If you’ve ever been in hospital, there’s a good chance that the one thing you look forward to – apart from visiting times – will be breakfast, lunch and dinner. As Cathy Griffiths, senior development technologist at apetito, says: “If you’re poorly or recovering, mealtimes can be a perk in the day.”
With so much anticipation around mealtimes, it’s essential that hospital food lives up to patient expectations, and the quality of what’s served is vital. Good nutrition is an important component of health and wellbeing and even more crucial in a hospital environment.
Creating hospital menus is a complex task as there are so many factors to take into consideration. Andy Jones, former chairman of the Hospital Caterers Association, explains: “One size does not fit all, because you’ve got different cultures, different age groups, different types of patient.”
As well as meeting the range of ethnic and cultural needs of the diverse population hospitals have to treat, other issues must be taken into account, such as conditions and treatment regimes that may suppress appetite or hinder swallowing, all leading to the greater risk of malnutrition.
While taking all these issues into account, hospital meals must also be tasty, nutritious and enjoyable so they can enhance patient recovery.
To ensure hospitals are meeting the needs of their patients and offering food that will influence health and recovery, menu creation has to be a collaborative process. A team of specialists, including caterers, dietitians, speech and language therapists, nurses and even the food supplier, such as apetito, will be involved at various stages.
For example, a stroke patient may also suffer with dysphagia, which means they have difficulty swallowing – there is greater risk of choking or even aspiration pneumonia with this condition, meaning an appropriate meal with the right texture is vital. Being able to develop and provide specialist meals to meet the needs of these patients and that adhere to national guidelines is a priority for apetito and working with speech and language therapists is essential.
Julia Pockett, a speech and language therapist, explains: “A patient with dysphagia may be recommended to have a puree diet or mashable or soft food depending on how their swallow is after assessment. Taste and presentation are very important – food that looks inviting, appetising and tastes good.”
An understanding of patient needs is central to the process. The apetito product development team are constantly working with their own dedicated dietitian and registered nutritionist, who in turn are constantly communicating with hospital caterers and healthcare professionals, to understand those needs – this allows them to develop meals that benefit and appeal to a wide range of patients with varying needs, whether that be an elderly patient who may be malnourished and requiring an energy dense meal or a younger post-operative patient needing high protein options.
They then use a sophisticated computer software system that can display the nutritional content of ingredients, allowing the apetito chefs to prepare each recipe to precise nutritional standards – in line with British Dietetic Association (BDA) guidelines.
This attention to detail is important because, as Amanda Squire, a lecturer, dietitian, and spokeswoman for the BDA points out, the kind of healthy diet devised for the population at large may well be inappropriate for a hospital patient: “While many of us are looking at lowering calories or a balanced five fruit and vegetables a day, that isn’t always the case for patients. Somebody who’s been through surgery or major trauma is going to have extremely high protein requirements to aid their healing and their recuperation.”
Caterers and food manufacturers not only have to think about dietary and nutritional requirements but also consider the food preferences of different groups of people. “The big challenge is inter-generational,” says Squire. A patient in her 80s will likely have very different tastes from a child of six.
Some ethnic minority groups may require a halal, kosher or vegetarian diet. Then there is the challenge of allergies and food intolerances. “Allergies are growing,” says Jones. “Young people have got more allergies than people towards the end of their life now.”
Once a meal has been researched, then created in the development kitchens, it will then go through rigorous trials and testing with customers.
Sessions are arranged with hospital trusts where staff, visitors and contract decision makers can taste the food and offer feedback. There is also a monthly quality review of products, says Griffiths: “We’re trying all the time to make sure that we’re meeting all of our quality criteria and exceeding them, and [if] that isn’t the case, looking at how we can improve things.” In the last six months, the firm has reviewed every product in each category to make sure it meets quality standards.
The final stage of the process is manufacturing and delivery. But before they can be delivered, a batch of every meal is put through rigorous testing in apetito’s state of the art microbiological laboratory – which is independently approved by the Campden Laboratory Accreditation Service. It is only once these tests have been completed and the satisfactory results achieved, can the meals be positively released, ensuring only “safe food” is delivered into the NHS. These high standards of testing can only be achieved with the frozen food system apetito operates.
Griffiths says: “The frozen delivery system means that everything is harnessed at its freshest … we lock in that freshness. The finished product is then frozen and delivered into the hospital trust in its frozen state, so from a hospital perspective there’s very little wastage.”
It’s a process that makes sure that the most important person – the patient – is always at the centre.
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