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This is a report of the second and final phase of the health evaluation element of the London Food Link Hospital Project, based on a case study at the Royal Brompton Hospital.  It documents the findings of a series of qualitative interviews with patients, staff and visitors to assess the impact of the introduction of organic and local food on food choices, knowledge and attitudes to healthier eating.  The impact on patient health per se was not assessed as part of this project.

Key findings
The interviews, conducted in October 2005, covered a range of issues including: attitudes to the food served in the hospital; interest in food and healthy eating in general; concerns about food in general; awareness of and reactions to the introduction of organic and locally-grown food on the hospital menu; attitudes towards the potential impact of organic and locally-grown food on health; affect of the initiative on food choices, both within and outside the hospital setting; perceptions of organic and locally-grown food; and potential changes to eating habits as a result of the initiative.

The main finding from the research was that the majority of those interviewed believed that introducing local and in particular organic food to the hospital was likely to be beneficial to consumers' health.  At the same time however, it was clear that most people had only a generalised understanding of why this should be true.

In summary we found that:

  • Overall the food at Royal Brompton hospital was highly rated by patients, staff and visitors; 
  • Some patients told us that, because of their illness, they were already focused on healthy eating before they came into hospital and the majority of all three groups claimed to have very or fairly healthy diets; 
  • Hospital staff were less concerned about healthy eating and more concerned about cost and convenience than other respondents; 
  • Levels of concerns about food in general varied, although visitors were more concerned than others.  In all cases the main issues of concern were additives, pesticides, salt and fat; 
  • Less than half the patients were aware that the hospital was using organic food; awareness was higher amongst staff and visitors; awareness of the use of local food was lower in all cases; 
  • The majority of respondents believed that there was likely to be benefit from increased consumption of organic food (and to a lesser extent of local food).  This view was based on a combination of being persuaded by publicity they had seen, and a 'common sense' assumption that foods without additives and chemicals were likely to be healthier;  
  • Although most staff and visitors claimed they would choose organic food from the menu, patients did not; 
  • Perceptions of what constitutes 'organic' were fairly accurate but the meaning of 'local' food was less well understood; 
  • Several visitors claimed they would try to change their eating habits as a result of the initiative, whilst most patients and staff did not..

There was, in general, considerable goodwill towards organic food (and somewhat less towards local food), but this was often based on inaccurate or incomplete knowledge.  Respondents frequently commented on what they presumed to be the health benefits of organic and local food but were less aware of other potential benefits.  However, there was little evidence that changes to the hospital menus would, in themselves, have much impact on respondents' food choices either in hospital or when they returned home.

If the public are to support initiatives for food of better quality, be it local and/or organic, they need to be better informed about what these foods are contributing to the better food agenda, to wider social policy, to local and rural economies, to agriculture policy, and to the wider environmental agenda.

The health benefits of local and organic foods will be notoriously difficult to demonstrate, but there are widely-accepted economic and environmental benefits.  These need to be better explained to the public and firmly championed, if initiatives such as this one are to be replicated elsewhere. 

Good Food on the Public Plate: Good Food on the Public Plate (GFPP) provided a wide range of assistance to a diverse cross-section of London's public sector organisations including local authorities, hospitals, universities and care homes, to enable them to use more sustainable food in their catering.

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