Following his TV series Operation Hospital Food, top chef James Martin said it would be a lifetime’s work to help patients across the country get good quality, more sustainable food. For William McCartney, catering manager at Sussex partnership NHS foundation trust, it’s almost proving a lifetime’s work to do this just where he works.
As NHS England announces it wants to cut corporate junk food at hospitals, McCartney is proud that there are no Burger Kings on site at the 16 hospitals he works with. Neither do they reheat frozen packaged factory meals, as is often the case with hospitals tied into long-term contracts with outside caterers.
Almost all of the 2,500 meals served daily are made at a small kitchen on-site at Amberstone hospital in Hailsham.
In post for 20 years following an earlier career which included a food quality management role at Unilever, McCartney is on an ever-evolving mission to provide his patients with healthy, fresh food from local farms and suppliers.
His effort is persistent, trying to log every item and ingredient in the supply chain along the way, always looking for better alternatives. But it’s meant Place (Patient-Led Assessments of the Care Environment) surveys show that around 90% of patients are happy with his team’s meals. No mean feat when the Campaign for Better Hospital Food claims that around 400,000 hospital meals are thrown away every day.
“We can get salad leaves harvested at 4am from three miles away and on patients’ plates by lunchtime; raspberries, strawberries and recently blueberries from down the road,” says McCartney.
There is big emphasis at the trust on food’s role in recovery. “Food is medicine. We’re a mental health trust with patients suffering from serious illness including substance misuse, anorexia, depression or psychosis. Patients can be with us for years and sometimes food isn’t a priority for them,” he says. “We want to give them plenty of choice and variety so that eating is as enjoyable as possible.”
Sittings take place in homely dining rooms and often family will join the patient at the table.
“It’s important for us to listen to what feels good for them. One patient really liked prawns so we brought them in. Some of our younger patients weren’t eating our apples, but we noticed that if we had a batch of smaller apples, they liked them, so now that’s what we provide.”
The menu runs on a six-weekly basis, so that long-term patients get variety. Dishes include, for example, beef madras and pork blanquette, all made with mainly fresh ingredients from a 70-mile radius.
McCartney has forged close relationships with local farms and food companies, sometimes even helping them develop infrastructure to supply him. He prefers these to bigger suppliers suggested by the government. They’re an adequate, easy option because they automatically comply with various regulations such as HACCP (Hazard and Critical Control Point Analysis System), he says, but he finds there is little attention to sustainability and little value for money.
“For example, we were using a government-listed supplier for our yoghurts, which cost 38p each. The company was bringing in tankers of milk from abroad to produce the yoghurt and call it ‘British’. We have now switched to a company using dairy cows in the south-west of England (the number of dairy herds in Sussex is rapidly decreasing) and the yoghurt is made locally in Patcham, costing 16p–18p per portion.”
A local butcher which has been given an A grade by BRC Global Standards – a leading safety and quality certification programme – is used, with Red Tractor-certified meat coming from across the south of England. “Everything can be traced. We had no panic when horsegate broke,” he says proudly.
In total, feeding each patient, including ingredients, labour, delivery and energy costs, comes to around £7.50 a day, which McCartney feels is more than reasonable. The most recent surveys show the average figure to be about £9 in the UK, with some hospitals spending just a few pounds and others more than £15.
Place stats show it’s not unusual for mental health trusts and hospices to score around the 90% mark when it comes to patient satisfaction with food. McCartney believes there’s no reason why acute hospitals can’t raise standards with some collective effort and knowledge-sharing.
“I’m lucky that the chief executives I’ve worked with have allowed me time and space to develop what we do. The Hospital Caterers Association has a lot of knowledge that can be tapped into,” he says.
“Hospitals need to question suppliers regularly to encourage them to lift standards. Let them know what we expect. We have KPIs and we look at what we’re getting from whom and all our costs very frequently, it has to be done to get the best value for patients. Hospitals need to take ownership if they want to do this.”
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