Five-star treatment

Private perks

H Visit from head chef or customer services manager for meal consultation

H Menus chosen one meal in advance

H Flexible hours of serving

H Food arrives with good-quality cutlery, linen and customer comment card

H Dedicated food team with hospitality experience

NHS nosh

l Check meal requirements on a card

l Menus chosen day before

l Mealtimes are set

l Food arrives in plastic utility containers

Contract caterers have found it difficult to find a way into feeding private hospital patients. In the mid-1980s, BUPA and Nuffield decided to use in-house catering for the private wings of the NHS and the 300-odd private hospitals in the UK.

That could change, according to Roy Donaldson, director of Gardner Merchant's specialist care division.

"The wheel is coming full circle, as the market evolves and perceptions alter," he says. "We think there's an exciting and realistic market opportunity and one we believe will grow."

Donaldson's optimism is based partly on the growth in use of private hospital facilities. A recent survey showed revenue from private hospitals and clinics expanding by around 10% last year, as the range of treatments increases. Major operations, as well as relatively minor ailments such as varicose veins and hernias, are being conducted in private centres. A quarter of all heart surgery in the UK is done privately.

Speed of medical attention has always been a key attraction of private hospitals, especially for less serious operations - although, once a patient is in hospital, there is very little difference between the quality of a private hospital's and the NHS's medical intervention. The differentiator is more on the level of comfort: private hospitals are effectively like hotels, competing for customers on the basis of superior food and service.

Added value

"Food does add value to the feeling that you are in a five-star hotel," says Rowena Edwards, managing director of Bateman Healthcare, whose NHS and private hospital contracts account for 15% of the company's turnover.

So a hospital's ability to fill beds will increasingly be determined by how well it meets paying patients' expectations in food and service. That's where contract caterers can score, benefiting from their extensive experience and resources.

Within the past five years Gardner Merchant has increased its private contracts from six to 26, with a varying degree of involvement in everything from purchasing arrangements to the provision of catering and full hotel services.

"Frankly, that's just scratching the surface," says Donaldson. "With in-house operations, beyond the level of the chefs, there is no hotel catering service people can draw on. Instead of having the catering and service function reporting to an administrator or matron, whose main concern is with medical care, we can offer a specialist service."

Contractors can also offer greater expertise in the related areas of marketing and merchandising, presentation of menus and hospital literature, he adds.

Being part of a group can help, too. Gardner Merchant is part of the French-owned Sodexho, which has more than 2,000 health care operations in 66 countries, while Bateman Healthcare has the advantage of being close to Roux Fine Dining and Leiths, members of the Compass Group with extensive experience of top-level catering.

Catering in the NHS has improved greatly in the past 20 years, but it is still fairly functional. Patients are asked to choose both lunch and dinner from a limited menu the day before. Although usually palatable, the food tends to be delivered in plastic utility containers at set mealtimes.

Compare that with the private sector, where a patient can expect to get a visit from the head chef - or customer services manager in the larger hospitals - to discuss their next meal. The menu is typically an extensive à la carte, with considerable flexibility as to exactly how it is cooked and when it is served.

Instead of being assembled in a distant kitchen, the food is likely to be finished at the point of delivery and presented with good-quality cutlery, a comment card and clean linen. Trained staff at ward level are constantly on hand to attend to the patient's non-medical needs.

Within the NHS, the logistics are somewhat more challenging, but high standards are still possible in the private wings. At Charing Cross Hospital in west London, Granada Healthcare Services (GHS) operates a kitchen on the 15th floor for two private wards, with its own team of chefs, stewards and hostesses.

"A lot more staffing goes into the actual preparation and we use a traditional hotel brigade system," says GHS's managing director, John Bennett. "The key thing is to provide service appropriate to patients' needs."

Bateman's Edwards agrees: "We have to recognise that our guest is ill. If they only want a boiled egg and soldiers we'll give them that but, by golly, it'll be good. If they want salmon hollandaise, that's fine too."

There is also more flexibility in schedules. Meals should ideally not be ordered more than one meal ahead, Edwards says, and will be mapped out to fit in with the medical treatment. If a patient is ill at lunch, for example, soup can be provided at 3pm.

Bateman has a specialist team run byexperienced five-star hotelier Nick Graham, who has previously worked as regionalmanager for Block Hotels in Nairobi, Kenya.Levels of training are high. Front-of-house skills are required by all staff who dealwith the concerns of people who may be seriously ill.

The budget is usually agreed with the healthcare provider, and is determined by the level of competition in the market and the image the hospital wants to project.

"Some are quite happy with three-starlevels but others insist on five-star standards," says Edwards. "There may be some constraints, but we challenge head chefs to work within a budget. If they overspend oneday and underspend the next, we can manage that."

The cost might include peripheral services, such as beverages, which would make it significantly more expensive. Often the patient has the opportunity to buy additional items - to have a friend or family member to dine with them, for instance, or to order from the wine list.

Budget principles are similar to other types of contract, says Granada's Bennett. "We agree a menu cycle with the clienttargeted, for instance, at £6per patient per day, then get customer feedback on the appropriateness of the menu, including advice from dietitians and nursing staff."

So far, none of the contractors have been involved in the Private Finance Initiative (PFI), a £2.5b programme that will build 30 new hospitals over the next few years. The first is only expected to open next year, so it is still early days, they point out.

But with the future expansion of healthcare largely riding on PFI, contractors say they would be surprised if it did not offer opportunities at some stage.

"Gardner Merchant would certainly be interested in being involved in a PFI," says Donaldson, "especially if it was as an equity partner rather than purely as a service provider." n