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Public sector focus: Red tape rules are hard to swallow

01 May 2015 by
Public sector focus: Red tape rules are hard to swallow

Food is one of the highest priorities in hospitals. Used effectively, it can help patients recover quickly, making the role of the caterer as important as the role of the clinician.

After all, we know that food is the best form of medicine, and when you are ill, whether it is in hospital, in social care or even your own home, you look for food that will not only help you get well again but also provide comfort. We all have our favourite food when we are unwell, be it a bowl of soup or rice pudding, and in the first instance we gravitate to these comforting foods that will make us feel better.

Then, as recovery progresses, we look for more nutritious foods that will help us further. But despite this, such comfort food is just not possible in some hospitals. Or, if it is 'allowed', we have to ask so many people - from health and safety to the fire officer - just to serve a slice of toast. It's sometimes easier just to say no, which will never do for the Hospital Caterers Association. Any NHS hospital doing this should be named and shamed.

Similarly, you can't just quickly nip out to get that tin of beans or rice pudding so coveted by a patient, because you have to request permission to do so beforehand. This is clearly ridiculous.

The good news is the Hospital Caterers Association is leading the way, driving change and seeing improved direct communication between the wards and kitchen. But this is not the norm. I want caterers to be allowed to lead the menus, to be informed by patients' feedback and requirements, and gain input from the clinical teams and dietitians. However, this is just the beginning, not the end.

We all hear a lot about local, seasonal food and I have championed this. Whatever systemwe operate, getting a seasonal menu in place should be simple. So why are we not doing it?

Enter red tape again. A change to the menus can often mean a wait of weeks or months. The dishes have to be checked by up to six people in various departments, including the caterer, speech therapists, dietitians and finance - yes, finance. By the time we get agreement, we are into winter, and it was April when we began! We need to speed the process up. But all this red tape could be easily overcome if caterers just took the lead and worked with patients on what they want on their menus, then worked with dietitians to agree that the menu meets the standards set by the British Dietetic Association.

This process can be simplified by making quick changes that can be done regardless of the system the NHS Trust operates (see box) on menus. Suppliers sometimes apply/hide behind red tape to dissuade us from using seasonal products, and we need them to make them more accessible - in fact, to champion them, and it's also a way for us all to support British suppliers.

How do we do this? By working with and listening to patients to ensure we provide the menus and the dishes they want to eat. That can vary according to the patient group, because one size does not fit all. We must also look at the words we use. I believe we have become 'too posh to nosh'.

Why do we have creamed potatoes on the menu when we all call it mash at home? Simple and familiar words can make a huge difference to patients, especially the elderly.

One of the key elements here is ensuring that we have seasonal menus. The Buy British idea is part of the Government buying standards and this could easily be met if we look at seasonal menus, which also allows us to keep them refreshed.

When I was young, we didn't have jacket potatoes all year round. To me, they signalled that autumn and winter had arrived. Then Christmas came and we had turkeys and satsumas.

These are the things we need to get back to. Strawberries for the patients in summer; English apples in autumn. We must all also think about
what ingredients are suitable. English asparagus is a springtime food, but is it something that the general population would eat? If it is, we should put it on the menu; if not, we need to look at the alternative ways of using that product - maybe in a quiche, which is very nutritional.

It's about putting calories into patients who need them to get well and recover. Patients' food is all about eating for good health and we need to focus on that. This is something this association has driven through in the various guides we have published and we are very proud that our Ward Guide is included in the Government's patient-led assessments of the care environment.

To me, the patients are my customers and the customer is always right. We must listen to what they want. After all, there are not many catering establishments or caterers who can actually say to their customer: "Well, I hope we don't see you again".

This is the ethos I want to foster. I don't want to see patients coming back into hospital as, these days, with modern medicine, it means they are usually really ill.

Going with the seasons

Fruit - don't name the type, just say seasonal fruit, so in summer we use soft fruits, in autumn we have English apples

Vegetables - don't name them, just say seasonal vegetables

Soups - soup of the day

Desserts - chef's special

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