surrey.

In fact soups can be both comforting and nutritious and are appealing to those convalescing.

"One of the areas we have fallen down on in the past is that the dishes can be far too rich. Meals should be relatively bland, not too rich and easy to digest, with a soft texture," she says.

James Martin recruited chefs Stephen Terry, Galton Blackiston, Paul Merrett, Lawrence Keogh, James Tanner and Chris Tanner to each work with a hospital in their own area.

Since then, a 92-dish menu he and Stephen Terry created has been adopted by 115 NHS hospitals in Wales.

Small girl being fed by mother in hospital Campaigners want more fresh, organic and locally-sourced fruit and vegetables

Gardening expert Alys Fowler has a partner who has a genetic disease and has two or three hospital stays a year.

"Sick people can be really finicky about what they eat. Depending on how you are feeling, anything challenging can make you nauseous. It's a really contested and difficult thing," she says.

Why is good nutrition important?

Savoy cabbage

Nutrition is critical to the healing process.

A good nutritional intake helps you to recover more quickly, and reduces the risk of complications.

You need to increase the amount of protein you consume in the weeks before as well as the weeks following surgery.

By increasing you protein intake, it will help your body heal itself more quickly and effectively. Protein is included in foods such as chicken, fish, and eggs (try to avoid fried greasy foods). If you are a vegetarian make sure you are meeting your protein needs.

Incorporate dark green leafy vegetables into your meals before and after surgery, such as, cabbage, spinach, broccoli, and asparagus. These contain vitamins and minerals which taken in conjunction with protein and water, will boost your healing rate and will aid in your recovery.

Source: Royal Orthopaedic Hospital

She has sympathy with catering providers, as "although the food system is not ideal, they are working on a budget".

However, "going for the cheapest option all the time is not always good for patients", says Amy Leech, a policy officer with the Soil Association, which campaigns for healthy and sustainable food and farming.

Some hospitals are criticised for preparing processed, non-locally sourced food.

Recently horsemeat has been found in some hospital food served in Northern Ireland, and questions are being asked over the supply chain in England's hospitals.

Buying cheap processed food "is not a sensible thing to do", says Alex Jackson, from the Campaign for Better Food.

"Local and seasonal food is good for a number of reasons: it creates less food miles, it supports the local economy and local farmers, and can be grown in a natural way," he explains.

"The kind of standards we'd like to see, are environmental and ethical standards. Eggs should be cage-free, hospitals should be buying more cage-free poultry and sustainable fish. It's not only about how healthy it is, but the benefits for all with good provenance."

So how do meals measure up nutritionally?

In Wales, a patient is assessed whether they are nutritionally at risk, healthy or well, says Alex Jackson. The assessment is used to decide what they are fed, a policy not necessarily followed elsewhere.

"Hospital food in Scotland and Wales has to meet nutritional standards, but hospital food in England doesn't," he adds.

Eat well in hospital:

Woman peeling apple in hospital with man in bed

Poor nutrition pre and post operatively may result in:

  • Increased length of stay
  • Headaches
  • Depression
  • Inability to concentrate
  • Increased risk of infection of chest
  • Increased risk of urinary tract infection
  • Increased risk of and wound infection and delayed healing
  • Increased risk of pressure ulcer formation
  • Increased chance of re-admittance to hospital

"If you look at nutritional guidelines on a daily basis, each meal served should contain a third of a patient's daily nutrients and a variety of micronutrients," says Lucy Jones.

"Malnutrition in hospitals is so widespread. It has a massive impact on recovery. It has been a problem in the past. People can end up with pressure sores if not getting enough to sustain them moving around," she explains.

According to the Campaign for Better Hospital Food, some hospital meals served in 2012 were saltier than fast food burgers.

James Martin has tried to ensure his menus are fresh and nutritionally-balanced.

Lucy Jones says variety is important, ensuring menus contain many types of foods.

"Those having cancer treatments may do better on cold, dry things," she says. "And anyone in there for a long time can get food fatigue if always having same things."

Nottingham University Hospitals and North Bristol hospitals serve a variety of fresh, local produce, says Amy Leech.

They follow a catering mark scheme designed to show that food is freshly prepared, free from undesirable additives and better for animal welfare.

"We are helping hospitals try to achieve the mark by serving 75% fresh food, farm-assured meat," she says.

It's a target James Martin has also encouraged hospital catering staff to meet.

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  • rate this
    +3

    Comment number 51.

    Just to throw a spanner in the works amongst all the negative comments: during my stays in hospital I was actually really impressed by the food. I can't guarantee this view wan't tainted by morphine, or the ready availability of ice cream. But generally I'm picky and enjoy good food, and had no complaints. On the whole, thumbs up to the NHS from me.

  • rate this
    +2

    Comment number 40.

    I spent 6 weeks on and off in hospital following surgery for cancer, I am vegetarian. All I was offered was sandwiches which were dry and too hard too eat, omelet or cauliflower cheese. Very quickly I was bored of this diet. On one ward the person who organised the meals offered me the halal menu to try and vary my diet, but half of this was very unappetising and she also got into trouble. I was not to have meals off the alternative menu unless I had been referred to a nutritionist via a nurse. I ended up having on my notes - will not eat the food, visitors to bring in. I lost over 2 stone in weight during my time and struggled for months to eat anything normal. All the while having further cancer treatment. Something has to be done and I hope James Martin's work spread.

  • rate this
    +7

    Comment number 27.

    All very well getting advice from passing TV chefs, what hospitals need to do is to hire decent chefs to work in their kitchens. They ought to talk to the local FE college, most of which teach BTEC Catering courses, discuss their specialist requirements, contribute to the courses and get young eager chefs excited to work in the NHS.

  • rate this
    +10

    Comment number 18.

    They have the same issues in other countries. Government organisations are charged tens or hundreds times as much as others for exactly the same product. Because it's tax payers money, nobody questions it. Get rid of these greedy profiteering cartels and then start talking about cuts and fancy (expensive) food.

  • rate this
    +14

    Comment number 13.

    We all know the root of this problem.
    The catering and soft services have been outsourced by over-paid fools in ivory offices. The pay the preverbial peanut, and take the profit as a well done for non work.
    We need to bring services back into the NHS, come on, rhis run it like a business attitude is not working.

 

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