Hospital Food Review calls for legally-binding food standards and investment in kitchens

The review made eight key recommendations, including upgrading kitchens, enshrining standards for nutrition, sustainability and quality in law (as school food standards are already), and tightening up the monitoring of NHS food by empowering the Care Quality Commission to report on compliance.There does not appear to be any new money allocated to help hospitals enact the recommendations.

Support from senior politicians has already been secured: According to the report it is backed by the Prime Minister, and the Secretary of State for Health and Social Care Matt Hancock said today that he wanted hospitals "to be beacons of good health". So far, government has committed to establishing ‘an expert group of caterers, dieticians and nurses to decide on next steps’ and promised that new hospitals will have kitchens and facilities on wards to allow patients to access ‘hot toast’ at any time of the day.

The recently published National Food Strategy: Part One includes a commitment to improve public sector procurement of food and drink. Henry Dimbleby, independent lead for the strategy, has promised to include a comprehensive recommendation in Part Two on what the government can do to ensure that the food the state pays for directly – including in hospitals – is both healthy and sustainable. 

The review's recommendations include several measures that are in line with what Sustain called for in our long-running Campaign for Better Hospital Food, for example the review calls for:

• Enshrining hospital food standards in law - like the school food standards are already, and ensuring that standards for quality, health and sustainability apply to patient, staff and visitor food, food manufacturers, and food retailers within hospitals, including vending machines
• Enhance the role of the Care Quality Commission to better monitor and enforce standards - The report described concerns that the current monitoring process - self-reported survey data - has become a ‘tickbox’ process for some trusts and may not accurately reflect reality. It said ‘There is very little evidence to prove that food and drink standards are being monitored closely enough.’
• A mandatory requirement to use a 40% cost/60% quality split across the NHS for all food and catering services, to make sure that themes such as farm assurance, food waste management, and engagement with small and medium enterprises (SMEs) have priority over cost. The report notes that here are no systems in place to monitor compliance with Defra’s Balanced Scorecard, and there is ‘enormous inconsistency with purchasing high-quality products, understanding the role of sustainability and managing food waste.’

Sustain’s chief executive, Kath Dalmeny, co-founder of the original Campaign for Better Hospital Food, said:

"We welcome this report and Prue Leith's recognition that food is medicine. The recommendations about setting food standards in legislation and boosting the role of the Care Quality Commission are very welcome."

"A decade ago, Sustain reported that £50 million had been spent by government on reviews, task forces, action plans, and voluntary measures, each with good intentions but failing to create real and lasting change because they lacked firm action, legislative change, money and enforcement needed to do so. Our detailed research into London hospitals in 2017 found that only half were meeting even the basic food standards."

"High hospital food standards are important for sick patients, for NHS staff, and for the farmers that provide for us. Food bought with public money must contribute to a healthy, sustainable future for our communities and our planet. Public sector caterers can and must lead the transition to a better diets, and hospital food is the perfect place to start. Prue Leith and a panel of experts have set out some excellent recommendations, and it is now over to the government and its regulators to commit legislative muscle and funding required to see them through."

Rob Percival, Head of Food Policy at the Soil Association, which runs the Food for Life Served Here food standard that many hospitals use, said; 

“This review could be game-changing in turning the tide on poor-quality food being served across English hospitals, but only if the recommendations are implemented in full. It’s time food standards were regulated with monitoring and inspections to ensure good practice. It would be brilliant to see hospital trusts using their buying power to support British farmers and enable environmentally sustainable food production.”

A helpful summary of key points from the Hospital Food Review is shown on the Food for Life website.