Hospital food: enough to make you sick?

Hospital food – enough to make you sick was the provocative title of one of the talks in Food Matters, a new series of talks at Bloom this year. The expert panel of speakers included a food writer, a dietitian, a food scientist and an endocrinologist.

Having spent quite a bit of time in hospital recently, food writer Biddy White Lennon was first to air her views. "The food is blooming awful in hospital – unappetising, dull menus which are inedible at times. There was a lot of frozen vegetables, white sliced bread, packet sauces and soups and artificial cream. The meat was overcooked and the fish served in crumbs. Apple crumble was one of the few highlights," she said.

White Lennon’s single biggest issue was the temperature at which the food was served at. “I was immune compromised for a lot of the time and I felt I was getting luke-warm food that had been lying around for hours. I even took out my food thermometer to check the temperature in some cases,” she said.

There are strict regulations about the temperature at which cooked food has to be kept hot, which environmental health officers are tasked with checking in all food establishments.

"We need to change our perceptions of hospital food," said Samantha Cushen, research dietitian who formerly worked at the NHS in the UK as a hospital dietitian. Cushen believes there is not enough emphasis placed on food as part of the treatment in hospital.

“We need to help patients and health professionals understand that food is part of their treatment in hospital,” she said at the event. Cushen said that there were standardised guidelines about the nutritional content of hospital food but these guidelines needed to be enforced.

Routinely screened

Prof Donal O’Shea, consultant endocrinologist, explained how everyone going into hospital was now routinely screened for malnutrition. He also spoke about the initiative in which patients’ meal times were protected, which means that ward rounds and visits from health professionals can not take place during mealtimes.

Prof Mike Gibney, food scientist at University College Dublin, said his biggest concern was people going into hospital already malnourished. "Malnutrition is one of the more frequent reasons for admission to hospital in older people. It also leads to more complications and readmissions," he said.

Gibney said the issue of hospital food was complex because it included food procurement right up to overseeing the consumption of food. Cushen agreed.

“Menu planning is very important and different types of nutrition will be needed for patients in different wards with therapeutic menus for some patients,” she said. “We also need texture modifications for patients who’ve had a stroke, pictorial menus and food for people from different ethnic and religious backgrounds.”

All panellists agreed that much more could be done to improve the quality of the food used in hospitals. The policy of national procurement of food means that food is bought in large quantities and then distributed to hospitals.

There is a vegetable garden at St Columcille's Hospital in Loughlinstown. Put in place with the help of patients, the main function is to encourage people to eat more fresh foods, said O'Shea. The produce from the garden is used in the cookery classes led by dietitians at the hospital.

“There should be more options for local procurement of food. For example, in St Columcille’s, we could source local eggs from Wicklow,” he said.

Cushen added, “I think there should be more diversity in the procurement of food, and hospitals should be able to control their own food budgets.”

Inspiration

Ross Golden-Bannon, member of the Irish Food Writers Guild, chaired the debate on hospital food at Bloom on behalf of the Grow It Yourself movement. He said the experience in Denmark could be an inspiration to Ireland.

"Copenhagen city has become completely organic and while it was expensive at first, they are finding that people are not getting as sick."

O'Shea is optimistic that the Healthy Ireland initiative could bring positive changes in the long term. "I'm also concerned about the poor quality food that is served to visitors and what's in hospital vending machines. It's like the Road Safety Authority – it will take 10-15 years to improve things."

HSE response - Margaret O'Neill, National Dietetic Advisor in the HSE's health and wellbeing division:

As part of our Healthy Ireland implementation plans at hospital group level and with the support of the acute hospitals division and the health and wellbeing division, we have two key projects underway in 2016: the development of a food and nutrition policy and implementation plan for hospitals.

This will support all hospitals, through their nutrition and hydration steering committees to provide leadership and promote and sustain improvement in relation to nutrition and hydration – including nutritional analysis of menus, protected mealtimes, malnutrition screening, therapeutic diets and assistance with eating as well as the healthier food environment .

We want to provide a forum to share best practice between hospitals and drive the improvements where they are needed.

The second project involves working with the Department of Health through their national clinical effectiveness committee, to develop a national clinical guideline for prevention and management of under-nutrition in hospitals.

This will ensure malnutrition screening and assessment is in place and appropriate early identification and referral on to services when required.

Calorie posting on menus and the HSE healthier vending policy is also being implemented this year.