Analysis
Nurses must work with caterers to improve meals Alamy
Under new nutrition guidelines, hospitals will be ranked for the quality and choice of food, writes Nick Triggle
NEW STANDARDS for hospital food in England have been drawn up, and they look set to have significant implications for how wards are run. The mandatory guidelines, to be enforced through the NHS standard contract from next year, cover everything from the quality and choice of food to the support patients receive in eating meals. Many of the new standards relate to the quality and variety of food provided by catering teams. For example, they stipulate fish should be served twice a week, half of deserts should be fruit based, and salt should not be used when cooking rice, potato and other vegetables. But several standards focus on how clinical teams, and in particular nurses, support and assess patients. These recommend that all: ■■ Patients should be screened on admission and then weekly while in hospital to identify those who are malnourished or are at high risk of malnourishment. ■■ Patients should have care plans that identify their nutritional care needs and how they are to be met. NURSING MANAGEMENT
■■ Wards should implement protected mealtimes. ■■ Front line staff should receive training on nutritional care. National Nurses Nutrition Group chair Liz Evans says that, to put these recommendations into practice, nurse leaders must ensure that staff on wards work closely with catering services. ‘What we need to work at is joining up catering services with what is happening on the wards,’ she says. ‘Food is still seen by many organisations as a hotel service, but it is a fundamental part of care. It is the responsibility of clinical staff as well as caterers to ensure that patients in their care have access to food when they need it.’ Ms Evans adds: ‘Nurses in charge of wards need to make sure that catering and ward staff work as one. This means making sure mealtimes are protected and that patients are getting the right help.’ Hospital Caterers Association chair Andy Jones agrees. ‘I would like to see catering services come under the responsibility of directors of nursing. In most hospitals,
they are under the director of estates and this sends out the wrong signal.’ Royal College of Nursing executive director Janet Davies thinks that staffing levels may have to be addressed too. ‘Many patients need help to eat. For example, it can take up to 45 minutes to assist someone with dementia to eat even a small meal. Hospitals must make sure they have sufficient numbers of suitably trained staff to deliver this care and assistance for every patient who needs it.’ As well as pledging to introduce the mandatory standards, ministers have said that hospitals will be ranked on the NHS Choices website for the food that they serve. The ratings, which are based on feedback from the Patient-Led Assessments of the Care Environment inspection programme, will cover quality and choice of food, and whether food is offered between meals, fruit is always available and menus have been approved by dieticians. Hospital Food Standards Panel chair Dianne Jeffrey says: ‘These recommendations will help staff make sure patients get appetising and nutritious food that they want to eat, and that they are given the help they need to do so.’ Other professionals question whether the standards will have their intended effects, however. Campaign for Better Hospital Food co-ordinator Alex Jackson, who resigned from the panel earlier this year, says the standards lack ambition and that their safeguards are ‘woefully inadequate’. ‘NHS contracts are long documents full of clauses that, without proper enforcement and monitoring, can be ignored by hospitals,’ he says. See also opinion, page 15 Nick Triggle is a freelance journalist
Find out more The Hospital Food Standards Panel’s Report on Standards for Food and Drink in NHS Hospitals is available at tinyurl.com/pob97yt Twenty Years of Hospital Food Failure: Why We Need Mandatory Standards, Not More Ineffective Voluntary Initiatives is available at tinyurl.com/brsnxff October 2014 | Volume 21 | Number 6
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 26, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
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Nurses must work with caterers to improve meals Alamy
Under new nutrition guidelines, hospitals will be ranked for the quality and choice of food, writes Nick Triggle
NEW STANDARDS for hospital food in England have been drawn up, and they look set to have significant implications for how wards are run. The mandatory guidelines, to be enforced through the NHS standard contract from next year, cover everything from the quality and choice of food to the support patients receive in eating meals. Many of the new standards relate to the quality and variety of food provided by catering teams. For example, they stipulate fish should be served twice a week, half of deserts should be fruit based, and salt should not be used when cooking rice, potato and other vegetables. But several standards focus on how clinical teams, and in particular nurses, support and assess patients. These recommend that all: ■■ Patients should be screened on admission and then weekly while in hospital to identify those who are malnourished or are at high risk of malnourishment. ■■ Patients should have care plans that identify their nutritional care needs and how they are to be met. NURSING MANAGEMENT
■■ Wards should implement protected mealtimes. ■■ Front line staff should receive training on nutritional care. National Nurses Nutrition Group chair Liz Evans says that, to put these recommendations into practice, nurse leaders must ensure that staff on wards work closely with catering services. ‘What we need to work at is joining up catering services with what is happening on the wards,’ she says. ‘Food is still seen by many organisations as a hotel service, but it is a fundamental part of care. It is the responsibility of clinical staff as well as caterers to ensure that patients in their care have access to food when they need it.’ Ms Evans adds: ‘Nurses in charge of wards need to make sure that catering and ward staff work as one. This means making sure mealtimes are protected and that patients are getting the right help.’ Hospital Caterers Association chair Andy Jones agrees. ‘I would like to see catering services come under the responsibility of directors of nursing. In most hospitals,
they are under the director of estates and this sends out the wrong signal.’ Royal College of Nursing executive director Janet Davies thinks that staffing levels may have to be addressed too. ‘Many patients need help to eat. For example, it can take up to 45 minutes to assist someone with dementia to eat even a small meal. Hospitals must make sure they have sufficient numbers of suitably trained staff to deliver this care and assistance for every patient who needs it.’ As well as pledging to introduce the mandatory standards, ministers have said that hospitals will be ranked on the NHS Choices website for the food that they serve. The ratings, which are based on feedback from the Patient-Led Assessments of the Care Environment inspection programme, will cover quality and choice of food, and whether food is offered between meals, fruit is always available and menus have been approved by dieticians. Hospital Food Standards Panel chair Dianne Jeffrey says: ‘These recommendations will help staff make sure patients get appetising and nutritious food that they want to eat, and that they are given the help they need to do so.’ Other professionals question whether the standards will have their intended effects, however. Campaign for Better Hospital Food co-ordinator Alex Jackson, who resigned from the panel earlier this year, says the standards lack ambition and that their safeguards are ‘woefully inadequate’. ‘NHS contracts are long documents full of clauses that, without proper enforcement and monitoring, can be ignored by hospitals,’ he says. See also opinion, page 15 Nick Triggle is a freelance journalist
Find out more The Hospital Food Standards Panel’s Report on Standards for Food and Drink in NHS Hospitals is available at tinyurl.com/pob97yt Twenty Years of Hospital Food Failure: Why We Need Mandatory Standards, Not More Ineffective Voluntary Initiatives is available at tinyurl.com/brsnxff October 2014 | Volume 21 | Number 6
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 26, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
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