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day shift catering team are knocking off, if the uptake is huge, there might not be anything left at 2am,” he explains. “It’s important to manage and understand the usage of it.”


The power of three – or four The review also urges hospitals to use the ‘power of three’, in other words, bring together catering, dietetics and nursing to help improve nutritional outcomes for patients. Some Trusts, like Nottingham, have gone one step further, stressing the importance of the ‘power of four’. “Our key partner in all of this is the


patient,” says Chris Neale, assistant head of facilities (City Campus and Catering) at Nottingham University Hospital NHS Trust. “When we were developing our new menu, we went out to the public and said, ‘If you were in hospital, what would you like to see on your menu?’ We had a big media push through local radio and social media, and we were inundated with requests from the public of Nottingham. It’s not about a catering manager sitting around a desk and saying here’s your menu.” The Trust’s new vegan menu was


also developed in collaboration with its patient partnership group, and since it was introduced, uptake has increased 100%. In addition, to ensure continuous


improvement, Nottingham University Hospital NHS Trust undertakes regular meal observations with catering, dietetics and nursing representatives present. “When there’s an audit with just one individual, scores tend to be high – 98% or even 100%. It’s almost like marking your own homework,” Neale says. “When other services are there to challenge – clinical to catering or catering to dietetic – we can better identify things we need to improve on.”


This could be as simple as ensuring condiments are being offered to the patient, rather than sitting in storage slowly edging past their sell by dates, or that main courses and desserts are served separately. “We openly admit that our biggest


challenge is the final nine yards,” Neale acknowledges. “It doesn’t matter what else


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we do – whether it’s sustainable purchasing or high-quality food – if it’s just slopped on a plate and given to someone at the end, you may as well forget about the rest.” Hepburn has seen this challenge


across many trusts. “Food can be cooked in a variety of different ways within the hospital environment, whether it’s off-site, whether it’s cooked locally, whether it’s hot-produced,” he says. “But if it sits around for an hour before it’s served, that’s when it deteriorates. It’s that final bit of service and delivery and the presentation of the food that really helps with the enjoyment of the food.”


Quality over cost One of the big changes Shelley is trying to encourage hospital trusts to make is prioritising quality over cost, as you would, he says, if you were shopping for your own home. “Most hospital teams have a decent budget so I’m saying to anybody involved


with catering procurement, buy as if it’s your own money and buy quality rather than just buying something you think is a cheaper option,” he says. “If you buy quality, whether for staff or patients, they will enjoy the food a lot more, more will be eaten and it will help towards recovery and minimize waste. The public sector is also a great link for local producers that are working really hard, particularly in the current climate, to get back on their feet.” Minimizing waste can also be achieved through the implementation of digital ordering systems. It is an investment, but one that Nottingham University Hospital NHS Trust has seen pay off. “Patients can choose their meal as near to mealtime as possible to ensure there’s no waste, as well as selecting exactly what they would like, down to which vegetables they want on their plate,” Neale says. “When we moved to our digital ordering system, one supplier contacted me to


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