A healthier health service       

NHS ENGLAND wants to kick junk food out of hospitals as part of a £5m plan to improve staff wellbeing. But lucrative contracts with the likes of Burger King could be a problem.

Foodservice Footprint P7-FullSizeRender-225x300 A healthier health service        Features Features  Telegraph Simon Stevens Phil Shelley PFI NHS England NHS HCA Costa

A spoonful of sugar may help the medicine go down, but NHS England is looking to restrict access to the white stuff at all the country’s hospitals. In September, the organisation announced a £5m plan to improve the health of its staff, including what appears to be a ban on junk food.


Its chief executive, Simon Stevens, said it is unacceptable for health-sector organisations to be contracting with caterers which mainly sell foods that don’t meet nutritional standards.


“It’s time for PFI contractors and catering firms to smell the coffee – ditch junk food from hospitals and serve up affordable and healthy options instead. Staff, patients and visitors alike will all benefit,” he added.


Stevens’ plan – aimed at improving the wellbeing of 1.3m staff and cutting the £2.4 billion bill for staff absence due to poor health – will also involve officials at the country’s trusts pushing for “easily understandable nutritional information and appropriate portion sizes”. There was also a quasi-commitment to the Government Food Buying Standards. Even the products offered in vending machines should meet existing nutritional standards.


However, the biggest question mark relates to the relationship between trusts and their catering providers. Can cash-strapped trusts really force big high-street brands to change their menus and force them out if not?


The majority of England’s 160 hospital trusts are struggling to survive and a lucrative deal with a popular coffee chain or fast-food outlet can bring in some much-needed additional revenue. This week the Sunday Times revealed that M&S branches in hospitals (and stations) still have “guilt lanes” designed to tempt queuing shoppers into buying sugary treats (the retailer has banned them everywhere else).


An investigation by the Telegraph last year found 92 Costa Coffee shops at 71 trusts, 32 WH Smith stores (a brand that appears keener than any other to push cheap chocolate and sweets), a couple of Burger Kings and a Greggs. The paper noted: “Addenbrooke’s, the renowned heart and lung hospital in Cambridge, hosts a food court, with a Burger King, Costa Coffee, Starbucks and pizzeria. The trust’s chief executive said he wanted to replace the Burger King restaurant with something healthier, but faced stiff financial penalties unless contractors agreed to changes.”


Speaking to Footprint, Phil Shelley, the chair of the Hospital Caterers Association, said: “It feels like the horse has bolted a little bit. We should have looked at this years ago [and brought in] a consistent approach to what we sell. These companies have been on sites now for two years and it’ll be very difficult to change the pattern.”


The contracts with high-street chains are probably for a minimum of three years and generally between five and 10, according to Shelley. “In a PFI building that means you can sit comfortably for 10 years with a set income, but of course it brings other questions,” he added.


Stevens has wasted no time in asking them. Last year, he said the health service needed to take “hard-nosed actions” to tackle obesity. Recently he turned his attention to the food companies.


“If you are marketing sugar-laden fizzy drinks and junk food at kids you have a responsibility to stop that,” he said in an interview with the Times, also comparing junk food to smoking or drinking in pregnancy. “We had chocolate bars 20 years ago. What’s changed is a combination of portion size and the ubiquity and affordability of these products for our children.”


But while chocolate bars, fast food and fizzy drinks may be cheap as chips on the high street, in hospitals they are anything but. This concerns Shelley, who also leads the catering services at Musgrove Park Hospital, part of Taunton and Somerset NHS Foundation Trust.


The trust’s retail partners “agreed to have the same prices as the high street but there are some areas of really bad practice and service station prices”, he explained. “You have to agree the prices beforehand with these companies or they can take you to the cleaners.”


Ten local NHS organisations and NHS England itself, collectively employing about 55,000 staff, have agreed to lead the implementation of Stevens’ new programme. Each will commit to “ensuring patients and staff are always offered healthy options in restaurants, cafés and vending machines on site, and actively promoting healthier options through targeted promotions”.


Shelley is aware that change needs to happen, but it will take time. “We are all trying to do the right things – offering discounted gyms, cycle sheds and showers [for staff]. If you offer all that and then have a supplier offering unhealthy food then it’s not a consistent message. These companies are incredibly valuable to us as commercial partners, so we must work together.”