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The Hospital Food Review – What is happening following the publication of the report

It is now some time since the Hospital Food Review was published, with its eight recommendations to improve staff and patient health and wellbeing through hospital food. The following outlines the progress that has been made since then.

In his new role as Senior Operational & Policy Manager – Soft FM with NHS Estates and Facilities, Phil Shelley is now responsible for the implementation of the recommendations. The new role was not planned when Phil chaired the review but was offered to him so that he was in the right place to drive the recommendations. He explains: “Leaving my role and colleagues at Musgrove Park (Taunton) after 28 years was a challenge but being offered the chance to work closely with Emma Brookes, Head of Soft FM Strategy & Operations for NHS Improvement, who also chairs the Healthcare Food Standards, provided me with the opportunity to ensure the recommendations actually happen. We are both committed to hospital food improvement programmes, providing quality food for patients, staff and visitors.”

Phil and Emma have a three-year plan, but they generally accept that improving the service will be a continual process. As a result of COVID-19, the past 18 months or so have certainly affected everyone working in the NHS and Phil is aware that a stronger environment needs to be created for them. To do this, there needs to be strong leadership and involvement from a committed team that will take the review forward.

To answer this, an Expert Group has been created, which comprises NHS professionals from a range of specialties, as Phil outlines. “We interviewed lots of applicants for a position on the Expert Group, fantastic colleagues from around the country who want to be part of the changes and drive the area they work in to make a significant difference. We’ve got catering managers, chefs, nurses, clinicians and dietitians in the group, with Emma and I leading the team.

“Each member has been set tasks that will involve the close teams in their specialty. For example, our dietetics member(s) will work not only with their professional body, the BDA, but with speech and language therapy colleagues and nutrition suppliers. The tasks will enable them to tell us what we should be doing, so it’s not just about us pushing the way forward but about listening to colleagues as well.”

The members of the Expert Group will visit hospitals to see what changes are taking place or need to happen to meet the review’s recommendations, with Emma and Phil monitoring progress and liaising with Government Ministers about any support and guidance required.

As well as the Expert Group, there are currently 14 Exemplar Trusts (with the plan to have 30 by the end of June 2022) who have been chosen to work with Phil and his team by sharing their good practice with other hospitals in their region and helping them move forward.

“It is important to recognise that these Exemplar Trusts don’t get everything right, but that they have made significant improvement in an area, and that is why they have been chosen,” says Phil. “It may be improvements in an aspect of patient catering or a 24/7 catering solution for staff, for example. A couple of Trusts have been chosen because their retail catering offer is strong. There is a lot that can be learnt from them because we must not lose sight of the fact that we need a much stronger business and commercial model in the NHS.

“The Exemplar Trusts are brave, courageous, and innovative and are not frightened to make decisions. And that’s because they have support from their Trust Board and the hospital’s Chief Executive and Chief Nurse. It’s certainly easier to make decisions when you have that support, so the Expert Group want to go to sites and speak to the Trust Boards so that they understand what catering could be like if they support caterers, and we can understand where progress is being made and where the challenges are.”

Current areas of focus

Staff health and wellbeing is a massive focus of the food review, particularly over a 24/7 period, but Phil is conscious that there are other considerations to be aware of. “There’s sustainability, the obesity agenda, the National Food Strategy (part 2) and the Government Buying Standards which are planned for consultation in the spring of 2022. We also need to support the economic recovery post-COVID, the long-term plan to integrate health and social care together, and the move for the NHS to reduce its carbon footprint and have net zero emissions by 2040.

“Investment in IT and going digital is absolutely crucial in reducing our carbon emissions,” continues Phil. “The NHS has always been progressive around digital solutions, and catering must not be left behind. We also know that waste is an enormous area of concern – not just food waste but equipment waste as well. I have had conversations with the NHS’ Sustainability team around the fact that we need to use our equipment in a more fundamental way, so if one hospital doesn’t need something then it can be sold on to another one instead of it being sent to scrap.

I am proud of the partnership working with Defra, and our regular meetings have helped to align our planning with the National Food Strategy and Government Buying Standards for food and drink, encouraging the use of local industries. Every Trust should look at the dynamics of their region and how they can work with their local suppliers to use nutritious, sustainable British produce. This means engaging with farmers and local producers so you can provide patients with food from their region that you know they will enjoy.” Financing the recommendations is of course important, and the Government has pledged financial support for the implementation of the Hospital Food Review recommendations, but until the money is actually made available then there is always the knowledge that it may not happen.”

The last spending review focused, quite rightly, on the immediate demands of the COVID-19 pandemic but NHS England and NHS Improvement will continue to prepare the appropriate documents with Emma, Phil and the team and put them forward to Ministers, who are being kept up to date with progress. The Expert Group will be asking for capital to support their key areas of focus.

So what next? Phil and the team understand the many necessary changes can’t all happen straight away, which is why there is a three-year work-plan. Phil explains: “We want to plant the seed for change and inspire everyone to make the changes happen, so there are short, medium and long-term plans being developed.

“I am very optimistic that progress can be made. I saw so much pride and loyalty during our site visits: no matter what the situation, our caterers are proud of what they are trying to do. There is also an inner confidence and positivity in trying to seek a solution that is right for them.

“We certainly need to be closer aligned across the whole of the public sector around care, nutrition, education, and innovation,” concludes Phil. “We can all learn from each other, we all have a voice, and the change we can make is in our hands. This is the NHS’ review, so it is our responsibility to take it forward. It is our opportunity to develop our services and see them flourish.”

Brian Robb, Honorary National Chair of the Hospital Caterers Association, agrees. “Seeing this from a four nations’ point of view, I can attest to the benefit of the whole public sector working together, especially during these uncertain times. The Association will continue its involvement with, and promotion of, the Hospital Food Review. It is crucial to offer patients and staff the right to nutritious and appetising meals. Food plays a vital role in the wellbeing of patients and staff alike, allowing them to perform better, recover quicker, and maintain a healthy lifestyle.”

Exemplar Trusts

There are currently 14 Trusts that have been selected to be an Exemplar Trust, as follows:

  • East Lancashire Hospitals NHS Trust
  • Nottingham University Hospitals NHS Trust
  • Royal Wolverhampton NHS Trust
  • Royal Berkshire NHS FT
  • Ashford & St Peters Hospital
  • Western Sussex Hospitals NHS FT
  • Sheffield Teaching Hospitals NHS FT
  • Royal United Hospital Bath
  • Darlington Hospital
  • West Suffolk Hospital
  • West London NHS Trust
  • Royal Devon and Exeter Hospital
  • Stepping Hill Hospital, Stockport
  • Robert Jones and Agnes Hunt Orthopaedic Hospital, Shropshire

To view the formal response to the Hospital Food Review click the button below.

View HCA response


Authors: Judith Lawton, Craig Smith (Immediate Past HCA Chair and Board Member of the Independent Hospital Food Review), with interview contributions from Philip Shelley FIH.

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