Hospital food – a receipt for sickness

Posted on the 29th April 2015

Hospital food has a notorious reputation and has been the target of numerous tabloid newspaper and celebrity chef backed campaigns to improve standards. But all of these initiatives have failed to tackle two significant issues relating to hospital catering: provision for vegans, and the serving of processed red meat to patients, particularly given its links to an increased risk of bowel cancer.

To assess the current situation, Animal Aid submitted a Freedom of Information (FoI) request to every trust and board in the UK responsible for an acute NHS hospital. It asked each if it had any processed red meat products on patient menus and whether it was able to cater for vegan patients. If it was able to cater for vegans, each body was also asked to provide an example of at least five days’ worth of vegan meal options – five days being the average duration of a hospital stay in the UK.

The most alarming aspect of the responses to these FoI requests was that of the trusts and boards that responded, all but one currently serves processed red meat to patients. This is despite the large and growing body of scientific evidence from around the world linking processed red meat – such as bacon, ham and sausages – to an increased risk of bowel cancer, the second biggest cause of cancer-related deaths in the UK. As a result of this revelation, we are urging all hospitals in the UK to remove processed red meat from patient menus and replace it with healthy plant-based meals instead. There is already a precedent for this; both tobacco and alcohol are banned from hospital premises across the UK due to their links to serious and preventable diseases. Removing processed red meat from patient menus would not only help to protect patients from the harmful effects of these products whilst in hospital care, but would also set a fantastic example in terms of healthy eating.

On the issue of plant-based meals, the response to the other part of our FoI requests on vegan provision was much more varied. In 2004, Animal Aid conducted a similar investigation into vegan hospital catering and found that, on the whole, it was pretty terrible. Fortunately, the situation today is largely much better, but there is still significant room for improvement. We assessed the FoI responses according to a list of criteria (see below) and assigned each a rating from awful to excellent, with the following results:

  • Awful – 8 per cent
  • Tolerable – 8 per cent
  • Adequate – 26 per cent
  • Good – 21 per cent
  • Excellent – 37 per cent

In the case of the worst performing trusts – those rated awful or tolerable – there were obvious ways in which they could improve provision for vegans, such as removing animal products from vegan menus, ensuring better labelling, and providing a wider range of meal options. I’m glad to say that, since writing to these trusts, a number have now committed to making such improvements. But even those that achieved our higher ratings still had areas where progress could be made. For example, almost all hospitals cater for vegans via a separate menu or by providing tailored meal plans, whereas if vegan meals were available through clearly labelled standard patient menus, they would be available to many more people. This could not only help improve nutritional intake, but also help to lower catering costs at a time when NHS budgets are under increasing pressure, as plant-based meals are usually much cheaper than those containing animal products.

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Criteria for rating hospital vegan catering

Below are the criteria used to determine the rating given to each NHS hospital trust for its vegan catering following our Freedom of Information request in March 2015.

Awful – Is unable to provide vegan meals; or has meals incorrectly labelled as vegan (i.e. contain animal products); or has fewer than four vegan main meal options; or provides vegan meals that lack an adequate balance of nutrients (e.g. no source of protein or inadequate range of fruit and vegetables).

Tolerable – Has a small selection of vegan options, but at least four main meals; or fails to properly identify vegan meal options on menus and patient information.

Adequate – Has at least five vegan main meal options as standard; or provides vegan meals on a purely ad hoc basis; or states it can provide vegan meals, but has failed to provide any further details.

Good – Has at least eight standard vegan main meal options, clearly labelled or on a special menu and all nutritionally balanced; or has a limited number of vegan options, but can provide more when required.

Excellent – Has an extensive range of vegan main meal options (at least 12), clearly labelled or on a special menu and all nutritionally balanced; or routinely consults patients about their individual dietary needs and likes on arrival and prepares bespoke menus accordingly.

After assessing each of the FoI responses, we obtained the following results:

  • Awful – 8 per cent
  • Tolerable – 8 per cent
  • Adequate – 26 per cent
  • Good – 21 per cent
  • Excellent – 37 per cent

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