The short answer would be that quality of food in hospital impacts on care in a variety of ways. Malnutrition (which in a hospital context generally means under rather than over-nourishment) affected 24% of adults on admission to Scottish hospitals according to a BAPEN (British Association of Parenteral and Enteral Nutrition) survey published in February 2014. While this was the lowest prevalence of all UK nations, it highlighted the necessity to make further improvements.
You can download the BAPEN Survey here.
Under-nourishment on admission is a particular problem, given nutritional status can often decline further during the hospital stay. Mainly, this is because acute illness or injury can impair appetite, swallowing and intestinal absorption. It is therefore highly important that patients receive effective, regular nutritional screening to identify their nutritional needs. They then must receive nutritionally appropriate food that incorporates any specific dietary requirements (e.g. allergies, texture modification, cultural preferences, personal preferences…) to deliver their needs. Food in Hospitals, published by Health Facilities Scotland (HFS), sets standards for nutrient and food provision for patients within hospitals, and provides practical guidance on how these standards can be met. Since 2009, HFS have published reports every six months on NHS Board’s mandatory compliance to their Food in Hospitals document. The first recorded compliance report (July to December 2009) showed 87.0% compliance. The last published audit (January to June 2015) revealed 96.5% compliance to standards across Scotland.
Palatability and aesthetics of hospital food are also of vital importance. When food is appetising, patients want to eat it, and this can then help improve their clinical condition. These qualitative components of hospital food are harder to define, and patient satisfaction is an important measure. The inpatient patient experience survey 2014 is one such example. This identified both areas for improvement and areas of strength. Recent events like Monklands Hospital’s food tasting allow patients, visitors and staff to sample the food served on wards each day, sample potential new menu additions and more generally give their views on what they want. This initiative is one example of the on-going work to support continued improvements in the quality of hospital food, at both a Board and national level.
The healthcare costs of managing individuals with malnutrition is more than twice that of managing non-malnourished individuals, due to higher use of healthcare resources. Malnutrition is complex and multi-factorial, and patients often present symptoms or are at risk prior to admission to hospital. However, NHS hospitals can aspire to mitigate this by providing food that is tasty and of high nutritional quality. Above anything else, food should be available, eaten and enjoyed. It makes prudent financial sense to address this issue, to help achieve and maintain a sustainable, value driven health service and eliminate food waste. Maximising opportunities for patients to eat, and maximising the quality and choice of food are seen as crucial to improving intakes. This necessitates adept, close collaboration between catering professionals and healthcare professionals, if all hospitals in NHS Scotland are to become exemplars of high quality food provision.
Guest author Kyle Malcolm – Policy Officer at the Scottish Government