SEPTEMBER/OCTOBER 2020

THE PATIENT THE WORKFORCE THE VISITOR

SEPTEMBER/OCTOBER 2020 Off to a good start With healthy & nutritious ideas for the best breakfast The gut-brain connection Exploring the relationship between diet and mental health

On Site with St Richard’s hospital in West Sussex and the new CPU

Dealing with COVID-19 and its impact on hospital catering staff and services

Contents SEPTEMBER/OCTOBER 2020 Regulars Features

11 HCA Comment 16 DAIRY PRODUCTS HCA Chair, Craig Smith recognises the A look at the role dairy products can play in countering malnutrition work of hospital caterers on the front line and boosting the immune system with details of some of the latest during the peak of the yogurt ranges for healthcare

12 On Site 20 DYSPHAGIA We find out about the new central Texture-modified meals have come a long way in a short time and production kitchen at Western Sussex are continuing to develop with the latest innovations including rice Hospitals NHS Foundation Trust, the moulded dishes and much more subject of significant investment in patient catering 26 WAREWASHING The latest developments in warewashing technology and advice 24 Palate Pleasers around the choice of chemicals, water treatment and maintenance Who doesn’t love a pizza … it’s a high street favourite and it’s also versatile, 32 BREAKFAST & MORNING GOODS adaptable to trends and different meal with wholegrains and optional added , nuts or seeds; occasions toast and premium breads; English muffins and American pancakes are all discussed as we look at the most important meal of the day 36 Top Table Glenn Roberts, Sales Director of 38 IMMUNE HEALTH Winterhalter UK, discusses how Kerry Taste & Nutrition shares the findings of recent research around connectivity has enabled them to identify the consumer’s growing interest in food and drink to boost their six common mistakes made by kitchen immune health staff that could damage warewashing equipment 20 40 Nutrition Marlene Watson-Tara, a health counsellor and author explores the relationship between what we eat and mental health - the ‘gut-brain connection’

42 Discovery Den The pandemic has had a significant impact on healthcare workers and the role of staff such as caterers has been widely acknowledged; we look at some of the outcomes - positive and negative - as a second wave of the virus starts to sweep the country

47 NHS Supply Chain In-house dietitian, Joanna Instone, discusses food and nutrition in the context of COVID-19 and initiatives NHS Supply Chain has introduced to help ensure patients receive the nutrition they need

50 The Vole Hospital Food + Service pays tribute to Mike Duckett, who has written this column since the first issue of the magazine in 2015 and who sadly passed away in April

September/October 2020 | Hospital Food + Service 3

WelcomeTo Hospital Food & Service

It’s good to be back, although life is far from ‘normal’ and anyone working in the health and social care sector knows there are some tough times ahead. As we began to ease out of lockdown I was this project, including how it was delivered by work visited by the ‘apetiser’ and the team from stream teams led by professionals at the Trust. apetito sampling some of their new meals in The link between mental health and diet is the Culinary Inspirations range as well as the discussed in our nutrition column (p40-41) and texture-modified fish and chips - with chips that food to boost immunity (p38-39). These are both are browned and have that chip shop taste of fascinating subjects, about which I think we will be vinegar! hearing much more in the months - and years - to The appetiser is a mobile presentation suite come. that has been specially developed and fitted out We are still unable to bring you any news of to provide customers across health and social the ‘Root and Branch’ review. I understand its new care the opportunity to enjoy socially distanced launch date is imminent, but times at the moment presentations and food tastings. The appetiser is are unpredictable and as infections escalate it is travelling around the country, so watch out for it always possible that it will be delayed again. This arriving in a car park at your hospital site. would be unfortunate, because if the pandemic has There is reference to COVID-19 throughout this taught us anything it is that food really is medicine issue as the virus has highlighted the importance and hospital catering and the teams that deliver it of good food and nutrition across the board. In the should be provided with the tools - resources, skills November/December issue of Hospital Food + and support that they need in order to deliver a Service we are planning a feature to focus on food, first-class service. The politicians have been making nutrition and obesity in relation to COVID-19. In this the right noises, now is the time to see that turned issue, Discovery Den (p42-44) takes a detailed look it into action. at the impact that coping with the virus has had on As always, I am interested in hearing from healthcare teams. NHS Supply Chain advises on any readers with interesting stories to tell or some initiatives they have taken to make it easier information to share - either as a result of Covid or for catering teams to compare and choose the right completely unrelated. Do please contact me. products for their patients’ nutritional needs (p47). Our On Site feature (p12-14) was organised before the pandemic took hold and lockdown arrived. The new central production kitchen at St Richard’s hospital (Western Sussex Hospitals NHS Foundation Trust) was covered in national news earlier in the year as it was visited by Health Editor Secretary, Matt Hancock. We have more detail of [email protected]

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September/October 2020 | Hospital Food + Service 5 News

Intensive animal farming claimed as most risky human behaviour for

The ‘Food & Pandemics Report’ produced by reinforcing ways. This is through the destruction of the ProVeg International, has identified the ’ natural habitats and loss of biodiversity, the use and farming of animals as the single most risky of wild animals as food and the use of farmed animals as human behaviour in relation to pandemics. It calls food in intensified animal . for urgent changes to the global food system in Around 75% of all emerging infectious diseases are order to prevent future outbreaks. zoonotic in nature. The report finds that dietary choices and the global The report also highlights the impact of climate food system are the key drivers of ‘zoonoses’ - diseases change, which increases the risk of future pandemics, and such as COVID-19, which are transmitted from non- antimicrobial resistance, which exacerbates their impact. humans to humans - in three clear and mutually Both are driven by our animal-based food system.

ISS supports winter wellbeing with new strategy

The Food Services arm of ISS’ UK business has published its renewed health and wellbeing strategy, created to support its customers in workplace, education and healthcare retail environments in staying well this winter and into the new year. The plan, which focuses on supporting physical, mental and emotional wellness, is designed to provide both adults and young people with health and lifestyle nudges and guidance as part of a holistic approach to wellbeing. With COVID-19 continuing to impact peoples’ lives, ISS is keen to play its part in supporting customers to build strength and resilience, particularly as the colder weather draws in. ISS has built its approach upon three pillars - ‘Eat Right’, ‘Live Well’ and ‘Go Green’ - each of which is plans to address current public health challenges supported by a bold pledge and series of commitments. and align with broader campaigns. These include the Many of the endeavours described in the strategy are Government’s Obesity Plan, National Food Strategy and well underway; ISS has reviewed and evolved its existing the newly released salt and calorie reduction targets.

6 Hospital Food + Service | September/October 2020 News Adjusting total protein intake helps build ageing muscles when switching to a -based diet

Research presented to The Physiological Society’s Future Physiology 2020 conference shows that a larger dose of soy and wheat proteins is required to achieve a comparable response of building muscles to that of animal proteins in people following a plant-based diet. The research outlines that animal proteins are Future of Food insight report more effective than plant proteins in supporting the maintenance of skeletal muscle mass with advancing age. Simply transitioning from an animal-based protein The COVD-19 pandemic has exposed serious flaws in the diet to a plant-based diet without adjusting total protein UK food system according to a new study carried out by intake is likely to be detrimental to muscle health during Veris Strategies in collaboration with 25 food industry and ageing. A more balanced and less extreme approach to experts. changing dietary behaviour, meaning eating both animal From supply chain disruptions to inadequate conditions in and plant-based proteins, is best. manufacturing facilities and in the living conditions of workers, the flaws, if not rectified, will leave the food system in a poor position to deal with the long-term effects of the pandemic. Key messages contained within ‘Building Back Better: Fixing the Future of Food’ include a ‘reimagining’ of the social contract between consumers and food businesses with more help for disadvantaged people and more inclusive workforce policies, and showing more regard for the consumer’s health, which dovetails with the National Food Strategy focus on addressing food inequality and eating well. The report envisages food businesses playing a greater part in guarding against obesity and the threat of a second wave. Other points in the plan of action focus on the need to relocalise, add resilience and responsibility and to redefine and reimagine businesses to cope with the ‘new normal’.

Natasha’s Law Technical Guidance published

The Food Standards Agency has published a Technical Guidance to help food businesses to comply with new allergen labelling requirements due to come into force in October 2021 (Natasha’s Law). The guidance, which was expected last October, provides more information on the new legal requirements for all businesses and organisations affected, which includes hospital caterers. Natasha’s Law aims to provide more protection for From October 2021, all PPDS food must contain, on millions of allergy sufferers by strengthening current the packaging or a label attached to the packaging, regulations around allergens. both the name of the food and an ingredients list, Currently there are no requirements for foods that are including allergenic ingredients. These must be prepacked for direct sale (PPDS) on the premises from emphasised every time they appear in the ingredients which they will be sold to display allergen information list, for instance, by using bold or different coloured on the label. Such foods include sandwiches, baguettes, type, underlining or capital letters. rolls, wraps, salads and other items that are prepared and These new regulations do not apply if the sandwich packaged before placing in a retail unit chiller cabinet for (or other item), is prepared to order in front of the sale to the consumer. consumer and then packed at the consumer’s request.

September/October 2020 | Hospital Food + Service 7 News

Build resilience with shorter food People Plan puts staff supply chains wellbeing at its heart

Shorter food supply chains can make the UK more resilient The NHS People Plan - ‘We are the NHS: People Plan in the face of pandemics and climate change - but only with 2020/21’ - has been published, putting staff wellbeing at bold government intervention, according to a report from the its heart with a new recruitment, retention and support Soil Association. package, including practical support for wellbeing. ‘Shortening Supply Chains; Roads to Regional Resilience’ However, there is no specific mention given to the looks at innovative farmers, businesses and councils already problems of recruiting and retaining catering or other proving sustainable sourcing can be more resilient as well as facilities staff and no specific plans to target staff shortages being more environmentally friendly. in those areas. The report sets out that local and national government have The plan focuses on how NHS staff must all continue to key roles to play in incentivising regional and more sustainable look after each other and foster a culture of inclusion and production through redirecting the £2bn spent annually on belonging, as well as taking action to grow the workforce, public sector food. train people, and work together differently to deliver It recommends re-writing public procurement regulations to patient care. allow a wider range of suppliers, no matter their size, to have The plan includes specific commitments around four key flexible access to food contracts in places like schools and actions: Looking after people; Belonging in the NHS; New hospitals. It suggests moving away from the practice of having ways of working; Delivering care and growing for the future. many fixed, high volume contracts with one large provider, A further People Plan has also been announced, which can lock out smaller and regional businesses. to follow once the forthcoming spending review has A year-long pilot is to go live towards the end of the year, confirmed future NHS education and training budgets. trialling a model for dynamic food procurement on a national In addition, the government will shortly publish its scale. It is believed this has the potential to transform public Social Care Winter Plan, building on NHS support for sector food procurement, significantly shortening supply the sector during COVID-19, to ensure the system chains ensuring food quality and cost control, reducing carbon has the support it needs in preparation for winter and emissions and providing more support for local suppliers. potential future outbreaks.

Reputational excellence helps ISS secure new healthcare contract

Bedfordshire Hospitals NHS Foundation Trust has appointed ISS Healthcare as its new provider of catering and domestic services at the Luton & Dunstable University Hospital (L&D). The contract award follows a 12-month tendering and evaluation process and will begin in November 2020. Cathy Jones, Deputy Chief Executive at Bedfordshire Hospitals NHS Trust, says: “ISS has an excellent reputation in the industry, and we are very pleased and excited to have appointed them. We look forward to working with ISS to deliver a mutually successful contract over the next seven years and realising the future benefits that will come from our long-term partnership arrangement.”

Calls for new wiring regs electrical equipment to be protected by an RCD (Residual Current Device) or RCBO (Residual Current Breaker with in commercial kitchens Overload protection). The advice also states that these following engineer’s death should be specific to each individual appliance, not installed as a general RCD or RCBO on the distribution board. The initial coroner’s report concluded that the engineer Following the tragic death of an engineer working on a would most probably have survived had the appliance he was commercial kitchen appliance, FEA, in association with working on been protected by an appropriate RCD or RCBO. CESRB (Catering Engineers Standards and Registration FEA consultant and CESRB Chairman, Nick Oryino, Board) and ceda, has issued an advisory notice covering is working with ceda and ECA (Electrical Contractor the installation and servicing of electrical equipment. Association) to push for the change to be put into law The associations are calling for all new installations of through the wiring regulations, covered by BS 7671:2018.

8 Hospital Food + Service | September/October 2020 News Pandemic fuels demand for organic produce Diary date 2021 will see Nutrition and Hydration Week According to retail sector data from Nielsen, celebrate its 10-year and drink sales in supermarkets have reached a three-year anniversary from March high. The 52-week data to the end of May 2020 revealed 15-21. The N&H Week year-on-year growth of organic food and drink of 6.1% - team are seeking almost double the growth of non-organic food and drink sponsorship for next products. In the 12 weeks ending May 30, organic sales year’s event rose by 18.7%. The Soil Association predicted the organic sector’s market value will reach £2.5 billion by the end of 2020, but these figures Congratulations to the HCA’s would suggest the sector is on target to hit £2.6 billion. Products which have seen exceptional demand include beef (+15.3%), 2020 award winners eggs (+14.8%) and preserves & spreads (+18.3%). The HCA recognised the winners of its 2020 awards during lockdown, celebrating what National Chair, Craig Smith described as: “The excellence and innovation we see daily.”

Caterer of the Year: Winner - Tony O’Hara, Senior Manager Patient Experience, South Eastern Trust Finalists - Chris Neale & Nicola Strawther, Nottingham University Hospital NHS Trust

Caterer Service of the Year: Winner - Catering Team, NHS Ayrshire & Arran Finalists - Catering Services at Nottingham University Food Strategy Part One Hospitals NHS Trust Catering Team; Acute Catering, South Eastern Trust describes British diet as a Efficiency & Improvement Award: “slow-motion disaster” Winner - Chris Neale & Nicola Strawther, Nottingham University Hospital NHS Trust Part One of what will be a two-part National Food Finalists - Joe Gilbey, Retail Lead, NHS Greater Strategy has been published and focuses on Glasgow & Clyde Catering Strategy Team, NHS recommendations to support the country through the Greater Glasgow & Clyde turbulence created by the current pandemic - with a focus on the diet of children and particularly the most The Special Contribution Award: disadvantaged children - and preparing for the end of Winner - Paul Kavanagh, Diversey UK the EU exit transition period on December 31. The review was led by Henry Dimbleby, Non-Executive Rising Star Award: Director of Defra with input from an Advisory Panel Winner - Wendy Bone, Deputy Catering Manager, of experts from across the food system. It references NHS Ayrshire & Arran extensively the impact of COVID-19 and how it has exposed the damage done to human health by our Leadership & Excellence Award: modern diet. Diet-related illness is one of the top three Winner - Karen McLaughlin, Deputy Community risk factors for dying of COVID-19, which, the report Services Manager, Northern Health & Social Care summary says: “has given a new urgency to the slow- NHS Trust motion disaster of the British diet.” Finalist - Chris Neale, Nottingham University Hospital The comprehensive plan for transforming the food NHS Trust system will follow in Part Two, due to be published next year. Henry Dimbleby advises to expect much more on Chairman’s Choice: health and the interwoven issues of climate change, Winner - South West Branch biodiversity, pollution, antimicrobial resistance, zoonotic diseases and sustainable use of resources. Wilma Wilkie Outstanding Service Award: The government has committed to publishing a White Winner - Phil Shelley, Facilities Manager, Musgrove Paper six months after Part Two and progress will be Park Hospital reviewed six months after that.

September/October 2020 | Hospital Food + Service 9

HCA Column

Our brave ‘NEW’ WORLD

Craig Smith, National Chair of the Hospital Caterers Association (HCA) commends the performance of all in the hospital catering sector throughout the pandemic and looks at some of the changes it has brought to how we work and behave.

“Whilst other It is encouraging to be writing a new column proud of the part they have played in keeping for Hospital Food + Service magazine, as the country going. parts of the people start to emerge from the enforced During the pandemic we lost many who hospitality lockdown. Having regular publications once were near and dear to us, and many readers again is a sign that perhaps we are now gently will sadly have lost friends and family. It industry had entering the first phase of the new normal. would be wrong if I didn’t make mention of to pull up the It is as important as ever to be maintaining Mike Duckett MBE, who was a stalwart of strong communications across our particular hospital catering, and who fell to COVID-19 shutters, the sector. During the pandemic, hospital caterers early on. He could always be depended have been finding some inventive ways to keep upon to have an opinion and he along with caterers within their channels open, to share ideas and to ask all the others will be sadly missed. healthcare have for information. The past six months, although they seem I would like to pay tribute to all those who to have sped by have almost seemed to been on the front have worked through the pandemic, to ensure ignore the events that had gone before. line throughout” patients who still needed attention were well Suddenly there has been harmony amongst fed. I extend this to include all of our suppliers political parties and everyone seemed to who did a valiant job in keeping the supply want to pull in the right direction. Lifelong chain going. competitors were working side-by-side so We have had some incredible acts of self- perhaps there are lessons that we have been sacrifice with catering staff actually staying given that should not be forgotten. away from home during the darkest days of the Now I am pleased to see we are moving crisis, along with entire catering departments back to some form of normality, for how being split into separate teams and developing long we don’t know, but hopefully in the their own social bubbles to ensure that the next edition we will be able to talk about meals kept flowing. the much-awaited Hospital Food Review. Whilst other parts of the hospitality industry This has been delayed due to Covid but had to pull up the shutters, the caterers has now been slightly re-worked to take within healthcare have been on the front line the pandemic into consideration and I look throughout, and I believe they should be very forward to sharing it with you. Stay Safe.

September/October 2020 | Hospital Food + Service 11 On site PATIENT CATERING OVERHAUL IN WEST SUSSEX

In February, a brand new £3m patient catering facility opened at St Richard’s hospital in West Sussex to produce patient meals for the three hospitals at the Western Sussex Hospitals NHS Foundation Trust. The highly successful launch, attended by Prue Leith and Matt Hancock, was the fruition of a project which began back in 2017 working with consultant, Neller Davies, as Hospital F+ S finds out.

“The truth is, this is the best institutional food some of the equipment, the review identified some I have ever eaten! And I’ve eaten in schools, simple issues with kitchen practice, for example, hospitals, prisons and all over the place. I think it recipes not being followed completely, leading to is amazing. I walked round and I couldn’t think of inconsistencies in the meals served. In addition, there a single thing to complain about - which is not like was no cohesion to the food service - the moment me.” Those are the words of Celebrity Chef, Prue the food left the kitchen the caterers were no longer Leith, speaking at the opening of this facility. involved - the Last 9 Yards was out of their hands. Ward But it hadn’t always been that way. staff, however, needed better training in food safety or In 2017, the Trust identified that catering needing customer service, which had an impact on the delivery improvement following an audit which found a 41% of food to the patient with less engagement in the wastage rate of patient food - with common complaints process. centring around quality and temperature. Following this research, Neller Davies presented Like many modern NHS organisations, Western three models to the Trust, with associated costs: Sussex was formed through the merger of two remediating and remodelling the existing operation into previously separate Trusts - the Royal West Sussex a modern, fit-for-purpose service; moving to a different and Worthing and Southlands Hospitals. As a result, it style of service, such as bought-in; or doing nothing. had two discrete and disparate catering operations - The Trust Board endorsed the first option and retained working from an old kitchen at Worthing hospital with Neller Davies to work with its different teams, including equipment that was no longer fit for purpose and a CPU estates and facilities, dietetic and clinical to deliver the at St Richard’s in Chichester that was solely focused on project. This collaborative approach was very important food production for the one site. to make sure the right decisions were made and The Trust’s Director of Estates at the beginning of this processes put in place from the very beginning. project recognised that something needed to be done about the food service and food waste and ordered a APPROACH AND RESULTS complete review, with the primary objective being to Three work streams were established, each led by a invest in patient catering. professional from the Trust, to methodically break Facilities management consultancy, Neller Davies, down and focus on aspects of the project including the was appointed to undertake a review of the patient development of menus, staff engagement across the catering operation, and to research and develop a Trust and design of the service and necessary facilities. strategic plan. Apart from the age and condition of Although the work streams each had their own remit,

12 Hospital Food + Service | September/October 2020 On site

“This collaborative approach was challenged to make a dish they thought patients would want to eat. Among the chefs taking part in this very important to make sure the right initiative was Mark McCann, a former Gold Medallist at decisions were made and processes put the Culinary Olympics, with a long career in contract catering including healthcare experience. Some of the in place from the very beginning” dishes that resulted from this process were ultimately incorporated into the new menu. they also had to keep an eye on the wider brief and To ensure patients receive the best nutrition possible, objectives of the project. a new protected mealtimes policy, Meal time Matters, The food work stream had to focus on menus, but was also launched at the same time as the new menu. realising that food should not be a blanket service, The policy means that, during meal-times, all non- needed to consider the varying needs and special essential activities and distractions on the wards stop. requirements of different patient groups. The approach The engagement work stream ensured that patient developed means that wards receive a differentiated food was not just the responsibility of a small group service depending on those requirements. of staff in the kitchen. It made food the concern of all The majority of specialist menus have been developed and involved HR and nursing teams working to re-train, with the dietitians. These vary and range from clinical, mentor and guide staff around issues including food cultural and therapeutic meal options. Some special diet safety and customer service. More than 200 people were meals are brought in externally to meet IDDSI guidelines re-purposed as part of the patient catering team, but currently but this is being reviewed. there were no redundancies or external recruitment. All The new menu was designed jointly by the Trust of these staff are now integral to all parts of the catering catering team, dietitians and nursing colleagues and food service process. (commonly known as the ‘Power of Three’) and The design team examined different models of facilitated and tested by Neller Davies’ culinary team. food production and service and concluded that It includes up to 50 main meal combinations available re-developing the CPU at St Richard’s to serve all every day, vegetarian, vegan and specialist options, three hospitals at the Trust, with the Worthing kitchen finger foods and menus which are popular with becoming a receipt and distribution unit for the site, older patients and those with specialist requirements. was the best solution. Provision was made for the In addition, external chefs were invited to a cook- hospitals to safely store and freeze food, leading to off where they were given a bag of ingredients and less wastage and more availability. At any one time, the

September/October 2020 | Hospital Food + Service 13 On site

“The approach developed means that wards receive a differentiated service depending on [their] requirements”

hospitals can store up to 16,000 meals. All patient food at the CPU is cooked fresh and portioned into containers which are finished on the wards using a bulk food service system. Patients order from an ‘a la carte’ menu with catering staff taking orders two hours before service using iPads linked to a Datasym system. The cook-freeze process offers far greater choice for patients which leads to better nutrition (patients are more likely to eat their chosen food), does not need any artificial modification to recipe ingredients and enables food to be served at the correct temperature, as it is slowly heated for 90 minutes on the ward. Food waste was reduced by half in the early days of the CPU going live and continued to fall as the system bedded in. A significant investment of £1m was made into new state-of-the-art equipment which allows for the implementation of lean processes and a ‘single flow’ design. This means the kitchen is segregated into distinct zones to ensure that there is no cross-contamination and that it complies fully with Food Safety legislation requirements. The Trust rejected the option to refurbish equipment where possible and only buy new where necessary. No equipment is now under condition B status, which is seen as a more sustainable investment. The latest specification industrial-grade equipment has been specified to ensure in-house and external capacity would be met; it was designed for 6,000 meals per day. Trolleys with HACCP controls were also included in the spec to monitor temperature and other elements. David McLaughlin, Director of Estates and Facilities, Western Sussex Hospitals NHS Trust, says: “We are really pleased with the outcome. For us, we want to continue to evolve the system, and use our offer here as an opportunity to share best practice with others. It’s really important that we all continue to work with each other to help improve patient catering services.” Julian Fris is an advocate of the Vested, outcome- based model of FM, which is based on a shared vision. Some elements of Vested came into play during this Some of the most popular dishes project, particularly the collaboration of different Cottage Pie disciplines and the way the Trust worked with suppliers. Fish & Chips “The Trust and its staff have delivered this project. Neller Pork Stroganoff Davies gave them the motivation and the tools to do it, Lasagne but they were the agents of change,” concludes Julian. Dhal

14 Hospital Food + Service | September/October 2020

Dairy products CRÈME DE LA crème The global dairy sector celebrated the 20th anniversary of World Milk Day in May this year, focusing on key themes of nutrition, community and enjoyment. The UK campaign, ‘Milk your moments’ invoked the association of milk with those moments that are often taken for granted, but which efforts to stem the spread of COVID-19 have either curtailed or removed entirely, such as enjoying a hot drink in a coffee shop with friends. It’s also easy to take for granted the nutritional benefit of the dairy products we consume daily, but which are now more pertinent than perhaps ever before in maintaining a healthy immune system and fighting malnutrition.

16 Hospital Food + Service | September/October 2020 Dairy products

Dairy products play an important part in the diet from Until very recently kefir was a niche drink, but after sales early age to old age. Milk, hard cheese and yogurt rocketed in 2019, Tesco predicted it would be one of the are key providers of calcium and iodine as well as major food trends of this year. Kefir - which literally means being good sources of protein, which are important ‘feel good’ in old Turkish - has been enjoyed mainly by for growth and development and for maintaining people in the Caucasus Mountains from where it originates strong bones. Whilst low fat dairy products are advised for 2,000 years and in parts of eastern Europe. An for people who are watching their weight, full fat indication that kefir is about to become more mainstream is dairy products are in demand at the other end of the that there are now nearly 10 dedicated kefir manufacturers scale for people who are malnourished or at risk of in the UK and kefir drinks in a variety of flavours as well as malnutrition. This includes a growing number of people different yogurt variants are now available from the local who have been adversely impacted by COVID-19 - supermarket aisle. either as recovering patients or through food insecurity as a result of the pandemic. YOGURTS In a recent letter to the Secretary of State for Health Müller Yogurt & Desserts points out that dairy can play and Social Care, the British Dietetics Association a vital role in providing nutrition in care settings being (BDA), working with the UK Malnutrition Awareness and a source of fat, protein, vitamins and minerals at a great Prevention Network (MAPN) warned of a “perfect storm” price per serving. for malnutrition caused by the COVID-19 pandemic. Müller’s yogurts are made in Shropshire, in the heart of Before the pandemic it was estimated that over three Britain using fresh milk from Red Tractor assured British million people in the UK - including over a million over- farms. The drive for public sector catering operations to 65s - were affected by malnutrition. This number is going buy British wherever possible has gained traction over the to have gone up, warns BDA Chair Caroline Bovey: last couple of years, fuelled by concerns over the resilience “Malnutrition, particularly amongst older people, is a huge of the supply chain through climate change, Brexit, and, problem, but one that is often more recently, COVID-19. missed or ignored. Dietitians Hospital caterers have see its impacts every day, “There are indications that the nutrient supported and participated from increased recovery times richness of dairy products can support in the annual celebration of and frailty to higher infection British produce and producers risk. COVID-19 has brought a healthy immune function” - British Food & Drink Fortnight this long-term issue into the for many years. Choosing public eye, especially as many Müller yogurts therefore helps people who have survived the disease return from hospital to support caterers in their drive for British products and needing significant rehabilitation and support.” supports work to achieve the Soil Association’s Food for Life Served Here awards. DAIRY AND THE IMMUNE SYSTEM Yogurt contains a range of nutrients that are important People with compromised immune systems are more in a balanced diet and a healthy lifestyle. Proteins vulnerable to illness and this pandemic has heightened contribute to the maintenance and growth of muscle and awareness of this among healthcare professionals and the maintenance of healthy bones. Protein is made up of amino general public alike. acids and yogurt provides all nine essential amino acids Milk contains vitamin B12, which helps the immune which can’t be made by the body and therefore have to be system to function. It also contains protein, vitamin A, zinc, present in the food and drink a person consumes. Yogurt selenium, and, in fortified milks and dairy products, vitamin also contains vitamins and minerals, including B vitamins, D, all of which are important for optimal immune function. calcium, iodine, phosphorus and potassium. All milk contains white blood cells that are designed to According to the Eatwell Plate - the Department of fight infection. The link between the immune system and dairy consumption is the subject of active research, although there are indications that the nutrient richness of dairy products can support a healthy immune function. The International Dairy Federation adds that many fermented dairy products that contain active bacterial cultures, such as probiotics, may support healthy gut microbiota. This also plays an important role in building and maintaining the immune system. Earlier this year, Britain’s biggest supermarket chain, Tesco, reported on the growth in sales of kefir drinks - a 400% rise in the 18 months to February 2020. Kefir is a yogurt-like milk drink that contains ‘gut-friendly’ bacteria.

September/October 2020 | Hospital Food + Service 17

Dairy products

creamy, flavourful, a source of protein and is calorie-dense for patients who need a nutrition boost. The smooth texture makes swallowing easier and meets IDDSI Level 4 for dysphagia sufferers. The flavour options of Strawberry and Peach have proven very popular and have received some excellent feedback from the care sector so far. Ubley Life Thick & Creamy Smooth Yogurts (12 x 120g) are available in Strawberry and Peach variants. They are perfect for patient feeding, being smooth, easy to serve, easy to eat, individually portioned and nutritious.

DAIRY ALTERNATIVES Whilst dairy products may be nutritionally beneficial, there are those who can’t eat - or drink - them because they are lactose-intolerant or they make a lifestyle choice to avoid dairy products. It is reported that as much as 75% of the world’s adult population is lactose-intolerant. At the same time, more people than ever before are “Protein is made up of amino acids following vegan diets - either because they don’t want to consume animal products or they are concerned about and yogurt provides all nine the sustainability of these practices and essential amino acids which can’t be their impact on the planet. Whatever the cause, consumption of plant-based made by the body” milks is growing. A trip down the local supermarket aisle is sufficient to demonstrate that, with a wider choice of Health’s healthy eating guide, low-fat yogurt is a key plant-based milks and formats than ever before. Most part of the dairy food group, which we should consume popular are soya milk, which, nutritionally, is the closest every day. to cow’s milk, as well as milk from coconuts, almonds and The natural nutrients present in yogurt are essential other , nuts, seeds and cereals, including rice, to growth, development and body maintenance. In a cashew, oats and macadamia. healthy, balanced diet yogurt can provide a quick and easy dessert option. Single pot formats offer portion control, www.muller.co.uk full nutritional/ingredient labelling, no preparation, clear- www.yeovalley.co.uk up time or labour costs. They are equally at home on the breakfast menu. Yogurts are loved by adults and children. Options available from Müller include Müller Vitality Thick & Creamy, a completely smooth yogurt made with whole milk, no artificial colours and containing 130 calories per pot. The 100g pots are cost-effective and perfect for hospital patient and residential care home dining for any ‘cost sector’ outlets looking to offer a more indulgent, full fat yogurt as a breakfast or snack item. Müller Vitality Thick & Creamy yogurts are available in a mixed case: 6 x Strawberry, 3 x Peach, and 3 x Toffee (12 x 110g). Müller Vitality Healthy Balance is a low fat and completely smooth yogurt made with semi-skimmed milk and 100% naturally sourced ingredients. These are also available in 110g pots and in straight flavour cases Strawberry and Peach (12 x 110g) with a mixed case from October 26. Both ranges are suitable for vegetarians and coeliacs. Yeo Valley produces its yogurts in Somerset. The Royal Osteoporosis Society recommends that Recognising the need for nutritious dairy for patients adults need 700mg of calcium per day and that most and staff, Yeo Valley has developed some new products people should be able to consume enough calcium in specifically to suit these needs. their diet through healthy eating alone. A new thick and creamy yogurt, available under the Ubley Life Yogurt brand, is completely smooth, thick,

September/October 2020 | Hospital Food + Service 19 Dysphagia Puréed to perfection Hospital Food + Service talks to Rosemarie Hoyle, Divisional Manager - Healthcare at leading provider of texture-modified foods, apetito, about planning a dysphagia menu to provide choice and nutritional balance and the latest new product developments across key IDDSI descriptors, Level 5 and 4.

It has been identified that between 15% - 37% of intent purposes looks like, and tastes like, a complete individuals who are diagnosed with dementia are also at meal. TM meals look good with strong visual appeal and risk of dysphagia1. Although most commonly associated importantly, offer safety in dining whilst enabling the with dementia, dysphagia can also affect patients with patient to feel they are eating a proper meal.” many other conditions, including mouth and throat cancers, There are different levels of TM solutions under the cerebral palsy, multiple sclerosis and stroke victims. IDDSI framework, which align to the severity of the According to the World Gastroenterology swallowing difficulty that a patient is experiencing. All Organisation, 1 out of 17 of us is likely to experience apetito meals are suitable against the IDDSI guidelines and dysphagia at one point or another during our lifetime. IDDSI itself provides greater overall patient safety globally. Managing nutrition can be challenging for hospitals A major part of apetito’s TM strategy is to encourage who are caring for patients living with dysphagia. the desire to eat in people living with dysphagia. Patient safety is of utmost important and the evolution The company puts a great deal of effort into making in texture-modified (TM) foods has been an important its meals look like the real thing (or as good as they step in helping to manage can be) and by doing so, malnutrition and in “Eating is a very emotional thing encourages appetite, which returning enjoyment to in turn, aids patients to a dining, whilst allowing those - food is one of life’s simple quicker recovery. living with dysphagia to “Eating is a very dine in dignity. pleasures, and for someone to be emotional thing - food The Healthcare sector has able to eat a meal which looks is one of life’s simple certainly come a long way pleasures, and for someone since the days of blending and tastes like a meal is very to be able to eat a meal foods, which 20 years ago, which looks and tastes like would have been ‘the norm’. important to them” a meal is very important to Over a decade ago, them. We know from the apetito was the world-leading pioneer of Level 5 TM feedback that our customers give us that our meals can meals. Continued innovation has contributed to the spark happy memories of mealtime enjoyment and that growth of this range, which has just been extended this can make a real difference to their lives.” further with the addition of several new dishes and an exciting development to perfect texture-modified rice. TAKING TM TO THE NEXT LEVEL “Texture-modified foods do what they say - ingredients There is always room for improvement and apetito’s are individually puréed to a soft consistent texture recent developments prove just that. “We are seeing and then moulded to replicate the visual aspect of the continued innovation in TM meals to give more choice ingredient they represent. The result is a meal that to all and new inspiration.”

20 Hospital Food + Service | September/October 2020 Dysphagia

Salmon in dill sauce

apetito has recently launched a ground-breaking range of shaped dishes, as part of its new Level 5 minced meals. Beef Grillsteak This is a visually enhanced range that provides more choice and variety, whilst being developed in line with the IDDSI framework and comprising the same safe texture for those recommended a Level 5 diet by a healthcare professional. “We wanted to visually enhance the dishes which form part of our Level 5 range, whilst simultaneously providing our customers with more variety and choice. The innovation lies in the shaping of the protein component in each of these dishes.” The four new meals are: Minced Salmon in Dill Sauce, served with mashed potatoes, broccoli and carrots; Minced Beef Grillsteak in Gravy served with West Country Cheddar mashed potatoes, broccoli and cauliflower; Minced Mixed in West Country Cheddar cheese sauce, with mashed potatoes and broccoli and Minced Beef in gravy, served with West Country Cheddar estimated that malnutrition currently accounts for two mashed potatoes, broccoli and carrots. million of the population and is costing the NHS £2 billion The texture of the main meal components has been per year, according to NHS England.” designed in line with the requirements for an IDDSI Level Containing a similar calorie and protein content as 5 meal, in an extremely thick sauce or gravy. A Level 5 apetito’s Purée Classic dishes, the Purée Petite range meal should require little to no chewing, ensuring a safe of energy-dense meals means patients with a smaller consistency for those on a Minced and Moist diet. appetite can be served a nutritionally-balanced meal in a apetito has also unveiled an enhanced range of dishes reduced portion size. Dishes include perennial favourites to improve the visual quality of its Level 4 Puréed meals. such as Pork and Mash, Steak and Chips, Fish “We are not aware of any other provider able to deliver and Chips and All-Day Breakfast. this. Our Purée Petite range now features sausages “Our latest innovation is the launch of our rice moulded which look freshly sizzled, chips and potatoes that are dishes, which accompanies the introduction of three authentically browned and grill steaks which appear further new dishes to our award-winning Purée Petite lightly seared, all to enhance the aesthetics of our texture- softer foods range, all of which incorporate a new and modified food selection.” highly innovative rice component. Of course, it isn’t just about the look of the food. It is “Due to its grainy nature and high starch content, vital for healthcare professionals to ensure appropriate rice is notoriously challenging to fully purée and home nutritional needs are being met, as they support their blending does not always achieve a smooth or adequate patients with advice on dietary requirements. “It is consistency. Here is a safe and attractive solution, due to

September/October 2020 | Hospital Food + Service 21

Dysphagia

Level 5 meals

COVID-19 and dysphagia

A whole new group of patients are now at risk of suffering with dysphagia - those recovering from COVID-19, some of whom sustain long-term respiratory problems. NHS England’s paper ‘Aftercare needs of inpatients recovering from COVID-19’ says dysphagia is “common and persistent.” Post critical care, patients may be nutritionally compromised and difficulties swallowing may be compounded by risk of fatigue during mealtimes. A TM diet could have further implications on nutritional intake - puréeing food by adding liquid risks diluting nutrients. Nutritionally-balanced, prepared meals overcome this problem, as they are produced consistently, to precise recipes in a controlled environment. Meals may also be fortified to ensure high protein and calorie content even in smaller portions. The apetito Purée Petite range, for instance is energy-dense, containing 500 calories and more than 15g of protein in each 227g portion. COVID-19 patients may also have muscle wastage, or myopathy, especially after a prolonged stay in ICU. NHS England advises that among

Rice moulded dishes patients who have myopathy, 91% have swallowing difficulties. Dysphagia assessment, therapy and rehabilitation are needed to ensure safe swallow the expert cooking and preparation methods, which have strategies. enabled apetito to achieve a puréed texture. “This addition of shaped rice is a ground-breaking concept and will be welcomed by healthcare customers. make a big difference - for example, ensuring the film on Equally important is the visual aspect, as it also looks as the meals is not removed too far ahead of service to the good as it tastes.” patient, which can cause a skin to form on some products. The new meals include: Beef Chilli, a warming puréed “Where a dysphagia patient has a small appetite, we chilli with kidney beans, served with rice and peas; Sweet recommend that staff offer a whole meal from the Purée and Sour Chicken, which comprises puréed chicken, Petite range rather than cutting a Purée Classic meal in half pineapple and peppers in a sweet and sour sauce along and sharing it between two patients, which will reduce their with rice and peas, and Chicken Tikka Masala. This puréed nutritional uptake. chicken has been infused with a medium spiced coconut “Lastly, it’s important to train staff to ensure they don’t stir and tomato sauce and is served with rice and creamed all the meal components together into a single gloop.” spinach. 1 The Relationship Between Dementia Subtypes and Nutritional TRAINING Parameters in Older Adults It is important to train staff on the importance of correct regeneration of meals to ensure texture and appearance Apetito: www.apetito.co.uk are not compromised. There are also elements which can

September/October 2020 | Hospital Food + Service 23 Palate Pleasers

OUR FAVOURITE ITALIAN IMPORT There can be few food traditions that have as many variations as the pizza. From the style and thickness of the dough to the choice of toppings the combinations are infinite. The pizza is adaptable to flavour and dietary trends and just about every meal occasion - from breakfast to dinner, main course to dessert and, of course, on-the-go.

The origins of the word pizza are imputed to two possible sources - the Greek ‘pitta’, a slightly leavened, “Modern twists on pizza toppings flat round bread or ‘bizzo’, which means bite in the include using pesto instead of a ancient Langobardic, a German language once spoken in northern Italy. The tradition of putting toppings traditional tomato sauce” onto bread to enhance flavour and taste before baking can be traced back many centuries. It is of course the It’s so easy to personalise a pizza by listing the possible Italians who are credited with the invention of the dish toppings separately on a menu that it is hardly surprising we know and enjoy today as pizza. It is widely accepted that signature, artisan pizza was put forward as one of the that modern pizza evolved from topped flatbread dishes predicted trends for 2020 by Eurostar Commodities. Chefs in and around Naples in the late 18th, or early 19th putting their own personal take on pizza was to be one of century. the year’s big developments, with suggestions including the addition of sauces that could be poured over the pizza by the diner after serving. Coronavirus obviously got in the Dessert pizzas use a sweet pizza dough, which way, forcing the closedown of much of the hospitality sector sometimes more closely resembles a biscuit base, for many months so we’ll never know if the personal pizza usually topped with lots of chocolate, sweets or fruit. would have been predominant across our high streets this year or not.

24 Hospital Food + Service | September/October 2020 Palate Pleasers

In the USA, October is designated as National Pizza “YouGov found that the nation’s Month. The entire month is a celebration of pizza and favourite ingredient to top the pizza is has been since the custom was introduced in October mushroom, enjoyed by 65% of people” 1984 by Indiana pizzeria owner, Gerry Durnell.

ANYONE FOR HAM AND PINEAPPLE? WHAT MAKES A PIZZA SPECIAL? Pineapple has to be the pizza topping that has divided Modern twists on pizza toppings include using pesto the nation. instead of a traditional tomato sauce, a wider choice of Usually referred to as the Hawaiian, ham and pineapple vegetables such as kale or beetroot and moving away from has been a standard choice on pizza menus across the UK mozzarella to different cheeses - a popular choice being for as long as most of us can remember. But a controversial goat’s cheese, or ricotta. YouGov survey in 2017 found that the British public are It seems you literally can put anything on top of a pizza divided over whether pineapple belongs on pizza or not. and depending on where you are in the world you probably Whilst 84% of British people were found to like pizza do. Some of the more unusual suggestions out there and 82% to like pineapple, only 53% admitted to liking include baked beans, whilst in Russia cold fish on a cold pineapple on pizza and 41% actually dislike it. pizza is all the rage, Finland invented the smoked reindeer Those that like it really like it though. Parkdean Resorts pizza and in Australia it just has to be kangaroo, emu and conducted a nationwide survey and analysed pizza sales crocodile. numbers from 65 of its restaurants across the country to come up with the nation’s favourite toppings earlier this year. What should you have on the menu if you want to At the 2019 World Pizza Championship, 775 competitors sell more pizza? Pepperoni topped the Parkdean charts, took part from 42 nations in 12 classes. This competition closely followed by the meat feast, with ham and pineapple has been held annually in Parma, Italy, since 1991 but coming in third place, rated particularly highly by residents the 29th edition due to be held in 2020 had to be of Edinburgh and Southampton. YouGov meanwhile found postponed. The event celebrates the world’s best- that the nation’s favourite ingredient to top the pizza is loved dish, which it describes as “always evolving and mushroom, enjoyed by 65% of people. interpreting the changing tastes and scientific research It is perhaps surprising that less than 1% of the votes from every corner of the world.” in Parkdean’s survey were for vegan toppings when it is Competition classes include the Classic Pizza, considered that reports the number of Freestyle, Roman Pizza, Neapolitans STG Pizza, Pan vegans in Great Britain quadrupled between 2014 and 2019 Pizza and more. to 600,000. Also scoring highly in the YouGov survey for what not to put on a pizza are tuna, olives, and topping the list of Whilst it’s the toppings that capture the eye of the ingredients that British people want to see banned are consumer and often become the main focus on the pizza anchovies. menu, there are two essential elements to a pizza that may be taken for granted - unless you happen to be a pizza chef - and are arguably more important. These are the base and the tomato sauce. The topping relies on flavour combinations that may be traditional to the pizza, or, increasingly in the 21st century, not. It’s the icing on the cake. The pizza dough, however, is the foundation on which the rest is built. How do you like yours? Thin and crispy, stone baked, deep pan, stuffed,

Pizza pie, or Calzone, the folded pizza resembles a pasty stuffed with pizza ingredients and also originates from Naples. sourdough, or perhaps gluten-free? Of course, to be truly authentic and artisanal, you have to make your own dough, kneading and stretching by hand - no machines allowed - to achieve the desired finish, thickness and texture. The tomato sauce must also be made from fresh ingredients before assembling and cooking in a traditional, probably wood-fired oven.

September/October 2020 | Hospital Food + Service 25 Warewashing WELL-

WASHED“Hospital caterers have done a magnificent job during The COVID-19 pandemic has the pandemic,” Paul Anderson, Managing Director of Meiko UK tells Hospital Food + Service. “My advice is highlighted the importance to choose equipment proven by independent experts to inactivate the Covid-19 virus and all the other food of hygiene and infection poisoning bugs; that is provided the machine has been professionally and properly maintained.” control. In the kitchen, Maintenance is critically important; poor maintenance risks everything. Equipment should be serviced regularly effective and efficient and staff trained properly and often. “Regular servicing is crucial to maximising the warewashing is one tool equipment’s performance and efficiency. There are substantial benefits of keeping equipment properly hospital caterers must deploy maintained, from lower running and reduced lifetime costs, to increased operating efficiency,” says Tim Bender, to the highest possible Sales Director of Hobart Equipment Division UK. standards. This feature looks Tim also comments on training, which, he says, needs to be offered to get new staff up to speed on best practice, at the latest technology, helping avoid costly breakdowns, which can be brought on by seemingly innocuous things like incorrect loading processes and innovation in of baskets. “Kitchens can often be the victims of high staff churn, making it imperative that new team members are equipment and consumables brought up to scratch quickly. Because of this, Hobart offers completely free on-site training for the life of its machines.” for hospital warewashing. To minimise the number of call-outs, lengthen the life and maintain the output of a warewasher, Crystaltech advises that staff are given training on the basics of keeping dishwashers clean. Daily cleaning of the filters and cabinet interior and ensuring that the chemicals are Hobart PREMAX topped up, machines are kept clean and food residues Care S are removed prior to loading, are all key factors in using model warewashers in the best possible way.

CHEMICAL CHOICES COVID-19 guidance for catering operators from industry body CEDA is that chlorine-based detergents achieve a higher rate of disinfection in commercial dishwashers than washing with standard chemicals where water temperature is used for sanitising. Chlorine-based detergents also offer potential for energy saving. The Chlorine in dishwashing chemicals is Sodium

26 Hospital Food + Service | September/October 2020

Warewashing

Colour coding for ease of cleaning and M-iClean with the hood lowering automatically maintenance in a Meiko machine

Hypochlorite, or bleach. Crystaltech advises two types are £1,000, whereas the filters for externally fitted RO systems available for commercial dishwashing. Chlorinated alkaline cost around £300. detergents are suitable for most dishwashing tasks as they Crystaltech has developed a system that pushes purified remove starches and grease. Chlorine only detergents are water through the wash cycle. This requires fewer chemicals most suitable for removing protein and tannin. Rinse Aid at lower temperatures to deliver perfect results and can is still required to break down the surface tension to allow reduce the need for cleaning chemicals by up to 70%, the rinse water to form only a thin film on the ware which making it a much more energy-efficient proposition. It also quickly evaporates. removes the need to polish glassware by hand post wash, Using the right chemicals and good water treatment can therefore saving valuable staff time and removing the risk of pay dividends in cutting running costs and extending the potentially transferring germs with cleaning cloths. longevity of kit. The latest development in wash chemicals Water softeners can dramatically reduce issues with can enable the lowering of wash temperatures and still limescale. The engineers at Crystaltech are often called deliver sparkling clean results. out to a glass or dishwasher A chlorinated liquid breakdown where water detergent is recommended “Any manufacturer “worth their quality is poor, and this for its high disinfectant salt” will provide a kW/hour has contributed to properties at lower the breakdown. “I think that temperatures. Lower wash estimate over a fixed number of for every millimetre of scale, temperatures decrease the the appliance uses about chance of thermal shock hours daily” 17% more power, so you will which causes cracking to the have a knock-on effect of surface of tableware and can that element burning out. An be detrimental to hygiene. Chemical disinfection rather element can cost a few hundred pounds, so the expense than a reliance on thermal disinfection is now advised, really mounts up,” says Derek. which has been supported by the FSA. “Using the right type of cleaning chemical can provide WARD LEVEL energy and water savings by enabling wash temperatures Reverse osmosis technology is particularly beneficial for to be lowered whilst still giving sparkling clean results. warewashers used at ward level. For these undercounter When using a Chlorine-based detergent it is the wash machines it makes sense to save space and simplify process that kills the bacteria and therefore the rinse water operation by choosing a dishwasher without a water does not need to be at as high a temperature as it would softener and opting instead for RO water treatment for thermal sanitising. Rather than setting the temperature technology. Paul Anderson explains why. “Ward level for 85/90°C it can be lowered to 65/70°C. The wash machines are used by staff usually in a rush and with no temperature can also be reduced slightly, typically from time to mess about topping up salt levels or trying to 70°C to 60°C,” says Derek Maher, Managing Director of work out what programme to use. Machines without water Crystaltech. softeners make life easier and more reliable. Control panels must be simple to use and feature a simple choice WATER QUALITY of programmes. There are several options to improve the quality of water used “Use the recommended detergent. The most common by a commercial warewashing appliance. One is a Reverse complaint about ward washers is ‘no longer washing Osmosis (RO) system and the other is a water softener. properly’. That can be down to lack of salt in softeners and Many of the latest warewashing machines come with because the original detergent has been changed for a internally fitted RO systems but these can be prohibitive as cheaper brand. The original is designed specifically to tackle the annual cost of a replacement filter can be as much as the high level of tannin/tea stains that every ward generates.”

September/October 2020 | Hospital Food + Service 29 WAREWASHING

“There are substantial benefits of keeping equipment properly maintained, from lower running and reduced lifetime costs, to increased operating efficiency”

CROSS CONTAMINATION conventional hood machines usually work fine in years 1-3, Tannin acid from teacups and pots leaves a sticky film that but as the springs gradually slacken as they get older that attracts bacteria, meaning glasswashers and dishwashers hood just gets heavier. Pushing up a heavy hood with one can be the main source of cross contamination within a or both hands, especially for shorter staff is not good for the catering environment if the right combination of chemicals back,” says Paul Anderson. and temperature is not achieved. “A chlorinated liquid The ability to sterilise ware in temperatures of up to 100°C detergent is therefore most suited to the machines used in is a level of functionality that has been “hardwired” into hospital kitchens. The higher disinfection properties also several specialist Hobart machines. Tim Bender advises that allow lower wash and rinse temperatures which result in a the COVID-19 crisis has increased demand for this type of reduction in energy consumption,” explains Derek Maher. machine. Advances have also been made in detecting the Hobart has also recently introduced a new range of cleanliness of both machines and their water source. smart undercounter warewashers, with dimensions that Crystaltech uses a new rapid hygiene testing system which mean they can be positioned on wards. Hobart’s newest delivers results on-site within minutes. The swab test can PREMAX Care S model is a double rack thermal disinfection detect if a warewashing machine is cleaning to the expected dishwasher benefitting from VAPOSTOP technology, standard and is therefore safe to use. The bioluminescence which puts an end to clouds of steam generated when test for adenosine tri-phosphate (ATP) has been developed the machine door opens. It also boasts a new TOP-DRY to measure the effectiveness of cleaning as it measures drying function which helps to eradicate the laborious and ATP from both microorganisms and from product/surface time-consuming hand drying, and WashSmart connectivity, residues and is therefore a reliable hygiene test. letting operators control the integral functionality at the Crystaltech can also detect bacteria from a specific touch of a button. A new VISIOTRONIC-TOUCH control water source with the 3M™ Clean-Trace™ Water Plus drastically simplifies the functionality of the machine with a - Total ATP (AQT200). This test is designed to rapidly display that visualises all important information using both assess equipment sanitation processes and the efficiency text and symbols. As a result, programmes can be easily of Clean in Place (CIP) procedures by the improved, selected, and settings adjusted. more accurate detection of organic contamination from microbial or product residues. The test gives an objective ENERGY-EFFICIENCY indication of cleanliness in water samples in seconds with It’s a hot topic in the kitchen. Meiko recommends that any more consistent and reliable results, providing greater manufacturer “worth their salt” will provide a kW/hour confidence in hygiene monitoring procedures. estimate over a fixed number of hours daily. “Start with what you consider is the leading maker’s quote, including water WHAT’S NEW? and detergent consumption and get the other potential The latest developments in warewashing include doors suppliers to provide matching detail for their machines,” on larger Meiko machines that open out, not up, cutting advises Paul Anderson. And share the information - making heavy lifting for the kitchen staff and making cleaning all quotes public is a good way of ensuring accuracy. Many and supervision quicker and easier. Blue colour-coded hospital colleagues will have been through similar exercises components make training and supervision easier by and can contribute useful experience. helping to spot what needs removing for daily cleaning. Budgets are always under pressure, but it is often counter- Automatic hood technology is another relatively new productive to persevere with old, struggling equipment benefit for hospital catering workers. Auto-hoods on when investing in new will bring immediate benefits in terms Meiko dishwashers stop the need to stretch awkwardly or of greater efficiency and productivity. So, the final piece of repeatedly lift heavy steel hoods when loading or unloading advice from Hobart’s Tim Bender is: “Buy better, sooner.” the dishwasher, reducing excessive movement, and cutting back and shoulder pain. The extra costs involved will be www.crystaltech.co.uk more than paid for by the labour and energy savings. www.hobartuk.com “Caterers know from experience that the hoods on www.meiko-uk.co.uk

30 Hospital Food + Service | September/October 2020

Breakfast & morning goods

A good start Hospital Food + Service examines the new formats and products that are available to help hospitals do more with their breakfast offering - for patients and in retail.

For weight control and the patient healing process, Bone, National Account Manager of Weetabix explains. breakfast really is the most important meal of the day. The Any-Which-Way-A-Bix campaign celebrates all of the Yet it is often the smallest meal of the day. There is unique ways Brits enjoy their Weetabix. considerable opportunity with breakfast products and morning goods to offer more choice and, in retail, wider HEALTHY CEREALS availability throughout the day. Nestle’s advice for healthy options are breakfast cereals that “Figures indicate that breakfast remains the fastest contain wholegrains and are lower in sugar, fat and salt - so growing meal occasion in the UK, which offers a great no red traffic lights. All nutritional information is provided per opportunity for hospital cafés and restaurants to generate 100g and per serving, which can be helpful when comparing more revenue,” explains Gordon Lauder, Managing Director one with another. Nestle suggests examples include of frozen food distributor Central Foods. “Many traditional wholewheat cereal biscuits, shredded wholegrain pillows and breakfast items are being eaten throughout the day porridge oats. now too, so it’s well worth paying close attention to your Wholegrains contain fibre and B vitamins and cereal is also breakfast and morning goods menu.” a good opportunity to add calcium to the diet if served with During the lockdown period, Weetabix invested in milk or yoghurt1. significant research around the breakfast opportunity. Nestle recommends caterers should also look for affordable In the home, it found that cereals are the real winner ways to offer fruit - such as or bananas - nuts and at the breakfast table, with cereal brands performing seeds as toppings. If the patient budget is tight consider particularly well. tinned fruit in juice and dried fruit - both are cost-effective “Consumers have returned to cereal because of its options. versatility - it’s quick and convenient but can also be Weetabix Original is a low sugar cereal, with all green traffic personalised with additional toppings and different milks, lights on pack. David Bone says: “We’re passionate about which taps into the trend for personalised breakfasts. That’s providing our consumers with the ‘Weetabix Advantage’ why we’re giving our Any-Which-Way-A-Bix campaign a every morning when they sit down for breakfast, giving them boost, as part of our £11m marketing investment,” David the strong start that only a proper breakfast can do. Now

32 Hospital Food + Service | September/October 2020 Breakfast & morning goods

Cornflakes, Crisp Rice and Bran Flakes come in two pack sizes suitable to bulk or ward catering. High quality bulk cornflakes and crisp rice are both available for CPU production units. An alternative format to traditional cereal, Weetabix On The Go breakfast drinks offer a tasty, convenient and nutritious breakfast. The range provides the protein, energy and fibre of a typical Weetabix cereal with milk, in a smooth chocolate, vanilla, strawberry or banana drink. Weetabix also offers the Protein collection, which contains 21g of protein per serving and a range of trusted products in portion packs to help hospitals safely deliver breakfast to its customers, including Weetabix, Ready brek and Alpen. In retail, offering a wide variety of morning goods will help more than ever, we know that consumers are still looking for a convenient and nutritious breakfast to give themselves a head start to take on the day.” David adds that Weetabix is “a must “Porridge is another delicious way stock for hospital caterers.” to consume wholegrains and a Porridge is another delicious way to consume wholegrains and a source of fibre. Nestle advises that with the emerging source of fibre” flavours and portability there are many options available to both patients and staff. The addition of fruit and seeds helps increase business, especially if they are freshly baked - the to broaden the appeal and offer different taste perspectives, look and smell attracts customers. With the help of modern whilst also being a good opportunity to add fruit to the diet. multifunctional appliances, such as Rational’s iCombi Pro and It can be difficult to produce porridge in the mass quantities iVario, hospitals are able to offer a wider range of fresh products required in hospitals, but not with the Rational iVario. This quickly with a limited number of staff. This means that caterers oven enables caterers to produce porridge in any quantity are able to generate more revenue whilst keeping costs low. required and its advanced heating system means it never Premiumisation continues to be a thriving trend and catches or burns, and there’s no need to monitor the process. speciality breads can contribute to these margin-boosting The technology’s precise temperature control allows all sorts opportunities, particularly during the breakfast session. of other delicate items to be cooked to perfection - such as There are conflicting definitions of ‘speciality’ breads. pancakes and scrambled eggs, which can also be part of a Mintel, for example, categorises speciality as non-sliced; balanced menu. bagels, baguettes, pittas, wraps and so on. Others relate it to the recipe; rye breads, sourdough, cheese and caramelised OTHER HEALTHY ALTERNATIVES onion, to name a few. The bread category offers a range of healthier options “One thing is certain; despite the continued appeal of a including free-from, wholegrain and also rye bread, which has sliced loaf, speciality breads are gaining traction on the high been linked to several potential health benefits such as better street and it’s a great way to mix up the hospital breakfast. blood sugar control and improved heart and digestive health. White bread continues to dominate the pre-packed bread Baker Street offers Seeded Rye Bread and Rye & Wheat Bread to help caterers meet the demand for healthier options, made with a sourdough starter and stonebaked for a premium finish. Both products are dairy free, a good source of fibre and protein and cleverly packed for 45-day freshness. The Seeded Rye Bread is packed with hearty linseeds, sunflower seeds, barley and oats, while the Rye & Wheat Bread is low in fat with no added sugars. “It’s the perfect way to introduce alternative and seeds into a hospital breakfast menu,” asserts Commercial Manager, Scott Oakes.

NEW PRODUCTS & FORMATS Nestle Box Bowls are a great format for retail outlets. They are grab and go, provide the recommended portion of cereal and are suitable for staff and visitors. The Nestle Box Bowls portion pack range provides cereal in a box - just add the milk. Box Bowls are doing well due to hygiene reasons during Covid as the product is eaten directly from the unit thus minimising handling on serving, and once consumed the unit can be discarded. They can also be used in departments where there are limited kitchen facilities. The simplicity of eating from the “box bowl” with no mess or fuss appeals to all. The foodservice range of Nestle Harvest Home products in

September/October 2020 | Hospital Food + Service 33 Breakfast & morning goods

segment but it is declining in value and volume sales2. In “Speciality breads can add value its place, “bread with bits” leads volume sales growth, not least because it can support growing demand for healthier, and increase margins on the artisan products2,” says Scott. The key for cafes, restaurants and retail areas in breakfast menu – but only if they hospitals is to showcase speciality breads on the menu. Whether introducing a healthier toast option such as rye are communicated to customers” bread or a premium sandwich carrier, speciality breads can add value and increase margins on the breakfast menu - but only if they are communicated to customers. Shout the premiumisation trend - and boost the bottom line - by about it on menus, table-talkers and other POS to draw topping with fresh fruit and whipped cream. customers in. Premiumisation should not only apply to commercial TOAST areas. Using Baker Street’s Seeded Rye Bread and Rye & There’s been so much said about serving toast for patients Wheat Bread, for example, in place of white bread for toast recently. Depending on the availability, configuration and or breakfast sandwiches, provides a healthier option. specification of ward kitchens it can be a problem for some English breakfast muffins and American pancakes are hospitals - or even just some wards - to serve hot toast. And particularly popular breakfast and brunch products from the there’s nothing worse than cold toast. Central Foods’ range, suitable for both eat-in and takeaway Rational believes it has a solution. “With a ten-grid and for serving throughout the day. combi steamer, such as the iCombi Pro 10 1/1, you can “Pre-Covid, pancakes were in the top five favourite hot produce 60 slices of toast in 4 minutes, allowing you to breakfast options, according to Kantar research - following serve fresh hot toast with little fuss,” says Theo Bostock, the full English, a bacon sandwich, and eggs, and just Regional Corporate Chef. ahead of avocado on toast. Some 10% of consumers said “Sliced bread is convenient and low in cost, so it’s easy that pancakes were their top hot breakfast choice, so it’s to see why toast is a popular choice,” says Scott Oakes. no wonder that we’ve seen such a high demand for our Even better, Baker Street’s Sliced White and Sliced Brown pancakes, both vegan-friendly and regular options,” says breads offer a choice of classic, simple loaves and with no Gordon Lauder. crust ends, so there’s less waste. “Try topping American pancakes with fruit, blueberries, honey and yogurt, scrambled eggs and salmon, bacon 1 NHS UK 2020 and maple syrup or some other nutritious addition. English 2 Mintel - Bread - September 2019 breakfast muffins can be used for traditional Eggs Benedict or topped or filled with a variety of ingredients, such as www.centralfoods.co.uk patties, smoked salmon, bacon or simply cinnamon www.nestle-cereals.com/uk and brown sugar.” www.rational-online.com KaterBake fruit bread - toasted and buttered - is www.stpierregroupe.com another favourite for breakfast and brunch. Or tap into www.weetabixfoodcompany.co.uk

34 Hospital Food + Service | September/October 2020

Top table

Connectivity … and how it’s going to make hospital kitchens better

Glenn Roberts, Sales Director of Winterhalter UK, looks at connectivity in the kitchen and unveils the top six warewashing sins.

Over the last few years there has been an upsurge in could highlight this, so that the issue could be sorted interest across the foodservice arena in the use of new before the machine broke down. Similarly, if a machine was and innovative technologies; product connectivity is at low on detergent or rinse aid, or if a filter was blocked, then the forefront of this. Its growing list of supporters say the system could warn the appropriate people. It can also it will revolutionise the way kitchens operate - others see if operator errors are being made and give advice on are more sceptical. Now that it’s been around for a best practice. If a machine did break down, then Connected few years, we can assess how the reality compares to Wash can usually indicate what’s wrong to service providers, the claims. Systems like our Connected Wash allow so that the engineer can bring the right parts and ensure a operators, staff and service providers to monitor and first-time fix. update equipment remotely, via the internet. But how One operator described it like this: “Connected Wash does that help in the hospital? is really useful. It lets us keep full accurate records of each Winterhalter was one of the first developers of wash, as well as helping to identify issues and get them connectivity in the catering equipment sector, building it fixed quickly. With the standards we’re working to, we need into our dishwashers, glass washers and, more recently, our the equipment to be working at peak efficiency all the time, utensil washers, so we’ve had more experience than most. and Connected Wash really helps with this.” Eighteen months ago, a prominent high street chain trialled Hygiene and safety are key areas where connectivity will Connected Wash as part of the service package we offered help in hospitals. As well as keeping appliances running at and has subsequently committed to using it across its optimum performance, it will store a life-long HACCP trail. estate. We were able to reduce downtime and call outs and In the case of warewashers, this will allow managers to show we improved productivity. The approach also drove down that the machine was operating at the right temperature, the hidden costs of breakdown, such as extra labour, and with the right dosing of chemicals, and so forth, however was shown to improve staff morale (thanks to the reduction far back they need to go. This type of information can be in downtime). especially important when dealing with vulnerable people, This was achieved by monitoring the operation of the so as well as being extremely useful it can give managers appliances, and sending warnings if anything was wrong. added confidence and peace of mind. For example, a too high or low wash water temperature might indicate a component was failing. Connected Wash The Top Six Warewashing Sins In terms of what sort of information connectivity can deliver, we recently analysed the data we monitor from “The approach also drove down the Connected Wash machines throughout the UK, to look into hidden costs of breakdown, such the most common mistakes that kitchen staff make when operating dishwashers and glass washers. We compiled as extra labour, and was shown to the results into a list of the ‘top six sins’ of warewashing. improve staff morale” What they show is just how effective connectivity is in terms of delivering practical, hard information that can really

36 Hospital Food + Service | September/October 2020 Top table make a difference to how well the warewasher is operating. salt regularly. If the machine has self-diagnostics, and tells And similar benefits can accrue with other ‘connected’ you to fill up the salt, do it right away. appliances, such as ovens and fridges. Sin #5: Running out of detergent. This error is so basic So, to the sins. First, why call them ‘sins’? Well, for one you’d think it couldn’t happen. But the Connected Wash thing, in every case bar one, the machine will have been data shows otherwise. In some sites, staff ignore the displaying a warning error code, which staff ignored or ‘out of detergent’ warning icon and carry on using the overruled. That underlines the importance of training. machine. The result is that items aren’t washed properly or It’s worth remembering that human error is still the most hygienically - which is a serious food safety issue, as it could common reason for service call outs. allow the potential transfer of allergens or viruses. Sin #1: Not pre-rinsing plates or glasses, and not Sin #6: The filter cylinder is missing. Staff sometimes cleaning filters. If staff aren’t pre-rinsing, then detritus forget to insert the bottom inlet filter after cleaning. goes into the machine and clogs up the strainers and blocks Operating the machine without this filter can lead to serious the filter cylinder. It can spoil results and ultimately damage damage, as there is nothing to stop forks, spoons or other the machines. The solution is simple: pre-rinse dirties and debris getting into the wash pump. Always replace filters check and clean filters regularly. after cleaning, and regularly check that they are in position. Sin #2: Opening the door/hood too early. This happens In addition, the Connected Wash data highlighted when staff open the door or hood before the wash cycle two other areas where efficiencies could be optimised, is complete, in order to get out plates or glasses more but where there are no error codes. The first of these is quickly. The key problem here is that, if the rinse cycle ‘operational readiness’ - this is where machines are turned hasn’t finished, then the ware may still have detergent on long before they are actually used. Connected Wash said on it, resulting in an unhygienic wash. This needs careful the average time wasted this way was 90 minutes - which monitoring, as there is no warning icon when the door or is a significant amount of wasted energy. The second area hood is opened early, although the error is logged by the involved the self-cleaning program: Connected Wash data machine and by Connected Wash. showed that, in some sites, this was not being run at the Sin #3: A badly loaded rack blocks a wash arm. This end of each shift. Not running the program over a period happens when an item such as a fork slips out of the rack of three or more days could result in poor wash results and and blocks the lower wash arm, or an item that’s too big even damage to the machine. for the machine blocks the upper one. If there are any So, connectivity can deliver practical benefits to the blockages, the wash arm won’t rotate properly and you’ll kitchen. It can prevent downtime. If a breakdown does get poor results. occur, it can help deliver a first-time fix when the engineer Sin #4: Running out of salt. If the water softener system visits. It can ensure that kitchen equipment is always running runs out of salt and the machine is using untreated hard at optimum levels. And its ability to spot bad practice and water to wash, then not only will results be poor but also human error helps train staff, to ensure they operate at scale will build up and damage the machine. So, top up the optimum efficiency too!

September/October 2020 | Hospital Food + Service 37 Immune health

With the COVID-19 pandemic reinforcing the importance of health and wellness The future of amongst healthcare professionals and consumers worldwide, there’s never been nutrition & a better time for the hospital foodservice sector to focus on nutrition and immune- immunity in supporting ingredients as part of their offering for patients, the hospitals workforce and visitors. A recent conference hosted by Kerry Taste & Nutrition • Hold the sugar - 43% of foodservice customers are looked at how nutrition is changing the game in interested in or following a reduced sugar trend, and foodservice and inspiring innovation on menus globally. increasingly searching for beverages with low sugar (57%) or As part of the event, Kerry Taste & Nutrition unveiled new no added sugar (53%) attributes. Interestingly, 41% see real pan European research, which revealed that eight out of fruit as a key beverage health attribute. This strongly suggests 10 (81%) of those consumers seeking to change their diet that real fruit as a sweetener is something operators could be believe that across the board foodservice operators have making more of. a responsibility to improve nutrition on their menus. • Finding balance - 81% of those seeking to change their Kerry Taste & Nutrition’s pan European research, ‘Nutrition diet believe foodservice operators have a responsibility to In Foodservice: Unlocking opportunities in a changing improve nutrition on their menus. The foodservice industry consumer landscape’, looks into consumer attitudes, needs, must respond to this overwhelming market demand. While trends and behaviours towards nutrition is an emerging trend, nutrition when eating out of taste still remains key as the home. The research focused most sought-after need. Many specifically on the transparency “According to consumer research are seeking out smarter ways of food sourcing, sugar to indulge, for example one reduction, the importance of carried out by FMCG Gurus in 2019, in three (38%) look for natural maintaining signature taste half of consumers had looked to claims when purchasing ice profiles and how this impacts cream. operators. In addition, new and improve their immune system over • Mind matters - consumers emerging health trends and the are increasingly focusing on importance of language when the preceding 12-month period” holistic wellbeing. This involves conveying healthy options to considering and nourishing all consumers were also examined. human elements - mind, body Key highlights of the research include: and spirit; 32% of people cite mental wellbeing as a key • Consumers get real - consumers are increasingly looking for reason to change their diet. food and drink options that are more natural, more nutritious and more environmentally sustainable with 35% considering IMMUNE HEALTH IN HOSPITAL FOODSERVICE natural ingredients/flavours the most important nutritional Global research conducted on behalf of Kerry Taste & claim at lunch and dinner. Respondents also said that there Nutrition in June 2019 looked into consumer awareness and are demands for ‘cleaner’ cooking methods with steaming, attitudes towards healthy lifestyle ingredients in fortified poaching and baking preferred over frying. foods, beverages and supplements. The research revealed • Transparency needs - across all seven markets researched, that in Europe, consumers ranked immune system support 6 out of 10 respondents confirmed they’d like to see more as the most important reason for purchasing healthy lifestyle nutritional information such as calorie content, fat content products. What’s more, according to consumer research and sugar content displayed on foodservice menus. carried out by FMCG Gurus in 2019, half of consumers

38 Hospital Food + Service | September/October 2020 Immune health

had looked to improve their immune system over the benefits at breakfast while 36% say they’d like such a drink preceding 12-month period. It’s worth remembering that this as a mid-morning snack and 38% would prefer it mid- research was conducted prior to the COVID-19 pandemic. afternoon. Providing these beverages on menus and making Additionally, Mintel research released in March this year them available for patients will give curious consumers and revealed that 66% of consumers were very or extremely functional beverage converts another place to find beverages worried about the impact of the pandemic on their lifestyle. with immune health ingredients. Elaine Druhan, Foodservice Marketing Manager at Beverages that can effectively communicate how their Kerry Taste & Nutrition, comments: “Given that immune products support immune health are predicted to flourish health was already a high priority for consumers prior to in the ‘New Norm’. Using simple, functional descriptors, the COVID-19 pandemic, we believe that there is a real such as vitality, boost, defence, immunity and detox opportunity specifically for hospital foodservice to learn from amongst others, can help to showcase natural immunity- this growing trend and in turn boosting ingredients, be able to evolve to meet their highlighting the benefits of customers’ growing nutritional fortification for consumers expectations.” “68% of European consumers are and help to make menus less An adequate and balanced complex. supply of nutrients is essential interested in consuming food with Elaine concludes: “Prior for a healthy, functioning to the COVID-19 pandemic, immune system. Additionally, immunity-boosting benefits at people were eating out more the effectiveness of the immune breakfast” frequently than ever before system can be directly impacted and demanding healthy by what we eat and drink. As options that don’t compromise consumers take a more proactive on taste. Additionally, given approach to supporting their immune health in the wake of the requirements within the NHS around the provision of COVID-19, introducing immune health boosting ingredients healthy, balanced nutrition, the hospital foodservice sector on foodservice menus - especially in the form of immunity- has never been more challenged to address this demand boosting beverages - could unlock opportunities. Trust is with nutritional improvements to menus. key, with consumers seeking ingredients with proven health “Our purpose at Kerry is to inspire food and nourish benefits, backed by science, which are familiar and offer life and as one of the world’s leading taste and nutrition reassurance. companies, this is a major focus for us. By sharing these Beverages represent a natural starting place and the insights into nutrition, immunity and consumer demands most realistic category with dairy-based drinks, plant- and behaviour, we’re pleased to be able to help our based alternatives and juice drinks offering the most active hospital foodservice customers understand these growing categories already featuring immunity claims. Kerry Taste & trends and in turn be able to evolve their businesses to Nutrition’s research found that 68% of European consumers meet the growing nutritional expectations of patients, the are interested in consuming food with immunity-boosting workforce and visitors.”

September/October 2020 | Hospital Food + Service 39 Nutrition

THE RELATIONSHIP BETWEEN MENTAL HEALTH AND DIET

Marlene Watson-Tara, health counsellor, teacher, author and co-founder of the Human Ecology Project, discusses the significance of diet on a person’s mental state.

40 Hospital Food + Service | September/October 2020 Nutrition

Mental health awareness Julius Wager-Jauregg, the only psychiatrist to have ever is an issue regularly won the Nobel Prize. There have been subsequent studies reported in the media. confirming this link. There is no one cause of mental illness and FIGHTING INFLAMMATION WITH PLANT-BASED often the primary cause NUTRITION is unclear. It can be the The modern diet is pro-inflammatory. This inflammation result of many events irritates the vagus nerve, the direct connection between such as suffering caused the gut and the brain. The resulting mechanism has from losing a loved one, been detailed in many studies, including the Journal of diagnosis of terminal Neuroscience Research, and the outcomes are the same. illness, the loss of a Our gut biome (the colonies of microorganisms that live in home, job or a multitude the gut) can be contaminated by the food we eat. The prime of challenges that people culprits are found in the modern mainstream diet. face daily, but sometimes The foods which most exacerbate inflammation are those it cannot even be pinned that are mostly present in processed foods. These include to a series of events or situations. simple sugars, fructose, dairy foods, eggs, alcohol, meat, One area that can have an impact on mental health is hydrogenated fats, palm oil and some and vegetables our diet choices. By having an awareness of what certain such as tomato and pineapple. These foods are not only food types do to our digestive system, we can be selective to ensure our food choices do not contribute to any mental health symptoms we are experiencing. “Traditionally fermented foods like soup, , naturally fermented soy THE GUT-BRAIN CONNECTION Connecting the gut and brain to mental health is a new and sauce and sauerkraut feed the gut biome” fascinating area of research. The gut-brain connection is now recognised as a basic causal in disrupting the gut biome but, if there is any tenet of physiology and medicine. There is no shortage inflammation in the body, they can feed the process. of evidence of gastrointestinal involvement in a variety of Using data from two large studies, Danish researchers neurological diseases. What has been discovered is that have found that higher blood levels of C-reactive protein gut bacteria can play a significant role in psychology and (CRP) are associated with a greater risk of psychological behaviour as well as digestion. stress and clinical depression. Eating a diet with significant The gut and brain are created from the same type of amounts of animal protein can cause a burst of inflammation tissue. Intestinal health can have a profound influence on that could increase symptoms in someone already suffering from depression. Eating a diet rich in antioxidants, a plant- based diet, has a profound benefit in stress reduction. “Gut bacteria can play a significant role This is good news since the gut biome changes with in psychology and behaviour as well as your diet. A plant-based diet can cut the C-reactive protein by 30% within two weeks because of the anti- digestion” inflammatory properties of antioxidants. This is important as clinical depression can be accompanied by increased mental health, and vice versa. As a single system, the gut oxidative stress and the autoimmune inflammatory and brain work together to keep body functions operating at responses it creates. peak condition. They use the same methods and nerves to communicate. Diet plays a huge role in mental health once FERMENTED FOODS - THE BEST ROUTE TO OPTIMAL we learn that the gut can be perceived as our “second brain.” DIGESTIVE HEALTH The gut has the same neurotransmitters and just as many Fermented foods have been traditional staples in most neurons as the spinal cord and peripheral nerves. It contains cultures, but modern food manufacturing has eliminated almost 95% of a body’s serotonin, the neurotransmitter that most of these foods. Traditionally fermented foods like helps regulate mood and social behaviour, appetite and miso soup, tempeh, naturally fermented soy sauce and digestion, sleep, memory, and sexual desire and function. sauerkraut feed the gut biome. Nourishing your gut flora is extremely important. Going vegan has multiple proven benefits. An exclusively According to the World Health Organization, more than plant-based diet is naturally higher in fibre and boosts 264 million people of all ages suffer from depression. It is bacteria that make short-chain fatty acids (SCFAs). These one of the leading causes of disability worldwide and a major SCFAs improve immunity against pathogens, provide an contributor to the global burden of disease. energy source for our gut lining, maintain the blood-brain Dr. explains that the relationship barrier, activate critical intestinal protection mechanisms between mental health and gut inflammation was first noted and help control our blood sugar and caloric intake. in 1887. The doctor who discovered this relationship was Eat well and stay healthy.

September/October 2020 | Hospital Food + Service 41 discovery den Operating in a COVID world As the country prepares to face a second peak of coronavirus with the infection rate on the rise and increasing hospital admissions predicted*, Hospital Food + Service examines the impact of COVID-19 on hospital catering teams and services, how caterers have risen to the challenges and the learning that should be taken from these troubling times.

There is no doubt that COVID-19 is having did it. Our teams are as integral to the NHS as a profound and lasting effect on all the doctors and nurses and that’s a very aspects of life across the world. important message. Hospital catering In the health service it has is an exceptional element of the created an extremely hospitality industry and we challenging environment really can - and do - make a in which to maintain difference.” service provision and Impact on the patient care. Hospital caterers have, by workforce necessity, remained The virus has on the front line exposed lack of throughout investment in the pandemic. staff and existing pressures have The virus has been compounded highlighted by vulnerable the importance staff shielding, of nutrition for staff suspected all. Staff need to of having the virus eat healthily to self-isolating and of maintain mental and course, staff becoming physical wellbeing, ill and, sadly, dying, all of as well as energy levels which are factors that have exacerbated staff shortages in this very demanding and left many working even working environment. As well longer hours, often without days off. as ensuring patients have the nutritionally-balanced meals they need A report released this month by for their recovery, in many hospitals catering Skills for Health (‘COVID-19 Insights: Impact on teams have stepped up their activities to provide workforce skills’) based on research carried out in June across food for staff as well, as the virus forced the closure the NHS and the wider health and care sector, claims that - or reduced operating hours - of retail outlets on nearly a quarter of organisations confirm loss of skills within hospital sites. the workforce. In addition to the issues just mentioned, other Speaking at a lockdown webinar, Craig Smith, National factors contributing to this include burnout - leading to staff Chair of the Hospital Caterers Association, HCA, paid tribute, resignation or extended sick leave, and staff opting for early saying he has “nothing but pride,” for the efforts of hospital retirement. catering teams across the country. “What I’ve seen across the The need for additional training emerged strongly within Four Nations is that the caterers have been involved right the report. This is training that is over and above the skills from the outset in terms of the contingency planning - what needed for individuals to do their job, reflecting the ‘new had to be delivered, how it was delivered - they got on and normal’. One of the key areas identified for additional

42 Hospital Food + Service | September/October 2020 discovery den training is infection prevention and control. Others include dealing with out of the ordinary situations and the “The virus has highlighted the appropriate use of equipment, facilities and materials. Areas in which organisations want additional support importance of nutrition for all and include with staff wellbeing, employee engagement and workforce planning. represents an opportunity that Andrew Lovegrove, Senior Workforce Development Consultant for Skills for Health and an expert in workforce hospital caterers should not waste” planning and skills development, issued a strong message. “We’ve long advocated that workforce planning and health problems. It found that young adults and women development is a vital activity of any health organisation. have been more likely to report worse mental health and COVID-19 has highlighted that we’ll ‘fail’ without adequate wellbeing during the pandemic than older adults and people planning.” men. Some of this is due to the caring responsibilities The People Plan, the much heralded and long-awaited that women assume, but social factors are also thought plan for the development and sustainability of the NHS to have played a part - women tend to have more close workforce, was published in July. The plan promises to put friends than men and therefore experienced a greater staff wellbeing at its heart with a new recruitment, retention increase in loneliness during the pandemic. and support package, including practical support for The report is inconclusive about whether certain roles wellbeing. Unfortunately, even though public recognition - for instance, key workers in healthcare - experienced of the roles played by non-clinical staff in the delivery of worse mental health and wellbeing than others. Two healthcare has been higher than ever before as a result of the studies found a difference and two others are reported to pandemic, almost all of the focus of the People Plan is on the have found no difference. In ‘The Psychological wellbeing recruitment and retention of medical staff. Specific schemes of frontline workers in the United Kingdom during the have been announced to increase undergraduate places COVID-19 pandemic’ Jamie Murphy and others found and clinical placements for nurses, midwives, allied health that frontline workers generally and individual frontline professionals, dental therapy and hygienists, but nothing has worker groups had significantly higher prevalence been announced to help recruitment into catering or other estimates of depression, anxiety and PTSD. Further facilities roles. analysis showed that food workers were nearly twice as likely as others to screen positive for anxiety. Frontline Raising the profile of food workers generally were significantly more likely than the The virus has highlighted the importance of nutrition for general public to have received mental health advice all and represents an opportunity that hospital caterers during the pandemic (26.9% versus 20.3% respectively), should not waste. The link between diet and mental and which was largely reflective of health and social care physical wellbeing for staff is being discussed widely and workers (37.9%). openly and the ‘food as medicine’ message for recovering The NHS Confederation’s Health and Care Women patients has never been stronger. COVID-19 has enhanced Leaders Network (HCWLN) has echoed these findings the public’s understanding of the importance of healthier on the impact of the pandemic on female staff, warning eating and nutrition, and it is vital that understanding and recently that women - who make up the largest focus on diet and nutrition does not become diluted as life proportion of the NHS workforce - are suffering from returns to some sort of normality. stress and exhaustion and are at risk of burnout. The HCA’s media and PR Advisor, Gail Walker of Open The HCWLN report also cites the caring Door PR explains that whilst the recognition of the role responsibilities taken on by women - both in and outside played by food, nutrition and the catering professionals of work - as a significant factor making them particularly who deliver these vital services within hospitals is so high, now is the right time for hospital caterers to engage with stakeholders and Chief Executives within their own organisations to ensure this message remains high profile, is understood, and that food is properly funded. “Our job now as communicators is to keep that pressure up and use this opportunity to escalate that recognition and keep that status really high.” Mental health ‘The COVID-19: mental health and wellbeing surveillance report’ published in September by Public Health England looks at population-wide mental health and wellbeing across England during the pandemic. Not surprisingly, the data found evidence of increased mental distress in many ways throughout April 2020 compared to the same month between 2017 and 2019. The report also drills further into population groups and which ones appear to have been disproportionately affected by mental

September/October 2020 | Hospital Food + Service 43 discovery den

“Our teams are as integral to the outbreak which saw another major sandwich supplier fail and others withdraw from the hospital supply chain. NHS as the doctors and nurses and It highlights the need for supply solutions that are sustainable and safe. that’s a very important message” Part of this is a renewed focus on buying British. The virus has challenged supply chains that rely on goods being moved around the world, with travel services by susceptible to increased stress. For example, since air, sea and rail severely curtailed or suspended. British the start of lockdown, survey respondents reported suppliers have demonstrated their flexibility, ability and that they took on an average of 11.22 additional hours willingness to get involved and ensure continuity of each week of non-work caring responsibilities, but only products into the hospital catering service. reduced their working hours to take account of these Some hospital catering teams have reduced menu responsibilities by 1.44 hours each week. choices during the pandemic. In part this has been to Samantha Allen, Chair of the NHS Confederation’s guarantee supply. There is a school of thought that it Health and Care Women Leaders Network and Chief is unnecessary to offer such a wide choice on patient Executive of Sussex Partnership NHS Foundation Trust menus. This is likely to be a topic for debate as we says: “Women make up more than three-quarters of the emerge out of the pandemic and issues such as plate NHS workforce, so we cannot afford to let these issues waste against the wider sustainability agenda take be ignored. Now more than ever, women across health higher priority. Ensuring all patients receive the same and care must have access to the right support so that we choice and keeping waste down is something of an can minimise the risk of burnout, protect their wellbeing, oxymoron, which requires more innovation in the process and make sure they are mentally and physically healthy of capturing the patient’s meal requests. enough to continue to care for and support our The catering team is also vulnerable to further communities.” outbreaks of COVID-19. At the time of going to press the testing system was under pressure with reports of Improving resilience through learning people showing symptoms, including key workers and Although there has been much praise for suppliers NHS staff or their families struggling to get tests. If one and how they have worked with the health service to worker in a large CPU tests positive, how many more maintain supplies and provide support to key workers, people in that environment will be forced to self-isolate the pandemic has nevertheless highlighted some weak for 14 days? Will the service be brought to a standstill? points where the catering service could be left exposed. It’s a sobering thought. For instance, quite early into the lockdown period a major supplier of sandwiches to the healthcare sector * The latest daily infection statistic available at the time of (Adelie Foods) went into administration. This was a going to press reported 4,926 new UK cases, with increasing double blow, following the impact of last year’s listeria hospital admissions and fatalities anticipated.

44 Hospital Food + Service | September/October 2020 New Products apetito extends range with series of launches

Culinary Inspirations is a new collection of almost 50 dishes from apetito, being launched in a six-part series over four months. The collection includes new main meals, texture-modified meals, a series of plant-based dishes and an authentic pasta range. For the first six new dishes, apetito reached out to five top chefs from the South West, whose businesses had been adversely impacted by COVID-19. The chefs worked with apetito’s product development team and in-house dietitian to create dishes that offer something different whilst meeting the varied nutritional needs of patients and delivering quality and innovation. Dishes include a Ham, Leek & Cheddar Tart, Coronation Chicken, Sausage & Smoked Ham Frittata, Chicken & Chorizo Paella, Smoked Haddock & West Country Cheddar Omelette and Chicken & Sweetcorn Bake. Crystaltech leads the way for This month (September) has seen seven new pasta favourites added to the Culinary Inspirations collection, including Beef COVID testing of engineers Bolognaise with Pasta, Chicken & Pasta with Tomato & Herbs, Tuna Pasta Bake, Macaroni Cheese, Penne Pasta in Tomato & Specialist warewashing company, Crystaltech, is leading the Basil Sauce, Cauliflower & Broccoli Pasta and Pasta Carbonara. way in providing safe services to the UK healthcare industry For details of the additions to the texture-modified range by implementing a rigorous monthly testing scheme for its for patients suffering with dysphagia, see separate feature on entire nationwide engineer workforce. All 60 Crystaltech pages 20-23 of this issue. engineers will be required to undertake a virus test every www.apetito.co.uk 28 days and will then be issued with a COVID-19 photo ID badge to show sensitive healthcare sites when they had the test and when the next one is due for renewal. Managing Director Derek Maher, comments: “Over the last few months our engineers have been working within strict safety guidelines when they have attended particularly sensitive sites including nursing homes, hospitals, public sector sites, supermarkets, MOD and production kitchens. Our monthly testing scheme will provide those sites with added assurances that all our engineers are working to the highest safety standards to prioritise the health and safety of those that they come into contact with.” www.crystaltech.co.uk

Meiko BioMaster makes short work of all food waste

The new BioMaster from Meiko Green Solutions, unlike many competitive food waste solutions, takes all food waste including cooking oils and fats and even bones, creating a biomass product that is pumped to holding tanks for collection. Biomass is used to create energy, providing a sustainable return, especially compared to competing ‘grey water’ solutions which see any benefit from food waste going down the drain. Apart from a small amount of electricity and water, there are no running costs for BioMaster; unlike grey water systems which require significantly more energy and often additional items such as chemicals, wood chips and enzymes. Both types of system will need regular maintenance, usually every six months for BioMaster (coinciding with the dishwash service). Various models are available in different sizes and capacity, making BioMaster suitable for all types of kitchens. www.meiko-green.com/en/solutions

September/October 2020 | Hospital Food + Service 45 New Products KaterVeg! vegan mince arrives for foodservice

Frozen food distributor Central Foods has launched a new vegan mince for foodservice customers as demand for plant- based products continues to rise. The KaterVeg! vegan mince is high in protein and low in fat and sugar. It is a source of fibre and its salt content is below the PHE 2017 targets. It can be used as a meat substitute in a wide range of dishes from spaghetti bolognaise and chilli to lasagne and shepherd’s pie. The seasoned soya mince is made with textured soya protein and is available in 1kg packs. It is the only frozen vegan mince currently available to foodservice operators that is also suitable Taking combi steamer productivity to the max for those on a gluten-free diet. The vegan mince allows foodservice operators to cater more One of the stars of Rational’s new iCombi Pro combi steamer widely for the growing number of people choosing vegan and is an advanced feature called iProductionManager which, the plant-based options. company says, not only increases productivity but also adds “According to Mintel, a quarter of young British millennials enormous flexibility to production schedules. At the same say that the coronavirus pandemic has made a vegan diet more time, it reduces running costs. appealing,” explains Gordon Lauder, MD of Central Foods. The option of cooking different products at the same time “The June survey also revealed that a vegan diet was proving in a combi steamer isn’t new, but iProductionManager takes more attractive to around 12% of Brits, rising to more than 20% the whole concept to a higher level. As well as telling you what of Londoners, since the start of the pandemic. This illustrates products can be cooked together, it allows chefs to select how important it is for foodservice operators to include delicious whether they want all the food to be ready at the same time, or vegan options on their menus.” if they want it all to be cooked as quickly as possible, or if they www.centralfoods.co.uk want it cooked as energy-efficiently as possible. Depending on the choice, iProductionManager then automatically prepares the optimum schedule. Energy efficiency is increasingly important and iProductionManager can help here, too, by creating the most energy-efficient schedule for multiple different foods. The iCombi control panel makes everything simple. Once the chefs have selected what type of schedule they want they simply drag the relevant icon, such as sausages, onto the appropriate shelf on the panel, so the system knows which food is where and can monitor it accordingly. With iProductionManager chefs can even split shelves, so that two different foods can be cooked on the same shelf, with the system monitoring each to ensure they are perfectly cooked. www.rational-online.com

FEA claims lobbying success over food for AD goes to landfill, due to contamination, while alternative waste management on-site systems of food waste management can contribute significantly towards the zero-landfill targets. FEA cited The Environment Agency (EA) has issued a Regulatory examples of these alternative systems, including dewaterers, Position Statement that changes its policy on the use of food digesters, sink to sewer disposal, in vessel composters and waste management systems by the foodservice industry. grease traps, grease removal units and bacterial dosers. Whereas initially the EA determined that on-site treatment www.fea.org.uk would require a permit, the agency has now confirmed that, so long as operators comply with the Regulatory Position Statement’s requirements, a permit will not be needed. The change was achieved by the FEA Food Waste Product Group, who presented a strong and well thought-out case, engaging with both the EA and DEFRA. Virtually everyone agrees that the collection of food waste for anaerobic digestion (AD) is a good policy. The FEA supports it, too, but its campaign highlighted that there is no ‘one size fits all’ solution, and that the various alternative technologies available can provide a greener solution, depending on the site’s circumstances. FEA also pointed out that up to 20% of food waste collected

46 Hospital Food + Service | September/October 2020 NHS Supply Chain

Mapping food to COVID-19 Joanna Instone, in-house dietitian at NHS Supply Chain: Food, looks at how food can support recovery through this pandemic.

COVID-19 presents a range of symptoms in a patient a great source of energy and protein, and drinks like and can be an enormous strain on the body. Sound milkshakes in different flavours can add in the extra dietetic measures can ensure patients get the correct nutrition needed to aid recovery. nutrients to aid recovery. Tactics such as these are not just useful for patients Symptoms can include difficulty eating and drinking recovering from COVID-19, but also for other due to a shortness of breath, weight loss and loss vulnerable groups such as the elderly and those of muscle and organ tissue, difficulties chewing and identified as malnourished. This is why NHS Supply swallowing, and a change in taste and smell. Chain: SC Food put together a useful guide to snack Giving the right food to nourish the body back to and drink suggestions, with a nutritional breakdown, for health can be difficult under these circumstances, use during the height of the pandemic. particularly with difficulty swallowing (dysphagia) seen These are just a few of a number of steps that can in some patients coming off a ventilator, sometimes be taken in the battle against COVID-19. The important after many weeks. This group of patients is likely to need thing to remember is that appropriate nutrition should food and drink that has had its texture and consistency be available for all patients with COVID-19 and other modified so that it is easier and safer to swallow. diseases. To view a full range of resources created by NHS The IDDSI Framework Supply Chain: Food visit www.supplychain.nhs.uk/ In the UK we use the International Dysphagia Diet categories/food/ Standardisation Initiative (IDDSI) to describe the type of texture modification that is needed for patients with swallowing difficulties. For example, IDDSI Level 4 describes puréed foods and IDDSI Level 5 describes “The tool has supported fast decision making by minced and moist foods. presenting this range of food clearly” Ensuring patients are given the right IDDSI level, as well as meeting dietary requirements and avoiding allergens, can be a difficult task, and requires the expertise of Speech and Language Therapists, and Dietitians. During the height of the pandemic one of the tools NHS Supply Chain: SC Food created enables NHS staff to review all the texture-modified Direct Ready Prepared Meals we offer through the NHS Supply Chain: Food framework and filter by things like meal type (main course, dessert etc.), allergens, vegan, and IDDSI level. The tool has supported fast decision making by presenting this range of food clearly – a valuable time saver during a pandemic.

Nutrition where it’s needed For patients facing the uphill struggle with COVID-19 and recovery, another great way to support is by offering high protein, high energy snacks and drinks between meals. This helps prevent weight loss, muscle wastage, and the associated weakness. The important thing here is to ensure variety with the snacks, to avoid flavour fatigue from having the same thing over and over. Flavour fatigue can lead to a patient choosing not to eat a snack or drink a drink at all. Things like fortified soups and porridge pots are

September/October 2020 | Hospital Food + Service 47 NHS SUPPLY CHAIN

Anglo Caledonian Enterprises Limited COLD BEVERAGES, Anglia Crown Ltd AMBIENT FOOD AMP Compass Contract Services BGL Rieber Ltd CONFECTIONERY & SNACKS Hobart UK (A trading division trading as Steamplicity of ITW Ltd) Food Network Corporation Ltd JLA Limited Harry Yearsley Limited Nisbets Plc Harvest Foods ScoMac Catering Equipment Ltd Maple Fine Foods Stephens Catering Equipment Co Ltd Medina Food Group Ltd SPL Foods Limited Williams Refrigeration The Punjab Kitchen Ltd Graham Knight Winterhalter Ltd Paterson Arran LTD Tillery Valley Foods Limited Commercial Director T: 01506 431031 T: 0161 624 1619 E: [email protected] E: [email protected] W: www.paterson-arran.com COLD BEVERAGES, W: www.spluk.com DESSERTS & SNACKS CMP CONFECTIONERY & SNACKS COLD BEVERAGES, AMBIENT FOOD AMP CONFECTIONERY & SNACKS

Calbee Group (UK) Ltd Adrian Blackburn Cawston Press National Account Mgr Andy Hope-Johnstone T: 01274 546405 Managing Director The Protein Ball Co. M: 0784 3346651 T: 07802 885642 Bethan Evans E: [email protected] Weetabix Limited E: [email protected] International Sales Manager W: www.seabrookcrisps.com David Bone W: www.cawstonpress.com T: 0207 117 2631 W: www.yushoi.co.uk National Account Manager E: [email protected] M: 07833 435742 W: www.theproteinballco.com E: [email protected] Fulfil Food Solutions W: www.weetabixfoodcompany.co.uk COLD BEVERAGES, Histon Sweet Spreads CONFECTIONERY & SNACKS Juiceworks Britvic Soft Drinks Ltd Midland Chilled Foods Ltd Coca-Cola Enterprises Ltd Nutshell Packaging Bbi Healthcare Cott Beverages Limited United Biscuits Limited Danone Nutricia Ltd (Medical) Chapple and Jenkins Dietary Foods Limited Green Park Snacks Heinz Single Service Ltd Harrogate Spring Water Ltd Ivory & Ledoux Ltd Kettle Foods Juiceworks Kellogg Marketing & Sales Co Uk Ltd Ben Brindley Kelloggs Sales & Marketing Co.UK LTD FOOD TO GO Macewen Falconer & Co Ltd Business Develoment Manager Kirtons Bakery Ltd Marillo Foods LtdMartin Mathews M: 07788 394175 Lucozade Ribena Suntory Nestle Uk Ltd E: [email protected] Nims Fruit Crisps Nutshell Packaging W: www.kettlefoods.co.uk P.Mulrine And Sons Sales Premier Foods Limited Propercorn Pritchitts Food By Design Pulsin Ltd Sleaford Quality Foods Ltd COLD BEVERAGES, RM Curtis & Company Ltd Tate & Lyle Limited On a Roll Sandwich Co. Ltd Tovali Ltd The Silver Spoon Company CONFECTIONERY & SNACKS James Stoddart Vitz Drinks UK Ltd Tilda Ltd Managing Director Vimto (Out Of Home) Ltd Unilever Uk Ltd T: +44 (0) 1642 707 090 Walkers Snacks Ltd Weetabix Ltd E: [email protected] W: onarollsandwich.co.uk

DELIVERED READY KP Snacks FOOD TO GO CATERING EQUIPMENT Juan Vorster PREPARED MEALS CONSUMABLES CMP M: 07436 589440 E: [email protected] Alliance Disposables Limited W: www.kpsnacks.com Brakes Catering Equipment Bunzl Catering Supplies Apetito Ltd Lockhart Catering Equipment-Berks Rosemarie Hoyle COLD BEVERAGES, The Sandwich King Divisional Manager, Hospitals Julie Crimlisk CONFECTIONERY & SNACKS T: 01225 756017 M: 07971 531 443 M: 07887 676707 T: 0113 2426031 option 2 E: [email protected] CATERING EQUIPMENT E: [email protected] W: www.apetito.co.uk CONSUMABLES LTD W: www.sandwichkinguk.com Mars Wrigley Confectionery Lisa Harwood DELIVERED READY Adelie Foods Ltd Cust Dev Ldr Compass & Sodexo Ginsters, a division of Samworth UK Market PREPARED MEALS Brothers Limited M: +44 7807 150115 Raynor Foods Limited E: [email protected] Sandwich King Burlodge Ltd W: www.mars.com Snackaway Limited Sunny-lee Lyeach Street Eats Food Limited T: 0208 8795700 NH Case Ltd. The Real Wrap Co Ltd E: [email protected] Jacklyn Case W: www.burlodgeuk.com Sales & Marketing Director T: 01963 828 900 E: [email protected] W: www.nhcase.com

48 Hospital Food + Service | September/Octoberl 2020 NHS Supply Chain Framework Directory

Island Foods Limited FRESH FOOD J R Wholesale HOT BEVERAGES & VENDING HOT BEVERAGES & VENDING J. Freeman & Sons Limited CONSUMABLES CONSUMABLES J.R. Holland (Food Services) Limited J.W. Young (Butchers) Limited Jaggstash Limited T/A Kirby And West Ltd Tetley Birchall Tea. Imporient (U.K.) James Burrows Limited Amy Wright-Hamilton Simon Woodfine Business Executive Coulton’s Bread Limited John Sheppard Butchers Limited National Account Manager T: 020 8338 4000 (head office) Graham Mahon Keenan Processing Limited T: 0208 699 0511 M: 07714844535 Sales Director M J Birtwistle & Co Limited Mike Maloney Country E: [email protected] E: [email protected] T: 0151 523 8226 Butchers & Bakers Limited W: www.birchalltea.co.uk W: www.tetley.co.uk E: [email protected] Minor,Weir And Willis Limited W: www.coultonsbread.co.uk Morris Quality Bakers Muller UK & Ireland Group LLP T/A HOT BEVERAGES & VENDING Aimia Foods Ltd Muller Milk & Ingredients Eden Springs Uk Ltd FRESH FOOD Multivend Limited CONSUMABLES Pelican Rouge Coffee Solutions Ltd Noel Chadwick Limited Refreshment Systems Ltd Wessanen (Clipper) Owen Taylor And Sons Limited P J Roofe & Son Catering Butchers P.F.D.(Carlisle)Limited Bridge Valley Coffee & Tea Ltd T/A Pioneer Foodservice Ltd Theo Tompkin MULTI TEMPERATURE GW Price Premier Fruits (Catering) Ltd Purchasing Manager Debra Willoughby R.Manners & Sons Limited T: 0117 947 7777 FOOD SOLUTIONS Director Limited T/A Total Produce E: [email protected] M: 07717 209 992 Ribble Farm Fare Limited W: www.bridgevalleybeverages.co.uk BAKO North Western Ltd E: [email protected] Ron Chalker ( BFS Group Ltd W: www.gwprice.co.uk “The Potato Man”) Limited T/A Bidvest Foodservice Scorse Foods Ltd Blakemore Foodservice Sharrocks Fresh Produce Limited HOT BEVERAGES & VENDING CONSUMABLES Brakes Bros Ltd Solent Butchers Limited Freshfayre Chilled Food Specialist FRESH FOOD GC Birchall Ltd M.A. Forshaw Limited Harry Yearsley Ltd Medina Capital Dairy JJ Foodservice Ltd Company Limited Juiceworks Ltd Medina Food Services Limited Mark Clegg & Company Ltd Middlesex Meat Company Limited T/A Clegg’s Chilled Food Service Midland Foods Limited Lyons Instant Coffee John Palin Martin Brown Seafoods Ltd Redbridge Produce & Flowers Lee Edgar Ann Newton M&J Seafood Ltd Start Fresh Limited M: 07903 749902 Contract Manager NH Case Ltd Threshfield Catering Supplies Limited E: [email protected] T: 01629 592415 Peters Food Service Ltd Tom Barron Limited W: www.lovelyons.co.uk M: 07843 267105 Savona Provisions Limited T/A Clifton Dairies Ltd E: [email protected] Sterling Supergroup Ltd Town Head Farm Products W: www.john-palin.co.uk Thomas Ridley and Son Ltd Limited (Dales Dairy) HOT BEVERAGES & VENDING Trevors Warehouses Ltd W.Mcclure Limited CONSUMABLES Turner Price Ltd T/A Parsons Of Kendal Vestey Foods U.K. Ltd. FRESH FOOD WA Foods Wells Farm Dairy Limited William White Meats Limited

Tchibo Coffee International Prescott Thomas Ltd Rabinder Sidhu Vikki Thomas Senior National Account Manager M: 07508 295651 Sales Executive HEALTHY START VITAMIN E: [email protected] T: 0208 558 9550 DROPS AMP W: www.tchibo-coffee.co.uk M: 07956881915 E: [email protected] Brunel Healthcare W: www.prescottthomas.com Manufacturing Limited

A.G. Axton & Sons (Wholesale) Limited HEALTHY START VITAMIN Arthur Brett Catering Limited If you hold a framework agreement with BAKO North Western Limited TABLETS AMP BFS Group Limited Cuttlefish Limited the NHS Supply Chain and wish to include T/A Bidvest Foodservice Braeforge Limited your contact information and logo in the T/A Pensworth Dairies Ltd Brake Bros Limited NHS Supply Chain Framework Directory, C & G Wholesale Foods Ltd HOT AND COLD FOOD Clegg`s Chilled Food Service DISTRIBUTION SOLUTIONS please contact: T/A Mark Clegg & Company Limited Complete Meats Limited Cotteswold Dairy Limited County Foods Limited LOUISE FULLER Creamline Dairies Limited Socamel UK Ltd Divisional Director of DairyLink UK Ltd Liam Moriarty Embleton Hall Dairies Limited UK Director Healthcare and FM Foodari Limited M: 0782 514 2910 FP Processing Limited (Fresh Pastures) E: [email protected] 01474 520 240 Fresh Direct (UK) Limited W: www.socameluk.co.uk Freshdrop Limited [email protected] Greenvale AP Limited Hallam Country Fresh Foods Limited Hebden And Poole Fine Foods

September/October 2020 | Hospital Food + Service 49 the vole The Vole

MIKE DUCKETT MBE AMBASSADOR FOR GOOD HOSPITAL FOOD

If you are turning to this page hoping to read more of Mike Duckett’s often challenging words around the world of hospital catering, I am sorry to have to inform you that Mike, sadly, passed away in early April. He was a stalwart of hospital catering and whether you agreed with all of his views or not, no-one could doubt his passion and knowledge for the catering sector and hospital catering in particular. As a contributor to this magazine, Mike never missed a deadline, and was always active in forwarding information, reports and comments he had come across that were of interest. Although he was retired, he spent much of his own time lobbying, writing and emailing decision-makers, politicians and industry bodies, campaigning tirelessly for what he believed to be the way forward for hospital food - a return to fresh cook. Hospital Food + Service is indebted to Julian Fris, of catering’. He was awarded an MBE and received the BBC Director of Neller Davies and a long-term colleague and Food Programme’s Food & Farming Award in 2012. friend of Mike’s for much of this obituary. Julian employed Mike said in an article published by the IoH that the Mike as Catering Manager for St Charles Hospital some hospitality fraternity have a collective responsibility to ensure 30 years ago. Over the years, he worked for a number of that the food we serve is healthier. He argued that we should contract caterers at St Mary’s & King’s College Hospitals in persuade those who manufacture meals to be more aware London but eventually he returned to the NHS as head of of the steps needed to reduce high levels of obesity - a catering at the Royal Brompton Hospital. familiar theme which resonates today around the industry There he came into his own - he was fanatical about whether healthcare, education or in the workplace. properly cooked fresh local food and how it was so Mike was a relentless campaigner for better food in important for patient care. He developed a network of hospitals, he strongly argued that food was medicine and meat and suppliers all within 20 miles or so of it was less about cost but the lasting benefit of patient the hospital which he and his team of chefs converted into recovery and wellbeing, which is unquantifiable. award-winning meals at the Brompton. He bemoaned the demise of the hospital kitchen and His catering service was the benchmark and was revered consistently argued against change for change’s sake, by many - the Soil Association, Hospital Caterers Association, which to his mind had devalued the merits of fresh cooked Sustain, Institute of Hospitality and many others. The food and its benefits. He has left a significant legacy to the Brompton’s catering was also highlighted in Lord Carter’s industry and much of it underpins the Government’s current report on NHS efficiency published in 2015. review of hospital food. He caught the attention of the Prince of Wales who visited the hospital several times. Prince Charles had a deep interest Amanda Roberts in this subject and once referred to Mike as a ‘brilliant head Editor 50THEHospital Food + Service | September/October 2020 VOLE