Feeding the frontline

Hospital caterers have reacted swiftly to the coronavirus crisis, adapting their menus, retraining staff and extending opening hours. Nick Hughes reports.

When a critical care nurse’s tearful plea for people to stop stockpiling food went viral in March it hammered home the intrinsic link between food and wellbeing. The NHS runs on many things: money, skills, equipment and compassion to name but four. It also runs on that most basic of human needs: sustenance, both of patients and of staff like Dawn Bilborough who shared her distress after she was unable to buy essentials from her local supermarket.

Getting food to hospitals and care homes is just as critical to a successful Covid-19 response as getting it onto supermarket shelves. So how have caterers done?

The good news is that as things stand the operational side of healthcare catering is holding up well. “The supply chain has been more than robust up until now quite simply because the majority of the hospitality industry is in lockdown and so there’s plenty of product to go around,” says Hospital Caterers Association chair Craig Smith.

Caterers, many of which are third party service providers, have acted swiftly and decisively to guarantee supplies. Oliver Miller, managing director of Autograph, Interserve’s catering business, says as a perishable goods business it is highly susceptible to the slightest changes in its supply chains and therefore does everything in its power to anticipate problems before they occur. “When the Covid-19 pandemic first started to cause disruption, we were prepared and in a relatively strong position because of the strategic planning we undertook. We engaged early with our supply chain and have also benefited from our approach of buying British,” he says.

Some caterers have bought themselves breathing space by tweaking normal operating models. Kate Cassidy, head of marketing, healthcare, at Sodexo UK & Ireland, notes the patient mix in hospitals has changed dramatically as the number of patients receiving elective or non-essential treatment has reduced to release bed space for those suffering from Covid-19. “This has meant demand, in terms of nutritional [and] clinical need, is very different,” she says. In response, Sodexo has simplified its menus, reducing the normal four-weekly daily menu rota down to a seven-day rota to lessen the complexity of menu items stored on site, making it easier to maintain a high level of service. Cassidy says by implementing a simplified menu early, Sodexo has been able to avoid any issues with supply and product availability. “There is still plenty of BDA (British Dietetic Association) approved food and drink available for all patient groups, delivered in the same way and with the necessary detailed allergen and nutritional information,” she adds.

Within the wider healthcare sector, providers have also taken steps to minimise the disruption to food supplies from Covid-19. Apetito, which produces meals for care homes and community services as well as hospitals, has appointed a dedicated coronavirus emergency team that meets daily and reports directly to CEO Paul Freeston. The group has established contingency plans to continually build stock around key raw materials and is currently maintaining production levels in line with customer demand.

Apetito has also distributed additional stocks across its local community hubs to ensure the resilience of its Wiltshire Farm Foods home-delivery service for ready-made meals, which supplies many senior-age people living at home.

Supply may be aligned with demand for now but pressures could yet come to bear. Miller predicts all catering firms will face potential hurdles. “We have already seen that Hungary has practically ceased exporting chickens due to exceptional domestic demand; Spain is considering limiting exporting fresh produce as domestic demand spikes and Italian exports of pasta, bread and dairy have significantly reduced.”

Miller also alludes to the challenge facing UK farmers, who in normal circumstances require around 90,000 seasonal workers to support the harvest – many of whom come from Europe. “Now that borders are practically closed, this is a significant issue,” he says.

A more immediate task for caterers is ensuring hospital workers can still access food at a time when many are working long hours in oppressive conditions. Most retail outlets, such as coffee shops, have closed in line with government social distancing guidelines. Some are still offering takeaway services. Others have been replaced with temporary stores such as the “pop-ups” operated by Compass Group UK & Ireland and Costcutter Supermarkets Group in 20 NHS hospitals in England, offering a range of staples such as bread and milk and household items including toilet rolls and soaps.

Cassidy notes that at the newly repurposed Crussh shop at Birmingham Children’s Hospital, Sodexo has introduced an app that provides a click and collect service for frontline staff to collect groceries and other essentials at the end of their shifts.

The picture is more mixed concerning hospital canteens, which in normal times welcome a steady stream of hospital visitors and staff. Smith says that some canteens are busier and open for longer hours than would normally be the case. “One hospital I was talking to said their normal catering arrangement was to close at 4pm because there is no financial incentive to open any later. They are now opening from 6am to 6pm and have additional provision for night staff meals.”

Others, however, have closed entirely, while some remain open but with social distancing protocols in place and takeaway encouraged to enable staff and key workers to get hot and cold food and drinks between shifts. Miller says there are two sides to hospital canteen closures. “The negative impact is that ordinarily mealtimes are when we socialise, create a moment of respite and bond with each other. The fact canteens aren’t operating like normal in our hospital settings is one example of the dehumanising impact that Covid-19 has had. The positive aspect is that the canteen closures mean we can focus on delivery of what is critically important – preparing high-quality food to patients and NHS staff.”

On-site catering for staff has been supplemented with a flood of food donated by businesses and support groups, many of which have been established in a matter of days to get surplus food to frontline NHS staff. Backed by brands including Leon, BaxterStorey and Dishoom, the FeedNHS group has already raised the funds needed to serve more than 1m meals nationwide. Although Footprint revealed this week that concerns over hygiene means some donated food risks being wasted, caterers are generally welcome of the additional support. “We have received donations of food and drink from many organisations which our teams distribute on their behalf to the frontline teams,” says Cassidy. “One retailer donated 2,000 Easter eggs for staff at one NHS Trust and a number of local chefs are helping at another hospital staff restaurant.”

To cope with unprecedented pressure on NHS services, caterers have been redeploying staff from inactive areas of the business like corporate services and sports and leisure, and in some cases recruiting newcomers – many of whom have been furloughed from the private sector – to work on the healthcare frontline. This includes the new regional Nightingale hospitals which have been rapidly constructed to boost the UK’s critical care capacity. Miller says Interserve has accepted dozens of catering team members from different contracts who were eager to transfer to support its NHS and healthcare catering businesses, including the NHS Nightingale North West Hospital which the business has been commissioned by the government to manage.

Recruits are not being thrust straight into the fray, with Smith noting that those working in Nightingale hospitals are put through a two-day training course. “We don’t want anybody wanting to volunteer think they can just tip up and breeze into these places, you simply can’t,” he says.

Indeed, it can easily be forgotten that the people serving food to patients in hospitals are as much in the line of Covid-19’s fire as the doctors and nurses caring for them. Smith says they must be looked after accordingly. “The people who are serving the food to the patients are on the frontline and they must be treated in exactly the same way as any of the clinical staff in terms of PPE (personal protective equipment) and so forth.”

As well as their physical health, employers are acutely aware of the need to support workers’ mental wellbeing. Interserve has launched a number of initiatives including a new health and wellbeing app called Thrive. It has also initiated a daily one-to-one check-in with each on-shift team member working in a critical environment to support their mental and emotional wellbeing.

As each day passes it becomes more and more evident that the tragedy of coronavirus will leave an indelible mark on everybody that has served on the frontline of fighting the disease. Those keeping the food flowing into our hospitals and care homes are no different. As with all of our key workers, the country owes them a debt of gratitude.


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