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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

    Comment number 73.

    The food I was given while in hospital having my daughter was utter rubbish. And being given a choice among foods didn't work - it seemed no matter how healthy I tried to be with my choices, the kitchen seemed to find a way to make it unhealthy. Boiling veg until grey, over-salting things, providing cole slaw in place of green salad - the list goes on....

  • rate this

    Comment number 72.

    Can anyone think of a celebrity chef who really cares what people eat,or what people buy?
    They are celebs.
    Which celeb has ever turned down a nice advertising contract?

  • rate this

    Comment number 71.

    Watched this morning's programme, and no, they didn't need a celeb to tell them just how much was being wasted, but no-one else had bothered to point it out! If the job was being done properly, then celebrity chefs couldn't be involved. The only meal I had in the nearest big hospital that was edible was breakfast (cereal from a packet, milk from the fridge, help yourself) otherwise I lived on stuff brought in for me (this is maternity ward btw). They put items together that just don't belong together (eg pasta and potato), and everything is so salty it's inedible, and boiled to death. Only decent hospital meals I have had were at my local maternity unit - prepared from scratch on site and a joy to eat - guess what, they closed it!

  • rate this

    Comment number 70.

    Not AGAIN!!!!!!!!!!!!!!!!!!!!!!!!! French hospitals aren't better off than the UK's but their food is... food, to allow quick recovery from patients. a heart sugery young woman with bread with egg mayo is not what you would expect but that's what our daughter did get. Speedy recovery??? They could not wait for her to leave. Maybe bad food is their way to push you out of the bed they supposedly need so much!!!

  • rate this

    Comment number 69.

    Sounds like we should go back to meat and two veg. A good basic meal that most people can eat will do the healing process the world of good and shouldn't cost a fortune.
    Get back to basics and produce good simple meals from seasonal food in hospitals.

  • rate this

    Comment number 68.

    "Can celebrity chefs improve hospital food?"
    I don't know, are they more nutritious than horse meat?

  • rate this

    Comment number 67.

    Most PFI hospitals are unable to make their own arrangements to provide any of the umbrella services, they are bound by their contract to let the likes of Sodexo do the catering, cleaning etc.

    I facilitate an event whereby we have outside pharma companies sponsoring our meals for the meeting. Most of those who sponsor our lunches bring in sandwiches from outside purchased from supermarkets because they think Sodexo charges them too much for a very basic meal. It costs over £7 per head for a sandwich, fruit & drink. If purchased externally, this costs less than £3 - if Sodexo are making more than 50% profit for providing basics & yet charge the hospital twice the price, you can see what goes on on a gigantic scales across every trust throughout England.

  • rate this

    Comment number 66.

    Style above substance. Business requires conscientious staff and accountability, not celebrities popping in once a year telling them how to do it.

  • rate this

    Comment number 65.

    I was in hospital in Aberdeen last year for 3 days. I lost 1/2 a stone during that time because I could not eat the food. Even the smell of it made me sick. Next time I have to go in I'll be taking in a supply of snacks and biscuits - not healthy but at least I'll be able to eat something.

  • rate this

    Comment number 64.

    We have a food industry which is out to get the most money for what they sell - raw ingredients do not seem to make as much money as the products that have add on value - ie horse meat (amongst other unknown products) sold as beef etc.Our farmers are subsidised to make our food cheaper, but I do not believe this actually works when millions are earned by those owning land & not farming at all - something wrong with the system from top to bottom, with supermarkets who dictate the price of goods. Our take away culture is encouraged to take away and not cook meal from scratch. How celeb chefs are meant to change our eating habits, beats me?

  • rate this

    Comment number 63.

    Shame I can't post a picture ,my partner is at Harefield hospatal with an infection ,he is on the heart transplant register . And they are feeding him burnt microwave meals And he has to ask them for his drink god knows what's going to happen when he's not well enough to ask ...

  • Comment number 62.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this

    Comment number 61.

    Nutrition is a hugely important part of hospital treatment, especially where an already poorly nourished patient needs a long stay - it is continually undervalued. Of the celebrities who have been involved, James Martin seems far and away the best - least self-serving. Next will be to make sure that everyone is able to eat the food, or gets help doing so.

  • rate this

    Comment number 60.

    15+ ops and overall the food has always been adequate but the tea/coffee is always awful. I've taken my own instant but it needs HOT water. Don't go OTT with this, you're not eating this, we are. Simple food with a nice cuppa - simplist is bestist.

  • rate this

    Comment number 59.

    Lawless-uk is right. The horrible regenerated factory food served in most hospitals is disgusting. Worst combination I ever saw was an omelette with salad. The omelette was leathery & stuck fast to the plate. The salad had been heated on the same plate & was unrecognisable.

    Wasn't always so. As a nurse for 30+ years, I lived on stews, shepherd's pie (sans chevaux!) and liver & bacon, Glamorgan sausage, plenty of fresh veg & yummy sponge puds with custard. It was all cooked on site & available 24/7.

    Now families can't even bring in home food or use fridges or microwaves to feed starving patients. I lost nearly 2 stone in weight in 5 weeks on an orthopaedic ward through sheer malnutrition.

  • rate this

    Comment number 58.

    Celebrity chefs sticking their noses in has led to stupid PR food menus being introduced. What hospitals need is a selection of basic healthy meals cooked on premises and delivered quickly in heated boxes. The patients are sick and only want tasty good, hot meals, not Jamie Oliver's restaurant selection.

  • rate this

    Comment number 57.

    Celebrity Chefs are a publicity stunt. Hospital food is unlikely to be improved by sprinkling condiments on it from above head height. The only one who might do something is Delia.

  • rate this

    Comment number 56.

    46.Realist of Worcester - ".....The only solution to this problem is to ensure that both the Catering Manager and Chief Executive are contracted to eat only the food supplied to patients....."

    And just how do you suppose hospitals will pay for better food?

    What area of their budgets should hospitals decimate to free up the extra funding (as it isn't going to come from Govt).......????

  • rate this

    Comment number 55.

    That picture of a cabbage put me on my guard. Food must not only be nutritious, it must also be enjoyable. When I was in hospital at the age of 7 for an appendectomy (many years ago now, admittedly) the nurses would regularly browbeat us kids (4-10-year-olds) and threaten "no sweet" to make us eat our greens (usually without success, thank God). Makes me shudder even now, many decades later.

    Also, getting a celeb chef in to the hospital kitchen is like a new year resolution. All's very healthy while he's there but what about when he leaves? Who keep up the standards then? Some bureaucrat?

  • rate this

    Comment number 54.

    As chefs we had to try all new dishes of the re-gen food. It was the day we all dreaded and none of us liked it (from a team of around 9 chefs) We all voiced our concerns over quality and were told we were being picky or difficult to please.
    Any chef wants to serve good food that will be eaten. But that stuff isn't food that most people can stomach so it all used to go down the waste disposal, especially the bolognese and mutton type dishes.
    Unfortunately, many hospitals no longer need chefs as such, they just need people who have completed a food hygiene course who know how to rotate stock in the deep freeze and can get the timing right and the positioning of the trays right within the oven.
    Catering assistants have actually stepped into the chef's role and saved the dept thousands in lower wages. Yet a massive proportion of catering depts are seriously over budget by 10's of thousands.
    I hate to say it, but theft happened a lot where I worked. It was a steady leak of expensive items that would be missing when you opened the fridge the next day.


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