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Hospital food: improvements on the menu

Thursday, 31 January 2013
Hospital food across Wales has been given a makeover to ensure patients have tasty choices which can address patient’s individual nutritional requirements.
SAM_0653.JPGHealth Minister Lesley Griffiths today (Thursday 31 January) launched the All Wales Hospital Menu Framework, which includes a database of recipes to be used in all hospitals, on a visit to Ysbyty Cwm Cynon, in Mountain Ash.
The database currently consists of 18 soups, 38 main course items and 42 desserts, snacks and accompaniments that have been analysed and meet strict nutritional standards.
Celebrity chef James Martin and Abergavenny-based Michelin star chef Stephen Terry have been involved in the process and contributed a number of signature recipes to the menu.
Lesley Griffiths said:
“Hospital food is an essential part of patient care. Good food can encourage patients to eat well, giving them the nutrients they need to recover from surgery or illness.
“Food should be viewed with the same importance as medication, with catering recognised as a clinical support service.
“We are leading the way in Wales by improving hospital food with an all-Wales menu. Standardising the food on offer so patients are assured of good food, wherever they are treated, will help them back to health and improve their experience of hospital greatly.
“Having tasted some of the dishes on offer, I believe the old jokes about hospital food will soon become a thing of the past.”
Chef James Martin said:
“I really feel that food is a medicine. Patients should look forward to meal times as one of the highlights of their day.
“So I was delighted to be invited by the Health Minister to get involved in such a brilliant project that will instantly benefit so many patients. I thoroughly enjoyed working with the All Wales Hospital Menu Framework Group and the team at Nevill Hall Hospital and wish them every success”.
SAM_0663.JPGChef Stephen Terry said:
“I am very proud to have been able to contribute to such an important and essential initiative.”
Judith John, Consultant Dietitian in Public Health Wales and Chair of the All Wales Menu Framework Task and Finish Group, said:
‘’This has been a very positive process with a shared enthusiasm and commitment across all Health Boards to drive this agenda forward. By developing an all Wales approach this has enabled a sharing of good practice and pooling ideas. 
‘’Everyone has had a role: caterers, dieticians,  procurement  and now it’s to time start implementing it and engaging more with nursing, ward staff and patients to get feedback. This is really only Phase One of a continual process for  developing a quality food service for the hospital population of Wales using a menu framework with standardised recipes and methods, which have all been nutritionally analysed to meet the required standards.‘’
All Wales Menu Framework Menu Items
Cream of tomato
Cream of mushroom
Leek and Potato
Carrot and Coriander
Butternut squash and lime
Cauliflower and apple
Potato and watercress
Cream of onion
 Roast parsnip and rosemary    
Cream of Pea and Ham 
Carrot, Lentil and Coriander
Chicken and Leek
Red Lentil 
Bacon and Butterbean
Bacon, Sweetcorn  and Cheddar chowder
Chicken, chickpea and coriander
Chef’s Lamb Goulash Soup       

Main course recipes 
Chicken Fricassee 
Chicken Chasseur 
Chicken Tikka massala 
Chicken and Ham Pie 
Chicken Casserole with Dumplings
Chicken Arriabata      
Tuna Cheesy Pasta Bake
Fish Pie
Fish Mornay
Fish Mornay Sauce
Battered fish
Crumbed  fish
Southern Fried Pangasius fish  
Corned Beef Hash
Lancashire Hot Pot
Chicken Tikka Massala
Pork and Pineapple Balti
Roast Beef/Lamb/chicken/pork/turkey
Beef Curry 
Shepherds Pie
Cottage Pie
Corned Beef Pie
Steak Pie
Lamb Hot Pot
Faggots in onion gravy
Beef Lasagne
Chicken and mushroom pie
Irish Stew
Chilli Con Carne
Chicken , bacon and bean casserole 
Spicy Pepperoni pasta 
Bolognese sauce
Pork Steaks in BBQ sauce
Ham, leek and mushroom pasta bake
Chicken fillet for gravy
Beef Casserole
Lamb Shoulder And Potato Pie   
Cauliflower cheese
Broccoli and cauliflower bake
Macaroni Cheese
Vegetable lasagne
Quorn Chilli
Cheese and Potato pie
Pasta and tomato basil sauce
Quorn Bolognese
Quorn & veg. Curry
Quorn cottage Pie
Vegetarian goulash
Vegetable and bean balti
Vegetable and 5 bean stroganoff
Jam Sponge
Chocolate Sponge
Lemon Sponge 
Eve’s Pudding
Chocolate Chip Sponge
Sticky Toffee pudding with butterscotch sauce
Pineapple upside down cake
Hot banana cake
Bread & Butter Pudding
Jam sponge
bread and butter pudding
Jam Roll       
Apple Crumble
Blackcurrant & Apple Crumble
Apple & Cherry Crumble
Peach Melba flapjack crumble
Fruit Crumble
Red fruit apple coconut crumble
Rhubarb Crumble
Pear and Apricot Crumble
Milk Puddings
Rice Pudding
Sultana Rice Pudding
Rhubarb Pie
Apple Pie
Blackcurrant & Apple Pie
Bakewell Tart
Gooseberry Pie 
Cold Sweets
Stewed Apple
Stewed Rhubarb   
 Stewed mixed fruit           
Blackcurrant Cheesecake 
Strawberry Mousse
Apple Cake
Pre – Cut cakes 
Fresh Fruit
Tinned fruit
Vanilla Sauce
Chocolate Sauce
Sweet White
Ice Cream

Development of the Framework:
In January 2012 the Health Minister asked officials to work with health boards to develop an All Wales Hospital Menu to support the implementation of the All Wales Nutrition and Catering Standards for Food and Fluid for Hospital Inpatients.
Officials established a multidisciplinary All Wales Hospital Menu Task and Finish Group with representatives from each LHB. Health Boards and the centralised procurement services have collaborated and have shared expertise to develop the All Wales Menu Framework which consists of:
  • A database of an agreed set of menu items from across Wales. It currently incorporates 18 soups, 38 main course items and 42 desserts, snacks and accompaniments that have been analysed and meet the nutritional standards;
  • Identified soft textured and healthy options on the standard menu;
  • Standardised tested and evaluated recipes for each menu item so that each catering department can follow the same recipe.
Timeline - Improving hospital nutrition and catering in Wales
In November 2007, the then Minister for Health and Social Services established the Empowering Ward Sister/Charge Nurse Task and Finish Group.  The report which followed, Free to Lead Free to Care made 35 recommendations. These included the development of an All Wales Fundamentals of Care Audit Tool, an All Wales Nutrition Care Pathway and an All Wales Food Record Chart.
In 2009 the All Wales Nutrition Care Pathway was introduced across all wards in every hospital in Wales. The Pathway assists nurses in the decision making process associated with the nutritional screening of every patient on admission and the nutritional care required throughout their hospital stay. The auditing of compliance with the All Wales Nutrition Care Pathway is carried out across all NHS bodies via the Fundamentals of Care Audit process.
The All Wales Nutrition Care Pathway is supported by the new All Wales Food Record Chart and the revised Daily and Weekly Intake and Output Charts, with accompanying posters giving pictorial illustrations of various portion sizes. These charts and posters enable the accurate, standardised recording of patient’s food and drink intake across NHS Wales, supporting the identification, monitoring and treatment of nutritionally at risk patients.
These developments were underpinned by a Nutrition Awareness Campaign for staff delivered by RCN Wales which aimed to raise the importance of food and hydration to the same level as that given to medication.
In 2010 revised Healthcare Standards for Wales, ‘Doing Well Doing Better: Standards for Health Services in Wales’, were published. The new standard for hospital food, Standard 14, and the accompanying guidance strengthened the requirements for meeting patients’ nutritional needs and the importance of implementing the All Wales Nutrition Care Pathway.
An E-learning training package to train all ward staff in the use of the All Wales Nutrition Care Pathway and All Wales Food Record Chart was introduced in September 2011. 
In September 2011 the All Wales Catering and Nutrition Standards for Food and Fluid Provision for Hospital Inpatients were introduced. They set nutrient and food based standards for meals, snacks and fluid. The Standards also covers important issues such as identification of ‘nutritionally at risk’ patients, food service standards that promote the best possible eating experience for patients, and menu planning.
In October 2011 an intranet website, the ‘Hospital Nutrition and Catering Framework’ was launched, bringing together all the policy guidance that covers hospital catering and patient nutrition. The website is part of ‘Health in Wales’, the organisational portal of NHS Wales, formally Health of Wales Information System (HOWIS).  The ‘Framework’ website is available on every ward in every hospital via the All Wales Nursing Information Zone.
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