Why is NHS food so crap?

[SpeedyGonzalez]

here

Quite so.

I like the mumsnet suggestion in the comments - anyone game? Let's show them what's what!

Actually, it would be funny if we did send a suggested menu to the Chief Exec of the NHS...

I spent just over a week at Addenbrookes when I was expecting DD. The portion sizes were tiny and we were only allowed a set amount. I ended up losing quite a bit of weight and DH was constantly bringing me food. Not a great way to look after pregnant women!

When ds was about 18 months old he was in hospital and was offered hard pizza and hot dogs, neither of which he could really eat (couldn't get his teeth into it and obviously not very healthy). He ended up eating crackers and yogs. Even baby food would have been a better option.

Having and elcs in 10 days and already have the snacks and juice packed :-)

I think the problem is that the relationship between good nutrition and a successful stay in hospital has been completely broken (if it ever existed). From my own experience what is offered in hospital is designed entirely with the convenience of catering and nursing staff in mind. The patient isnt considered at all.

For a year improving NHS food was part of my job. Loyd Grossman had given up, Jamie Oliver had given up and was concentrating on schools, so how difficult could it be?

I spent most of my time gibbering 'but WHY??', for example the majority of hospitals don't have their own kitchens - the meals are brought in ready-made and heated up, so if they don't have enough low-fat/halal/whatever diets in the building, tough, you'll have to wait for tomorrow.

And all the PFI hospitals where they have to pay a premium of about 1/3 for delivery. Why? Because the route to the delivery bays is too low or narrow and the standard food delivery lorries can't get in, so the hospital has to pay for the boxes to be transferred into two small trucks and two drivers...

And the majority of hospital patients being conservative over-60s who refuse to eat anything exotic like curry and demand classic meat+2-veg, which as we all remember from school dinners, doesn't cope with reheating well.

Apparently all the meals have to and do meet strict nutritional standards, but it's the getting the right meal to the right patient at the right time which is a nightmare - and a simple lack of staff who actually nurse, now that nurses aren't the ones with the responsibility of feeding and cleaning patients. I think the people who do that stuff now are called 'healthcare assistants' but they don't have much training and there's not enough of them.

There's some good hospitals out there, usually where someone dedicated has taken over food procurement, but almost always where they have their own kitchens. I spent 3 days in St George's a while back and the food was certainly respectable, if a little potato-heavy. Luckily I had an interpreter with me as otherwise I'd never have found out it was there, or got any, seeing as I was tied to the bed for the first day, and you had to walk down the corridor for it.

I was in hospital for a week last September and the food was fine - I had a particularly nice curry and the nurses always gave me extra biscuits on the tea rounds.

Think it must be a hospital by hospital thing.

Barts food is fantastic. Well done, them.

I have spent 9 weeks in Barnsley Hospital in the last 3 years and the food is very good indeed. I think the kitchen staff are employed directly by the hospital and the food is made on site.

There is a choice of veggie, kosher, hallal, diabetic, weight loss and post operative meals. Pudding, fruit or cheese and biccies. Have also eaten in the restaurant a few times, and prices are very reasonable. Better than our apparently subsidised canteen at work.

I was just thinking that I wonder why the trusts don't look at satisfaction surveys and see which is the best and learn from them.

Then I realised that all trusts allocate their own funds and the better food is bound to be more expensive. So it depends on prioirities and other financial pressures.

Then I realised that going forward as the hosps are going to have to tender for servces from the GP consortia and presumably price will be the main driver (?) food costs will almost certainly be driven down??? Or will GPs favour places with good food - will they be able to if they have tight budgets? No idea...

"Then I realised that going forward as the hosps are going to have to tender for servces from the GP consortia and presumably price will be the main driver (?) food costs will almost certainly be driven down??? Or will GPs favour places with good food - will they be able to if they have tight budgets? No idea..."

The idea is that as hospitals 'compete' for patients - the more tangible aspects of the service will improve.

The hospital will have an incentive to drive out inefficiency costs and the costs of poor administion, so they can spend money on areas which patients value.

At least you lot saw some dinner!

My bed was round the corner of an L shaped ward, so they didn't even bother coming round with the trolley for the first day and a half of moving me there.

Still after having been moved from the bed next to an old dear farting and bottom spluttering on a commode next to me with nothing but a plastic curtain to shield me from noise, smell and leakage I was almost happy to starve.

That was Salisbury hospital, awful, awful place.

Food was terrible in Bath maternity ward too.

Chippenham mat ward was fantastic, like the best school meals as if they were made by your nan, and babies weren't allowed in the dining room, to give you peace to eat.

I didn't want to come out.

I would have thought that commissioning GPs would be looking at cost, waiting lists, success rates of procedures, success rates of treatments, death rates, that sort of thing.

I would have thought that what the food is like will come way way down the list.

"The hospital will have an incentive to drive out inefficiency costs and the costs of poor administion, so they can spend money on areas which patients value." It's not the patients doing the commissioning though is it.

If you think hospital food is bad, try having a medically necessary special diet.

On my recent stays in Worcestershire Royal I came foul of the 'you must order 24 hours in advance' rule. And this applies ward by ward - so day 1, someone did go to the canteen for me. Day2, I was starved for surgery until 10pm when it was apparent it couldn't happen - but there was nothing gluten free to give me. Day3, I went to surgery, but was still vomiting at dinner time, and there was nothing gf available after. Day3 - nothing gf available at breakfast (only cereals or toast), salad for lunch, salad for dinner. Day4 repeat of day 3. Day5, transferred to a different ward, no food as the order doesn't transfer...

Same on an admission a week later in spite of me trying to ask them to arrange things. And they wouldn't heat anything up from outside and visiting hours were such you didn't want to eat then.

I lost over a stone in two admissions

Sardine -

" I would have thought that commissioning GPs would be looking at cost, waiting lists, success rates of procedures, success rates of treatments, death rates, that sort of thing."

Yes, but apart from cost, these things are actually difficult to measure. And the information available is often not very useful unless you can 'drill down' to what relevant. Eg. Current waiting list for your secific operation.

So, if you have one hospital with great food and one which serves slop (or forgets to serve any food at all) then the GP will tend to favour the good food one.

Food being reasonably tangible (ie easy to judge) compared to, say, success rates of proceedures (even if the GP can understand the stats - communicating it to a patient is difficult.)

I spent 7 weeks in the Royal London summer 2010 and found the food to be very nice, other than one breakfast and one dinner when they forgot to bring food to my bay I have no grumbles.

jackstarb I think you will find that all hospitals keep records of waiting lists, success rates of procedures, success rates of treatments, death rates and so on.

If anything cost is the least easy thing to measure as each patient will have a different set of procedures and care needs and each person caring for them will be on a different pay scale, and to split down to eg how much an average hip replacement costs would be extremely difficult. As some people will become ill and end up in intensive care, others will need extensive physio, some will need follow up care at home, others will have a quick easy recovery and some will die quickly (pretty cheap but not a good outcome!). You would need to normalise the "average" cost for so many variables that it would become meaningless.

I remember the cottage cheese salad when I was on the maternity ward. Half a plate of chopped up iceberg lettuce, nothing else, no dressing, and a dollop of cottage cheese. Appalling.

I don't think it's a budget issue - it's possible to make tasty, healthy food on a budget - but rather a can't be arsed attitude.

I also think you will find that when GP consortia are looking at commissioning say a hospital to perform their orthopaedic functions, they will be far more interested in waiting lists and success rates than what the food is like. I would imagine that the average time to discharge would be a key figure.

I had an operation in a private hospital last year - and I was give a 3 page menu and a separate wine list!

I have had the misfortune of being in both french and Italian hospitals and I have to say the food would be top of the priority list.

When are we going to learn that what we put into our bodies makes us healthy or unhealthy? Why is it important to other countries and not us?

If a hospital can't get a balanced menu then what hope do we have?

Nancy66 I remember about 10 yrs ago the head chef from the QE in Brum did a job swop with the head chef at the Priory private hospital- he was amazed to find that he had a budget of £20 per day per patient with which to plan menus. In his normal job, he was lucky if it was £20 per week, per person. I wouldn't have thought there has been much change in the spend per head over the last 10 years.

Sardine - you are probably right about cost.

But much of the variability you describe could equally apply to procedure and treatment success rates. All the numbers given to the GP would be averages and might not be as useful they initially appear. E.g - a higher mortality rate, because the hospital specialises in the procedure and so gets the toughest cases, might not the negative it initially appears.

Of course GP's will have general ideas about which hospitals are best for which proceedures - based on experience and local knowledge. But patients will judge a hospital based on their own experience. Therefore quality of food, as well as quality of care, comfort of bed, and other more 'tangible' features will play a major part.

Their feedback will contribute to the GP's long term relationship with a hospital.

Bit of a sweeping statement OP!
Our hospital food is lovely, all made on site, dished up on the ward itself and served on proper plates.
I realise that I am lucky though, when my mum was in hospital last year it was all sadwiches and jacket potatoes.
Some places can get it right, it's not rocket science!

I'm interested in why you think that patient feedback is going to be a big deal with this new regime?

Also I think if it does hold any sway the person's experience with medical professionals will hold more weight than what they thought of the grub. I just don't see it.

Will be happy to be proved wrong!

I was in hospital a couple of weeks ago, had nothing to eat (under their instruction) from 10pm Sunday evening. Nil by mouth all day Monday and by the time I was out of theatre in the evening it was too late for food. On the Tuesday morning, having not eaten for over 36 hours I was given a slice of bread and one of those little pots of jam. That was breakfast. The bread wasn't even toasted.