Jelly in their bellies

There can be few tougher or more rewarding catering jobs than the one done by Jane Verey and her team at Birmingham Children's Hospital. Her customers are not just hungry and ill, they are often frightened. So the challenge is not just preparing the food, but also getting it eaten.

"This is a brilliant job," says Verey. "I want to stay here forever. All the catering staff do. We're not just the hospital caterer, we're sometimes the stand-in mum and dad. We get to know the children by their first names. It's like cooking for your own kids."

Yet putting the emotion to one side, as catering manager for Gardner Merchant Healthcare, Verey knows she has a business to run. "This hospital was only converted to a specialist children's hospital in May last year. Before that it was a general acute hospital with an in-house catering team. We're obviously being watched to make sure we deliver the best possible service."

Gardner Merchant has a five-year contract at the hospital. It gets an undisclosed daily patient allowance from the hospital from which it has to buy the food, cook it, then deliver it to the ward. The serving of food is done by nursing staff. The daily feeding allowance is to provide lunch and evening meals plus up to 56p of "tuck shop" snack foods such as chocolate bars, fruit and salted snacks, which are held on the ward and which the kids can have when they want.

Breakfast is Continental and run entirely by the nursing staff, though they buy most of the breakfast materials from Gardner Merchant. Because children can get hungry at odd times of the day, Gardner Merchant also provides sandwiches, which are paid for by the hospital as an extra cost.

With a tight staffing level of only 34, Gardner Merchant manages to provide its breadth of service by having flexibility of labour in the kitchen and cook-chill foods bought in from Gardner Merchant's subsidiary, Tillery Valley Foods.

While the hospital's up to 200 staying patients plus day patients are all categorised as "children", it invariably means a range in ages from birth to 16, which, in turn, requires a diverse menu structure. "You can't offer a 16-year-old Mr Men potato waffles, yet we need them on the menu to encourage the very young to eat something."

Comfort foods

There are no nutritional rules banning child-friendly comfort foods. "They can have chips and tomato sauce every day if they want. Why stop them? That's what they'll have when they get back home, so why try and change their diet in just a few days? The important thing is to make sure they eat," says Verey.

That is also the attitude of the hospital's head dietitian Anita MacDonald, who works with Verey on devising food for the three-week menu cycle. Healthier options are always there on the menu, but if it's the difference between burger and chips or nothing at all, the catering staff will serve burgers.

Another child-friendly aspect of the feeding is to recognise that kids often want to "graze", eating snackier items but more regularly than three times a day. "It wouldn't suit a big acute hospital to have patients eating at random times during the day, but we've adapted to it here. It only takes a few minute to make a sandwich. You just can't regiment kids in the way you can with adults," says Verey.

The menu has just undergone one of its periodic revamps by Verey and dietitian MacDonald. There has been a cutback in the amount of vegetarian dishes - "they just don't like them," says Verey - and an increase in sandwich options. Menu items are chosen from a mixture of feedback from ward staff, parents suggesting favourite foods, watching plate waste, and the first-hand knowledge of the catering staff as parents themselves.

Each ward food order is delivered in bulk-service format, using foil trays holding four or eight portions. Catering staff assemble each ward's order in a chilled assembly area in the kitchen, loading them into Colston multi-temperature regeneration trolleys. Regeneration is done in the kitchen just before service time, then the trolleys are taken up to the wards and plugged in again to stay hot.

While some wards might have little patients with little appetites, there is no increase in the number of portions served from a standard tray of food: eight portions remain as eight portions. Neither are the portions packed by Tillery Valley deliberately made smaller. Special diet meals (such as sodium-free or flour-free) are cooked from scratch in the diet kitchen.

Nurses choose

Meal-choice pre-ordering is a nightmare. "It just doesn't work to ask a small child to order their meal in advance. They forget, or they change their mind. The nurses do the ordering for them by looking at the menus and using their instinct and knowledge of their patients on what to order. They know what their kids will or won't eat," says Verey.

When the food reaches the wards, the nurses explain to the kids what they have got today and ask what they fancy. While the Patients Charter has a target of no more than two meals having to be chosen in advance, at Birmingham Children's Hospital the choice is made at the point of delivery.

As well as ward service, there is a small cash cafeteria run by Gardner Merchant. Although mainly used as the hospital staff restaurant, visiting parents also use it. The menu here is conventional cafeteria food and is not subsidised.

Typical menu items are a £2 fixed-price lunch with a hot main course such as chicken pie, potatoes and vegetable. In the evening there is a cheaper fixed-price hot meal at £1.50, which, typically, might be pizza or sausage, chips and beans. In addition to the fixed-price meals there are roast meats, dishes such as lasagne and cold snack items.

As it is a children's hospital, the catering staff never miss the chance of having a party. "If it's a birthday we'll make a birthday cake and do all the little bits of party food kids expect at home. The whole ward is at the party," says Verey. "We did a party recently for a patient who was making her 100th visit to the hospital." There are also lots of product-promotion items that come in from suppliers. "The suppliers are very good - we are always getting phone calls asking if we want things." n