This week a West Yorkshire hospital branded the highly publicised Loyd Grossman menu too expensive to implement. The menu may have been designed to make NHS food more appealing but introducing it is often far from easy, as Ben Walker found out.
Most Greater London hospitals are putting off serving the new NHS menu, including its Loyd Grossman-inspired dishes, because they do not have enough money to pay for it.
The results of the efforts to introduce the menu have been mixed. Some hospitals have succeeded in meeting the end-of-2001 deadline for introducing three new dishes, but many NHS trusts are waiting until April to upgrade catering, when their budgets are expected to rise by between 6% and 13% for the first time following eight years of cuts.
More worrying for those who invested hopes in the Grossman menu, Airedale Hospital in Keighley decided to stop introducing the dishes last week (see Caterer & Hotelkeeper magazine 17-23 January 2002, page 4).
The mixed picture is hardly surprising, considering that the extra £40m made available last year to improve hospital food amounts to just 2.1p per patient per day.
Most NHS trusts inside the M25 are about £4m in debt. According to Mick Forse, secretary of the South West Thames branch of the Hospital Caterers Association, no chefs want to work a 45-hour week in London's hospitals for a basic pay of £15,000, and so short-staffed trusts are forced to push up their expenses by shelling out on overtime pay and agency rates.
He added that the huge differences in the sums of money which each trust decides to use for food had failed to be addressed by the Government.
The Government's Better Hospital Food programme set a deadline at the end of last year for every hospital to add three Loyd Grossman-sponsored chef specials to its menu, and provide snack boxes and hot and cold drinks 24 hours a day.
At the Charing Cross hospital in Hammersmith, London, catering manager Lee Buckingham heads more than 300 staff. He is responsible for feeding about 800 patients, for whom he has a budget of about £22 each a week. He also runs a 286-seat restaurant, a 50-seat coffee bar and oversees functions at six conference rooms.
The hospital does not cook patients' meals in-house but, like 30% of the UK's hospitals, uses manufacturers such as Brake Bros and Anglia Crown to prepare the meals and deliver them. These cooked and chilled dishes go through regeneration ovens whose operation is risk-proof, said Buckingham.
The hospital had 24-hour provision in place last November, but has not introduced the chef specials yet. John Benson-Smith recipes produced by Brake Bros have been trialled at the hospital. Buckingham said the Better Hospital Food programme was "a big change - challenging, unusual, but not unreasonable".
He added: "Cooking the chef specials in-house is not going to work. We don't have the infrastructure to do it in-house and I don't think any other hospital of our size does. It's too dangerous and hard to monitor."
Forse agreed that for such large numbers of patients, precooked meals were easier to keep hot in the regeneration trolleys as they were taken around wards.
Hospitals could originally choose from 46 leading chefs' recipes, which was not enough for the varied needs of different trusts. Another 50 were added last November.
Forse concluded that the success of health secretary Alan Milburn and Loyd Grossman's chef panel had been in giving hospital food a much greater profile and emphasising the importance of food to patients. This had made trusts address the issue.
He added: "Caterers use the same gravy or flavouring in a series of dishes, so patients suffer from taste fatigue. What the chefs are doing is introducing a different flavouring or spice. It's relatively simple but it can make quite a difference. And with an extra 2.1p a day per patient that's all the extra money will cover really - buying a couple of spices."
The chefs involved in devising the NHS menu include Michael Caines, Shaun Hill, Anton Edelmann, Eugene McCoy, Cyrus Todiwala and John Benson-Smith. But although it may be a glittering line-up, it did not make much difference to many hospital catering staff, said Lee Buckingham, catering manager at Charing Cross Hospital.
"None of my staff knows who these chefs are," he said.