Hospital food and beverage services

Food service Menu planning The Food Chain Home

Menu planning An inclusive process Requires in depth knowledge of the needs of the patient Menu requires structure Menu requires content Menu is complemented with non-meal food and beverage services Home

An inclusive process Nutritional value of food not eaten is nil Need to involve the consumer at the planning stage Need to involve the producer and make sure that plans can be delivered Need to include service staff to engender a pride in the product Need to check nutritional content and menu capacity Need to check cost and affordability Home Start of this section

In depth knowledge of the needs of the patient Age and gender Ethnicity Food preferences State of health State of dentition Mental health Home Start of this section

Menu requires structure How many meals per day? How much choice on offer? Range of accompaniments etc etc Home Start of this section

Menu requires content Home Start of this section What is the most suitable range of dishes? What specification of dishes? What is the most suitable portion size? What is the nutritional specification? What are the ingredients specifications? What are the cost specifications? How will specification be met? Standard recipes Standards of procurement Menu testing Feedback from patients Feedback from staff Nutritional capacity testing Nutritional analysis of menu Home Start of this section

Menu is complemented with non-meal food and beverage services Ward issues of: Milk, breakfast cereals, bread, butter, sugar, preserves, tea, coffee etc Suitable items for between meal snacks Supplements Home Start of this section

The Food Chain Patient orders food Food order communicated to kitchen Provisions procured Provisions delivered and receipted Provisions stored Food produced Food distributed Food served Food intake monitored and appropriate action taken Home Start of this section

Patient orders food Ordered at time of service Ordered using menu card Ordered using hand held device Ordered using bedside terminal Home Start of this section

Food order communicated to the kitchen Ward order predicted by forecasting Card collated at ward level Card collated centrally Hand held linked on ward or centrally Bedside terminal linked by ward or centrally Systems can be linked to nutritional databases Home Start of this section

Provisions procured Ingredients and product specification need to be determined PASA system provides data PASA manages specification of NHS contracts GM free Compliance with salt model Allergen information Nutrition information available Home Start of this section

Provisions delivered and receipted Availability is critical to success Critical control point with regard to hygiene and cost control Food bill in typical 1000 bed hospital c£1.5M per annum C£4,100 per day of perishable goods delivered Home Start of this section

Provisions stored Responsibility for food safety begins with delivery Food poisoning killed 19 people in Wakefield 1985 Poor storage adversely affects nutritional content EHO enforces food hygiene regulations EHO can shut kitchen down with immediate effect Breach of regulations can lead to prosecution Home Start of this section

Food produced Standard recipes are vital: Home Start of this section Nutritional quality control Cost control Quality assurance Home Start of this section

Food distributed Any hospital with more than 300 beds will need to consider distribution technology Cook chill Cook freeze Sous vide All distribution technology requires regeneration at ward level Home Start of this section

Food served Home Start of this section Protected mealtimes Essence of care – food and nutrition benchmark HCA food service at ward level Ward prepared for the meal Patients prepared for the meal Right meal to the right patient Appropriate equipment available Appropriate assistance available and planned for Arrangements in place for last minute changes Home Start of this section

Food intake monitored and appropriate action taken Responsible Registered nurse must be aware of patients intake Systems in place to record food intake for vulnerable patients Systems in place to record missed meals Systems in place to trigger action when food intake deemed inadequate Regular communications with dietitian and clinical team about food intake Home Start of this section