HCA Conference speakers call for wider NHS support for the role of nutrition and hydration

THE 2014 Annual National Conference and Exhibition of the Hospital Caterers Association (HCA) took place at the Hilton Birmingham Metropole, NEC, Birmingham on 10 – 11 April. The HCA Annual National Conference and Exhibition is the premier annual event for healthcare catering managers, hotel services and facilities professionals and industry suppliers.

Foodservice Footprint IMG_3743-300x199 HCA Conference speakers call for wider NHS support for the role of nutrition and hydration Features Features  Yvonne Spencer Taunton & Somerset NHS Stuart Wray South Devon Healthcare NHS Foundation Trust Sodexo UK & Ireland Maxine Cartz Matt Dawson Manchester Central trust Liz Jones Jay Rayner Hospital Food Standards Panel Hospital Caterers Association HCA Annual Conference Dr Irene McClelland Depatment of Health Co Durham & Darlington NHS Foundation Carol Dight Barts Health NHS Anne Donelan Andy Jones











Hosted this year by the HCA’s South West Branch, the 2014 Conference theme was “Engineering the Future”, taking its inspiration from Isambard Kingdom Brunel, the South West mechanical and civil engineer whose vision and passion demonstrated that ‘anything is possible’. Speakers at the Conference who included food writer, Jay Rayner and former Rugby World Cup winner, Matt Dawson, shared their vision for an NHS that needs to think, plan and act differently in order to address the balance of feeding patients, as well as staff and visitors, in a suitable environment whilst offering a choice and quality that meets their individual needs.


A common theme and call to arms was the need to break the mould of NHS culture and for hospital caterers to be empowered in order for them to make a difference to the nutritional care of patients. The HCA has already made considerable contributions to food being more widely recognized as being as important as medicine. The 2014 Conference focused on the need for hospital caterers to be allowed to lead on the setting and implementation of high quality national food standards for patients, staff and visitors.


Carol Dight, Executive Director of Nursing and Governance, Taunton & Somerset NHS Trust set the scene for Conference with her address entitled “Culture – Quality and Safety are at the Heart of What We Do”. She explored what needs to be done to ensure that good nutrition and hydration is integral to patient care. She said that doctors and nurses are equally part of the challenge to ensure meal times are not interrupted by routine tasks. She also added that it is central to a nurse’s job to ensure patients are fed and provided with essential hydration. Although serving food is a core nursing activity, she believed that more work is needed to ensure that they fully appreciate the role nutrition and hydration play in patient wellbeing and recovery including them being equipped to handle essential aspects such as monitoring patient food consumption.


Liz Jones, Head of Patient Environment, Department of Health talked about the mission of the recently formed Hospital Food Standards Panel. Set up by Age UK and the Government to address the variations in food quality across the NHS, the panel comprises of nurses, dietitians and food industry professionals. Liz outlined the scale of the task facing the Panel. The NHS spends £½ billion on food and drinks for inpatients per year and more than 50% of the food prepared in hospitals goes to staff and visitors. Research has shown that 30% of inpatients are at risk of malnutrition and patients with reduced appetite may only want to eat familiar or even ‘unhealthy’ foods. The focus, she explained, was on supporting the premise of ‘healthier eating’ for non-patients and ‘enhanced nutrition’ for vulnerable inpatients. Their work has to take into account, she said, many considerations in arriving at nationally acceptable hospital food standards, ranging from the wide and diverse needs of differing patient types to the different hospital operational systems for preparing and serving food.


Trevor Payne, Director of Estates & Facilities, Barts Health NHS Trust explained why sustainability should be fully integrated into all aspects of delivering healthcare within the NHS and why it should be seen as being of paramount importance to the provision of healthcare in England. With The Lancet recently proclaiming climate change to be the biggest health threat of the 21st Century and with the values of the NHS centred on protecting public health, Trevor argued that the NHS has no option but to embrace sustainability and support environmental measures. He said that the 2008 Climate Change Act stated that there were scientific, legal, health, business and leadership reasons for all to do so. Taking simple actions to save energy could save the NHS millions per year. With poor air killing 29,000 people annually, the cost to the NHS could be £20 bn a year – twice that of obesity. Trevor urged hospital caterers to take greater action to support recycling, waste reduction, on site energy generation and even on site vegetable planting. All, he said, were NHS-able.


Under the banner of ‘Overcoming the Obstacles’, four speakers focused on the same concept but from different perspectives. Each outlined their individual perspective of supporting the patient experience:


Maxine Cartz, Dietitian outlined the benefits of hospital caterers using the British Dietetic Association (BDA) Nutrition & Hydration Digest: Improving Outcomes through Food and Beverage Services to plan menus that will achieve acceptable nutritional standards. Patients, she said, want traditional comfort food prepared well not gourmet cuisine and, she added, the food trolley was as important as the drugs trolley.


Dr Irene McClelland, Lead, Meal Time Enhancement, South Devon Healthcare NHS Foundation Trust focused on the sterling work of her Trust’s Mealtimes Companions Scheme which involves a volunteer force who, through providing feeding support, are actively helping to improve patient nutrition.


Stuart Wray, Head of Catering, Co. Durham & Darlington NHS Foundation Trust summarised the success of his Trust’s food versus supplements project which aimed to ‘match calories through real food’ and their introduction of À La Carte Menus for patients offering 42 choices per day, some 8000 meals per week. This has now been extended to lunch and supper menus offering 84 choices per day.


AnnYvonne Spencer, Facilities Matron, Manchester Central Trust said that her Trust was committed to the concept of good nutrition for patient wellbeing and recovery. A key exercise was to try and analyse why satisfaction with food varied between different patient groups. With dissatisfaction levels higher amongst oncology patients, research determined that certain menus did not offer sufficient flexibility according to the varying levels of appetite suffered by those patients. New measures were taken to not only create bespoke menus and food or meal options but other measures were taken to improve flexibility such as a choice of portion size, electronic same day menu ordering and pictorial aids to manage patient expectations of meal content and presentation.


As Ambassador for Health & Wellbeing for Sodexo Ireland and UK as well as Celebrity Masterchef winner and former Rugby World Cup winner, Matt Dawson gave a highly inspiring session under the banner of “Not Just Talking the Talk”. Matt offered his views on why healthy lifestyle choices are a must for everyone in both their personal and professional lives and why he believes that staff following health and wellbeing regimes, are crucial to the delivery of effective health care to patients within the NHS. Matt believes that organisations like the NHS need ‘super staff’, not ‘super stars’, that we all need to ‘buy into’ health and wellbeing as a way of life and that all those within a team need to align in order to be effective in achieving a positive outcome.


An HCA Life Member and a long term Catering Dietitian, Anne Donelan spoke of the changing relationship between dietitians and caterers over the years. Also a Member of several active groups including the Government’s new Hospital Food Standards Panel as well as the HCA’s ‘Ward End Service’ Group and the British Dietetic Association ‘Food Counts’ Group, Anne called for the Government and the NHS to leave it to the caterers to manage all aspects of patient meal service. She also called for an end to conflicting and misleading information over the efficacy of different food types such as organic and for patient food to be served with concern and consideration for its important role.


Andy Jones, the HCA National Chair, summarised the extensive collaborative work the Association is undertaking as part of its aim to improve food service for patients. He outlined the multi disciplinary partnerships that are being nurtured with like minded professionals, organisations and the Government. As HCA Chair, Andy is seeking to gain greater respect for food and drink and wider recognition within the NHS of the role nutrition and hydration play in patient recovery. This includes seeking the involvement of clinical leads in the work of the HCA and through a requirement to report on food services, greater engagement of Trust Chief Executives. He also wants to see improved training for Ward Hosts/Hostesses and increased involvement of the end user i.e. the patient, in the planning of food services. Andy also urged caterers to tackle the issue of small packaged items such as jam, sauces and juice cartons which some patients find difficult to open without assistance.


Journalist, Writer and Broadcaster, Jay Rayner gave a ‘no holes barred’ grand finale address entitled “Feeding the Patient when the Planet is Ailing”. He described the global challenges of food security facing us all in the 21st Century. With a global population heading beyond nine billion by 2050, he outlined the impact this growth will have not only on our collective ability to provide sufficient food for everyone on the planet but also upon the imperatives of feeding patients well, in a manner that will aid recovery. He said that 50% more food had to be sourced from the same land mass and food prices were going to rise as production endeavours to keep pace with population expansion and demand. What was going to be important in the future, he said, was not where, but how, food is grown or reared. He strongly called for conclusive scientific research to prove beyond question, the efficacy and cost benefits of feeding patients well, a move that would obligate Government to make greater investment in NHS food services.


Commenting on the outcomes from the HCA’s 2014 Conference, Andy Jones, National Chairman, Hospital Caterers Association says: “Engineering healthcare services for the future is going to be our greatest challenge but the Association is one hundred per cent focused on the drive to create a resilient structure. We also intend to lead on the major aspects which will enable hospital caterers to provide high standards of food service in the long term. Our speakers this year provided enlightening but in some cases, daunting glimpses of how food production and supply coupled with population growth, longer life expectancy and major environmental issues are going to impact on the National Health Service in this country and our collective ability to provide effective and sustainable care for our patients”.


“Ensuring that good nutritional care remains central to every single patient’s recovery plan is fundamental to the HCA’s mission within partnerships and all stakeholder relationships. To achieve optimum nutritional care for all patients, we must strive to build catering operations across Trusts that are properly equipped and financed to overcome the obstacles and meet the challenges that not only lie ahead in all areas of the NHS but also those that are destined to impact on humanity as a whole. Whilst the hospital environment and the workplace in general will have to change to keep up and regardless of all the external factors and pressures, there is one thing that is absolutely certain for caterers and that is, we must continue to keep the health and wellbeing of patients, staff and visitors, right at the heart of all that we strive to do”.