Royal Brompton HospitalSustainable Food

Procurement

Food

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What needs to be done

• Collaboration on a mandatory specification and a standard on for food procurement to one menu for all public food catering services.

• Regional. local or area procurement agreements that all public services can use i.e. hospitals schools prisons colleges and universities.

• Reduce the choice of menu make it simpler and traditional. One national NHS Menu

• Make fresh food cooked daily on site a priority

• OUR OBJECTIVES, SPECIFICATION AND POLICY (past, present and future)

• Local food chain – supporting shorter routes from supplier to consumer

• Influence and maximise the public sectors use of sustainable food and future security of the food chain through collective bargaining.

• Promotes a food strategy for the NHS with an agreement for a base standard and specification. London Trial of 4 hospitals with sustains new food project

• Encourage collectively and collaboration on food chains with all public catering services. (NHS Supply chain does not work)

• Emphasise the healthier option and promote healthier eating for patients and staff feeding

Acknowledgement of Main kitchen with Royal Visitor. Hospital chefs a vanishing breed. Hospitals

built with no kitchens !!! Leads to the individual microwave meal!!!

Royal Brompton Hospital Achievements

• 36% of all food and food related procurement is now sourced from a radius of 50/80 miles in the South East. This % will increase yearly.

• We have established that local and seasonal food has a better taste and healthier -supported by high patient satisfaction. We are in the top of best performing trusts for food and service Quote CQC 2011

• Fresh local food cooked on site has improved the plate wastage figures - more is eaten.

• All fish is now Marine stewardship awarded through procurement from a London Fish Wholesaler

• Standards have been increased by buying better quality food less wastage. Meat quality is higher than the UK Meat buyers guide

• All bread comes from a north london bakery

Achievements in London

Seven other Hospitals now work in collaboration in procuring high

quality meat and meat products, local seasonal vegetables, free range eggs, organic milk and

orchard fruitNext steps

A London NHS Sustainable Menu

Our local suppliers• Our local farmers and small businesses are now

colleagues and discussions on food are through local agreements, based on keeping costs within budgets, developing collective partnerships on security of food, having less deliveries

• Formation of menus are now discussed with what food and commodities are available locally and grown seasonally

• Local food is definitely healthier. Must be an important part of the NHS plan to improve the nations health reduce obesity in adults and children. A healthier nation reduces the high cost of treating patients

Who should determine the future Hospital menu ?

• Firstly it should be the patient/customer the patient satisfaction will be the number one governments objectives.

• Secondly the menu should reflect what is available locally and seasonally and discussed with the local farmer/grower/ small business

• Thirdly and lastly the Catering Manager/dietician/head chef. The budget must be calculated at this stage

• The client then has the ultimate choice

Local Food at its best

• Venison, game and wild rabbit• Essex and Hertfordshire Free range eggs and local bacon• Bedfordshire and Hampshire Organic milk and organic porridge oats• Seasonal orchard Kent fruit and juices• Soups are freshly made local commodities daily• Forequarter meat butchered for roasting• Freedom food chicken • Organic burger and additive free sausages• Whole breast meat chicken nuggets• Asparagus in May and June Seasonal strawberries only • Food with no preservatives or modified ingredients• Potatoes grown in Kent for the Trust• Sausages made from local ingredients to an agreed recipe

Why a single menu• Cheaper local food• Better specification• An agreed portion/s• An agreed basic

commodity• An agreed basic meal

cost nationally• A more professional

Service to our clients• Reduces costs of printing• Helps development that

in house preference

1.Collaboration improves future security

2.The buying power increases

3.Determines and agrees a specification

4. Better quality and taste of food.

5. A national or regional menu is vital

6. Puts good food on the plate mandatory nationally

• Those Important Sustainable Changes made to the Menu and Service at the Royal Brompton Hospital.

• Cooked breakfast introduced – Medical advice- most important meal of the day – providing a substantial start to the day and introduces 20g extra protein to the diet

• A lighter bistro style lunch with one main course and a sandwich or salad alternative.

• Afternoon tea a traditional English custom

• A later supper dinner menu which is more substantial and served later so that it reduces the time until breakfast

• Recommendations to the HCA for national lead

NHS Catering Service Statistics • There are approx 138,074 available beds in English hospitals. At

any one time they are 85% occupied • 75% of these occupied beds have patients who are actually able to

eat ( 117,363 ) • The average cost of providing a catering service is £13 per patient

per day. Equates to approx £10 million or over £500 annually• The NHS Supply Chain (DHL) calculate that with one menu the

procurement savings per annum would be approx 10-15% or at least £50 million saving.

• Introducing local seasonal sustainable procurement this would result in £180 million being spent in the local farming and local business environment and according to our figures every £25 spent locally £19 goes direct to the farming and small business

One single menu ??

• Produce a weekly menu that can be altered.• On line to an agreed template• Average patient in an acute hospital stays 5.5

days• One does not open the fridge and a menu

jumps out• Cycled menus portray a poor standard of food

get menu fatigued and a disinterest in food

Budgets will be even more tightMenu will need re visiting Most important meal is the breakfast

A cooked breakfastcost 85p -1.20p

A lighter bistro style lunchcost 95p – 1.30p

A more substantial evening menu served later in the day

cost 1.25p -1.70pThe minimum requirement for

Total cost per patient per day 3.575p (at least)

plus beverages and snacks £5.00

Developments at the Brompton

• food waste is now collected for composting

• Vegetable oil is collected for bio use

• Bottled water is done on site

• Cashless system for staff to improve income

Issues / Barriers

• Poor catering budgets• Delivery of local produce to London can be

expensive done as individuals• Lack of enthusiasm from main suppliers to

alter the way they source their produce• Initial low volumes of products can be

improved by collaboration with other government facilities.

• Security of the food chain must be sustainable.

Learning Outcomes

• The importance of taking a ‘step by step’ approach in altering menus

• Take the initiative - willing to alter suppliers to those who will provide more local/organic food

• Work closely with suppliers to assist them wherever possible i.e. reducing deliveries

• Gaining support from catering team is vital Having a passion and determination to improve and supervise/monitor that agenda

Improved patient satisfaction• Royal Brompton Patients say that food

satisfaction is 23% higher than the national hospital average.

• Food cooked fresh every day on site enables flexibility of service patient is able to have a meal outside the meal times

• Recipes use ingredients mainly from a sustainable source this is promoted.

• Food is cooked as near the mealtime as possible. No frozen plated meals

Future

• National NHS Menu for all hospitals to standardise food to an acceptable level

• Local procurement and specification for all food and an organic alternative

• Seasonal food only supporting the British farmer and suppliers

• Collaboration on purchasing reduces costs by 10% nationally on a budget of £500 million would save £50 million

Contacts

• Mike Duckett MBE FIH Catering Services Manager m.duckett@rbht.nhs.uk

• Direct line 020 7351 8433• Address• Royal Brompton Hospital• Sydney Street• London SW3 6NP