Episode 1 Operation Hospital Food with James Martin

People in hospital are already at their most vulnerable

without having to be subjected to unhealthy and unappetising food.

All people want is just good food.

I believe that good, nutritious food

not only lifts the spirits of the patients confined to our hospital wards

but it can be a medicine as well.

Patients in our hospitals are simply not getting the food that they deserve.

-The food's awful.

-Tasteless.

-Atrocious.

-Quite bland.

In a recent survey a third of people asked described the food as unacceptable.

And nearly a quarter of patients wouldn't eat it,

instead relying on food brought in by family and friends.

£50 million have been spent over the last decade

to improve the quality of our hospital food

but so far there's been little sign of improvement.

I want to find out why and took up the challenge

to bring healthy, tasty food to the wards of Scarborough General Hospital

while sticking to very tight budgets.

We're getting the price at what we want it to be and it's under £3.49!

We slashed an astonishing amount of wastage.

I was shocked to find 40% of what we serve today for lunch just goes in the bin.

Patients who'd previously been turning away their food

are now looking forward to mealtimes.

-I think the food's excellent.

-No complaints whatsoever.

And the soups now are brilliant.

Revamping food available for staff and visitors

has brought in new cash flow and made the restaurant a destination.

And changing buying practices has even meant a shot in the arm

for local suppliers, bringing investment into the area.

So I've proved it can be done.

Now the challenge is to try and bring about change across the rest of the UK.

You know, I'm not trying to create a Michelin star meal

but what I am trying to create is good simple food.

Every year the NHS spends a whopping £300 million on food

that unfortunately many patients just don't want to eat.

It's estimated that around £26 million worth of food gets thrown in the bin.

Over the last decade successive governments have spent over £50 million

on failed initiatives to improve hospital food.

Appalled by their lack of progress, I embarked on a mission

to try and succeed where others have failed

and find a model that would see nutritious meals served to patients

without increasing stretched NHS budgets.

I cannot tell you how annoyed I am with this!

365 days a year, this is waste.

I knew that this would be a massive task

but I found that some simple business common sense

and encouragement of demoralised staff can bring about huge change.

-Is that cooking?

-No.

What do you want?

Fresh soup. I wouldn't mind doing that whatsoever.

The team at Scarborough General Hospital took up the challenge

and proved that real, practical change is possible.

Now I want to roll this out to other hospitals around the country.

It changed so much and I think, looking at it,

we can still make a massive difference to the bigger picture.

I'm launching this next stage of my campaign

here at the Royal Orthopaedic Hospital in Birmingham.

In 2009, a vicious fire ripped through the kitchen and restaurant.

But with a brand-new kitchen and equipment,

this hospital's catering department should be firing on all cylinders.

Not so.

Because the one thing the patients and staff say lets the hospital down is the food.

We thought it was a joke to start with.

Mushy and tasteless.

It was all hard and the pastry wasn't cooked enough.

-Most of them have been cold.

-Then it deteriorated.

And for this catering team, it's personal.

If things don't improve, the way that the food is prepared will totally change.

And they're likely to be made redundant.

The fact of the matter is if they don't get this right they're out of a job.

Here goes. I don't know what to expect to be honest

but having spent four months at Scarborough

I doubt it can get any worse!

Is Gaz anywhere?

-Are you Gaz?

-Yeah.

Hi there. James, nice to meet you. And you'll be? What's your name?

-Vicky.

-Vicky? So this is a new kitchen?

-Yeah, our new kitchen.

-It's fantastic, isn't it?

It took its time getting here, but it's all right, yeah.

-So who's the head chef?

-Er, Tracey.

-She's in Turkey.

-She's in Turkey?!

-Till today.

-Right, OK, she's on holiday then?

You've got brand new pans and brand new equipment. That's a start, isn't it?

Yeah!

How many people have you got in your team? How many people work with you?

Erm, we've got about... What, five, six chefs?

Five. Five?

-Five? How long have you worked here?

-Ten years.

-And you don't know how many people are in the kitchen?

-No!

-It changes all the time.

-It's a good start, isn't it?

How many people do you do in a day?

Oh, we've got about 100-odd patients, and you could say the same for staff and visitors.

-That's breakfast, lunch and dinner?

-Yeah.

So explain to me how it all works then. So breakfast is?

Well, breakfast the patients tend to have cereals and toast and stuff. They get that on the ward.

For lunch, we just send a bulk amount up

and they take pretty much what they want off that.

And what about the restaurant? Do you cater for that as well?

We do separate things for the restaurant.

Who decides the menu then?

Erm, it tends to be Tracey. We've got it on a rota, a set menu.

-But we change it sometimes.

-But we can change it sometimes.

OK, well, that's a positive thing.

Yeah, so we've changed it today from kievs to mushrooms.

We're giving them three choices instead of two.

Kievs, are those the frozen things over there?

-Yeah.

-Right, OK, kievs or mushrooms.

Home-made but home-made by someone else.

Premade by somebody else and then placed in the freezer.

In fact, that's not the norm.

Around 80% of the food here is freshly prepared on site, which is a good start.

The trouble is they have no clue how many they're supposed to be catering for. It's all guesswork.

How do you know how many people you've got for lunch? Where's that part?

We phone the wards up and they'll tell us how many patients.

You phone the wards up?

And then we'll send up enough meals for that amount.

We don't know exactly, individually, what they want.

-They decide that on the ward.

-We used to.

Back in the day they used to pick what they wanted but they took it off.

-Who took it off?

-Every patient used to have a menu.

They'd tick off what they wanted so they got what they wanted.

-But they took it off.

-Who took it off?

-Don't know.

-When did that happen?

Sometimes you'll get a phone call saying we haven't got enough of this, enough of that,

and we can't provide it for them.

So basically in theory,

you don't know who you're cooking for, how many people you're cooking for.

-You're just cooking and send it up.

-In theory, yeah.

Well, that's the first problem then, isn't it?

It seems crazy and a false economy to have stopped handing out menus.

The kitchen staff is just taking a stab at how many dishes they need to cook

and that's clearly going to lead to horrendous waste if they guess wrong.

Hiya, it's the kitchen. Hello. Can I have the numbers, please?

23? Any special requirements?

Okey dokey, that's great, cheers, bye.

Yeah, so this ward's full up, so we'll probably just send...

What, about 15 lamb hotpots.

-Right.

-And about six to eight pasta.

And it will be topped up with sandwiches.

The decision to remove the ordering system was made around five years ago

by the management team in place at the time

as it was felt that it wasn't working efficiently.

But in my experience the way they're working now

can only lead to one thing - waste.

Can I have the numbers, please?

20 at the minute? So you might be full?

Shall I put you down for 24 then?

23.

I can't believe what I'm hearing!

At the moment they've only got 20 patients,

and they're not sure how many more's going to come in.

I've got to send even more food up there and that's more waste.

How did this used to happen before? They used to phone down?

No, before, we'd, erm, patients would have a menu.

Which they'd have the day before, tick it off, comes on the computer,

exactly what they've ordered, every patient.

-When's been this problem with waste?

-We barely had any waste before.

-You didn't have any waste?

-Well, barely.

I've only been at Birmingham for a matter of hours

and already I can see where they're going wrong.

They've been busy cooking here since 7am

but the kitchen team has no idea how many patients they're catering for

or what any of them want to eat.

To make matters worse, the team has been told unless they can turn things around,

they'll all be replaced by an external company who would cook the patients' meals off-site.

That sort of food is usually called cook chill.

If it comes here, it will make the team's kitchens and jobs obsolete.

I've heard a rumour about this, this is a big threat for you guys.

-Massive.

-Cos you've got a new kitchen.

It's constantly being brought up now.

-We've been told to up our game.

-Or cook chill?

Which means fundamentally some of you are out of work, is that right?

Yeah, we've got the possibility of it, yeah.

Well, that's what, realistically, that's what it would mean.

Well, you won't need us cooking so yeah.

It's obvious that the constant threat of losing their jobs

is massively affecting morale within the kitchen.

I grabbed a moment with Vicky to find out more.

We never get any positive back, it's always negative.

When was the last time somebody said anything positive to you? In here?

Last week telling us that you were coming, honest to God!

We had this sudden staff meeting! We've got news! We was like that.

James Martin's coming. Oh, right, sound!

-So how long you been here then?

-17 years.

-17 years you've been here?

-Yeah.

And how have you seen it change over the years?

It's not like it used to be.

But you've got a new kitchen, you've got a new...

It's not about your kitchen, it's about...

-It's about here.

-It's about saving money.

You could still have fresh veg. You could still have all that and save money.

-That's what we need.

-The difference is...

To me, there's just no communication in here, none.

There is when we do something wrong.

There is when you do something wrong?

-Great communication!

-Is there?

Absolutely, the best.

I get the sense that the team has been low and demoralised for a long time.

On the surface they have everything they need but from what I'm hearing

it seems that there's no structure, poor communication,

and they feel like every day is a battle.

Well, we've got new fridges.

I mean, let's face it, any chef would be happy with this.

It's surprised me, though,

you can feel that attitude in the kitchen,

you can feel that can't be bothered,

sort of not mixed together with just demoralised,

just stuck in a rut.

Which is a shame because they've got all the stuff, you know.

They've got a massive stockroom. Argh! Packet soups everywhere.

When you've got a stockroom like this,

you've got new equipment,

you almost think it's the opposite to Scarborough in a way.

But because of that I think for me, to be honest,

I think it's even more hard work, this one,

because just the massive lack of communication.

Half of it's not even the kitchen,

it's the wards, it's everything else,

it's just common sense.

Surely if you start work at seven o'clock in the morning,

surely you know roughly how many people to cook for.

We'll wait and see.

I've got a suspicion that guessing the numbers they're catering for

is just one of the reasons why I keep hearing that so much of the food

seems to get thrown in the bin.

And it can't help that I haven't seen any of the chefs following a written recipe

for any of the dishes they're cooking, or weighing out any ingredients.

Which means they have no idea if they're using the right amounts.

I've just seen you make that. How much have you got?

-What, portion wise?

-You don't know, do you?

-You haven't measured it.

-There's no way of measuring it.

Course there is.

-You've taken custard powder out of there.

-Yeah.

You've taken milk powder out of there, sugar out of there.

You haven't measured it.

I reckon I've got about ten litres of custard still sat in there.

-Ten litres?

-Yep.

I reckon I could add milk to that and you've just poured double cream into there.

-Mm-hm.

-You haven't got a clue how much you've made.

No, but I will, I will split that up and it will all go.

If we're on about costings, right,

the fundamental thing is about costings,

and you haven't measured

and you don't know how much custard you've actually made,

then how can I help you?

If I hadn't have spotted that, that would have got thrown in the bin.

-Wouldn't it?

-Yeah.

-So that's five litres of custard for lunch.

Five litres for dinner. That's ten litres, 365 days a year.

-It adds up.

-Ten grand.

-Well, I'm going to dish this up.

-Yeah, but have a think.

-You know what I mean?

-Yeah.

-You've got to think.

You just put double cream in there as well.

Is there any need to put double cream in there?

No, but I mean you get a better flavour out of it.

Yeah, but you've put double cream in there and that's two quid's worth.

Times by 365 days a year, times by two, it's a thousand quid.

Mm. But...

That's 11 grand I've saved and I've been here two minutes.

-Just on cream.

-On custard.

So for the last ten years we've had no recipes to make anything?

-So you've done it all on guesswork?

-Yeah, pretty much.

There's your problem. There's your problem.

Tore me apart there over a bit of custard!

Unbelievable.

Am I totally mad cos I can see it, and I ain't been here ten years.

I've been here, well, it's half past ten. I started at seven o'clock.

So three and a half hours.

The fact of the matter is, if they don't get this right,

they're out of a job, it's plain and simple.

Who the hell's in charge? You've got no ordering system.

You've got certainly no order when it comes to ordering food for ie suppliers.

No recipes to work off, nothing,

and you don't know how many you're cooking for.

Honest to God, it is all over the place.

My chefs would kill for a kitchen like that

and the equipment that they've got.

It comes down to the fact that I can teach people how to cook

but I can't teach people how to care.

You know, and if they don't care...

Just does my head in.

It's hard to believe that the team here

don't understand why they need to follow recipes that set out the quantities they should be using.

Especially someone like Gaz, who's been here ten years.

It's so basic. They're wasting huge amounts of money needlessly.

And of course, all the issues I'm seeing

have a direct effect on the most important people in the hospital.

The patients.

Anybody hungry? Lancashire hotpot with potatoes and gravy?

-I'm having pasta.

-You're having the pasta? OK.

-Hi there, ladies.

-Hello there.

You've got your own private room round here!

-You all right?

-Fine, thanks.

-What's your name?

-Lynn.

How are you, Lynn? Are you recovering or are you...

Recovering. I'm going home today.

-From what?

-Total hip replacement.

-And you're feeling better?

-Yeah, brilliant, yeah.

Is that both sides, the hip replacement?

I had that one done this year. This one I've got this year.

-You got two for the price of one.

-I've got two new knees as well.

Have you? So you had a full MOT, haven't you, really?

And how's it been?

It's been fine medical wise but the food's awful.

-I haven't eaten a proper meal.

-Since you've been here?

They brought cheese and crackers because I hadn't eaten anything.

So my family brought sandwiches in to me.

But you've got this, this...

I haven't tasted it cos you were coming.

Try it, try it. I haven't made it! I've only been here for a few hours.

It looks chewy cos there's a lot of fat on that.

-You don't like it?

-No. It's just not appetising to look at. It's just...

What time you leaving?

-Four o'clock!

-Four o'clock!

-When my husband gets me.

-Nice to meet you.

-Glad you're feeling better.

-How long you been in for?

-Since Friday.

Since Friday? And the food?

Atrocious would be a good word.

That's the one thing that lets the whole hospital down is the food.

There isn't any choice. I don't think you get five veg a day.

The five veg a day routine doesn't exist.

I think if you were gluten free or if you've got any allergies, there's no choice for that either.

So you generally get whatever's left, or is that...

You just get what's on the menu, which is like two choices or so,

which I don't think's sufficient.

Improvements for you would be choice, would that be it?

I shouldn't eat bread but I've ended up eating a lot of bread.

-You shouldn't be eating bread but you've had to?

-Yeah.

-Because there's nothing else to eat?

-No.

I've got my work cut out here then, haven't I, really? Take care.

It's so sad to hear patients saying that they haven't eaten a proper meal

and that friends and family have to bring food in for them.

Surely it's not too much to ask for a well-prepared, appetising meal when you're recuperating?

Food hygiene policy stipulates that once the food has gone up to the wards

it can't be served to anybody else even if it's been untouched,

as it may be contaminated, so it has to be thrown away.

So we have to make sure that all the food that goes up is eaten.

And I need to see for myself just how much food is going into the bin.

This is two wards? I thought this was the whole lot!

-No, this is two.

-This is another two wards.

Another two wards?

Got a lot of custard, haven't we!

I can't believe this!

I'm just showing you this.

I cannot tell you how annoyed I am with this!

This is every day, 365 days a year...

..this is waste,

thrown in the bin.

And this is only a drop in the ocean of what we have here.

Another one!

See, bear in mind, right, this is a small hospital,

we're not talking about a massive hospital.

This has got four, maybe five wards, all right.

I reckon this is more than half of the food that was sent up there.

And these guys make this fresh every day.

You know, it's no wonder they're demoralised, is it, really?

More custard.

This has never been touched then, has it?

-They have two each on each ward.

-That's never been touched?

-No.

-But it's got to go in the bin?

Yep.

I knew there was a waste issue at this hospital

but I never imagined that so much food

was literally being thrown in the bin every day.

I can't ignore this. I need to give the team a wake-up call

to show them just how serious this is.

Am I right in thinking this is the first time you've seen this?

-Yeah. It's terrible, isn't it?

-Mm.

How does that make you feel? You made it. You were making it all.

-It's depressing, isn't it?

-Yeah.

-What a waste.

Heartbreaking.

Between 40 and 50% of everything you're making every day is thrown in the bin.

-Look at all that gravy!

-Eh? All that gravy, yeah.

-I'm thinking of the hot pot!

-These are gallon containers.

Maybe they just wasn't having a gravy day!

-You weren't having a gravy day?!

-They wasn't having a gravy day.

They weren't having a pea day or a pasta day!

You know, do it once a week, have a go at it once a week.

It'd be quite interesting to find out what you see.

-The menu will solve a lot of this.

-Yeah.

But also, scales and measuring and recipes and stuff like that

will solve a lot of it our end.

So from this moment on, forwards.

The key to implementing any change in this hospital

is convincing the people who control the purse strings

and here at Birmingham that's head of facilities Emma Bridge.

In you go.

Right, if I told you this was just the waste I could salvage, there was more than this.

So there's more gone in the gobbler?

There's more, this is just what I could get hold of.

This is from four wards only.

Now this was going to go in the swill.

Wow.

-You've got five of them that have never been touched.

-Yep.

You've probably got about three of the six hotpots that were made,

never been touched.

I don't know what that weighs, but what do you reckon? Three kilo?

There's more than a ward's worth of peas on there, isn't there?

It's three kilos probably of frozen peas.

You've probably got nigh on 15 litres of custard.

All that is gravy.

And that's more Lancashire hotpot, probably eight to ten kilos.

So with all this food on the table, how many people do you think we'd feed?

-50.

-Two wards. Wow.

So really we're cooking for 150 people when we should be cooking for 100, but we don't know.

-Do you want some for lunch?

-No. You're all right.

I'll pass on that one, thank you very much.

-Sure I can't tempt you?

-No, you're all right, thank you.

I've seen enough to know what my first step here has to be.

I'm calling the team together to set them a task.

Oh, God, we're going to get told off again!

I've been here three and a half hours and I've seen lots of things.

Fundamentally we've all got to work as a team to make it better.

And the only way we can possibly do that is if we have some form of food standard,

getting it right, and that is recipes without a shadow of a doubt.

If we want change this is what's going to happen.

I want you all, by the next time I see you,

to have written three recipes each off the menu.

Happy with that?

So then next time I come up we'll have a recipe book. Fantastic!

-Thank you very much.

-Thank you.

This is going to make us think now definitely.

We can't just sit back and let it go now.

We ain't got a leg to stand on when it comes to waste and stuff like that, have we?

Feeling a bit "prff" at the moment.

-What do you mean?

-Don't know.

Just stupid mistakes we're making is costing so much money.

-But you never...

-I didn't realise.

Yeah, you never, you never clock it, do you?

And I'm not wasting a pea!

I've set the catering team in Birmingham a challenge to bring about change in the kitchen

and also help them keep their jobs.

But the problems here have made me see that improving hospital food

across the whole of the UK is going to be a mammoth task.

I'm going to need some backup.

So I'm heading back to Scarborough, the hospital where all this began.

It was a slog but in a short time at Scarborough, we pulled off astonishing change.

With the team newly fired up,

we replaced packaged food with nutritious freshly prepared dishes on the menu.

-Is that cooking?

-No.

-What do you want?

-I want fresh soup. I wouldn't mind doing that.

We started buying from local suppliers, giving the local economy a boost.

We hugely reduced waste.

And for the first time ever turned the restaurant into a profit-making business.

And all this was done without any increase in the budget.

We're getting the price of what we want it to be

and it's under £3.49.

I've been keeping in regular contact with catering manager Pat and her team.

Today I'm back, not just to see if they have carried on the success

but also I have a favour to ask.

-Hello!

-Hello, my darling.

-She's still sat in the same place.

-How you doing? You all right?

-Yeah, nice to see you.

Nice to see you. You all right? Good to see you.

-How are you?

-Fine, thank you.

You're all still here! Well, two of you are still here anyway.

-How are you doing? All right?

-You know.

-We're well chuffed with how things have gone really.

-Well chuffed?

Don't get too smug now! Don't get too smug!

Well, it was hard work, wasn't it?

-There is lots of things to tell you.

-I thought there might be.

-We've had some good results.

-Have you got a list?

-I've got a list.

-I thought you might have!

And what about everyone else in the kitchen, they're all happy?

They're all fine. Things are going really, really well.

Me and Sharon have come up with a new menu that we need you to peruse over

cos I need a couple of recipes off you.

That's fair enough. And how's Big Bird and the rest of them?

They're OK, yeah.

-They're still here?

-Yeah.

-We haven't had anybody leave.

-Really?

-No.

-Have you got anybody new then?

No, but after we went out on air people were ringing up to ask if they could work for me.

-Really?

-So we can't be that bad, can we?

-Fantastic!

-Yeah, it was lovely, actually.

We even have people coming on holiday to Scarborough

and coming to Pat's Place for a meal now.

Fantastic!

But we never expected that in a million years.

I would have never expected it either! It's brilliant.

-I'd better get changed then.

-You better had do.

-We're going to put you to work.

-Here we go, usual.

When I first came to Scarborough the feedback from the patients wasn't positive.

-It's not good.

-As a package, it's pretty poor.

I don't like it at all.

But what do they think of the food now?

I think the food's excellent. For hospital food it's superb, really.

The food has been very, very nice. No complaints.

I've been here three or four times this year

and the food's improved every time I've been, really.

And the soups now are brilliant.

I've heard so much about these different hospitals

and the food and people nearly starving to death

but I assure you if they came in here

there's no way that would happen, it's such great food.

I hope by the time I've finished in Birmingham,

the patients will have the same high praise for the food.

It wasn't an easy task to transform the meals at Scarborough General Hospital.

There were tears, and moments I felt we were never going to achieve our goals.

But against all the odds,

with the help of Pat and her team, the transformation was amazing.

I'm curious to find out if Pat and head chef Sharon

have managed to keep things on track and on budget.

Compared to last year,

the new menus haven't cost us much more than what we had before.

Sorry, what was that?

What was that? You're mumbling a bit. What was that?

-James, because...

-No, just...

-No, excuse me.

Just because I was very strict

on what I allowed you to put on the menu, right,

the menus haven't cost us much more than they did before.

But if you'd had your way totally it would have blown me out the window!

So how much was the budget per patient?

Last year it worked out at £3.30 per patient.

-So you're 19 pence under budget?

-Yeah.

-But at the moment...

-There's always a but, isn't there?

-Why can't she just go...

-There's not!

The but is I'm still trying to get the Soil Association award.

-The bronze award.

-How far away are you from getting that?

I think I have just about sourced everything now.

But we haven't changed the menu to reflect that.

-So we're not far off then, are we?

-No, no.

Only three UK hospitals

have got one of the Soil Association's prestigious bronze awards

which guarantees that everything on the menu is free from controversial e-numbers

and that meals are freshly prepared using local produce where possible.

Pat's determined to win one for Scarborough.

It's also fantastic news that Scarborough's catering team

is now under budget whilst providing a higher standard of food and service.

It can be done!

I, as you know, have recently been to Birmingham.

Yeah...

I'm going to list you the things here, these are genuine things.

I was there 48 hours ago.

They've never written a recipe,

so there's no recipes, so there's no costings,

so the dietician is not looking at anything, they're guessing.

There's no menu given to the patients.

And they don't know how many they're cooking for till half past ten

when they've got to phone up the wards.

They're guessing everything, so this is where I'm going to throw a curve ball to you.

12 months ago you asked me to help you.

I'm going to pull in a favour.

SHE LAUGHS

I'm asking you for your help,

and I wouldn't do it if I didn't mean it

because I'm trying to make this work.

My goal was to roll this out,

and I've suddenly realised

what a massive, massive uphill struggle it's going to be.

I genuinely don't know where I'm going to start.

But I think I need you guys to give me some guidance

and give the management team some guidance

of how to at least do this menu system because it's a disaster.

Look what we've turned around here, and I think as a team we can do massive things.

James Martin asked for our help!

Right, can I have a drink now?

ALL LAUGH

I'm delighted that Pat and Sharon have agreed to help with this project.

I'm thinking of sending some of the team from Birmingham to meet Pat

and come up with a way of implementing an ordering system.

People's attitudes have changed hugely,

and that comes with confidence

and I think we can take a bit of that

and implement it in certainly Birmingham that I've seen.

That's what I said to Pat. They've got years of experience, those two.

40 years' experience between the two of them in hospitals

and I think you've got to ask for advice when you need it.

I cannot believe he's asked for my help after what he put me through last year!

He's had to eat humble pie and ask me.

SHE LAUGHS

There seems to be a lack of very basic systems

and to not have basic recipes and costings.

I don't know how any catering department can survive in this day and age.

I've really got to go away and get my head round Birmingham

because it's broken and I don't know quite know how to fix it yet.

What he has done has been fantastic for this trust

and if he can roll it out to other trusts it can only be a good thing,

and put hospital food back on the map again

and I really hope he succeeds in that.

When I went to Birmingham, I never thought it would be as bad as Scarborough.

I mean, with Birmingham it's a pandemic right throughout the whole thing.

I don't know where to start.

I can teach people how to cook, I can teach people how to change that in a week,

but how do you make people care?

When you see simple things like custard being made like that.

I could see it in two minutes so why the hell does it take me two minutes to see it

and not somebody who's been there 16 years?

But I think if we are going to roll this out,

maybe not to the extent of what I originally planned,

cos I thought, do you know what, we could easily roll out soups

right across the NHS, that would be easy.

It ain't going to be like that.

It's back to Birmingham where already I've found ways

where I can bring nutritious, affordable food to the patients

and maybe even help the team keep their jobs.

In charge of the kitchen is head chef Tracey, who's back from her holiday

and preparing to help lead this huge challenge.

-How was your holiday?

-Lovely, thank you.

-You might need another one in a bit!

I catch up with Tracey for a coffee to get her take on what's going wrong.

So what would you like to see?

You've got a fresh start, you've got a fresh restaurant, new kitchen.

What would you like?

Just more support, really, regarding, you know,

like you say with budgets and where to get things from.

And you know, everybody being happy,

the whole staff, and not being criticised.

It's always negative, negative, negative. We don't hear a lot of good stuff.

You know, raise the morale of the team really.

Waste was quite a big issue.

Yeah, that is our main problem because basically we're guessing.

Why are we guessing? Why haven't you changed anything?

-With regards to patients?

-Yeah.

I did a year ago with my old bosses

and I had some input into it

but it is, you know yourself, changing a whole menu,

you've got to go through the dietician, go through the nurses.

That would have been fine as long as there's recipes

but the guys have been telling me there hasn't been any recipes

so you can't then go to a dietician if there's no recipes.

In the next week I definitely want a cost of recipes

and I want to see those recipes

-and I want them strictly adhered to from now on.

-Yeah.

If you haven't got a recipe, you've got five chefs doing five different recipes.

They're just producing what they want.

So your costs are spiralling all over the place.

In my restaurant I have a recipe and I have a recipe for a reason.

-And they have to follow it.

-They have to follow it and it works.

But it all comes from the top.

I know it comes from higher up from where you are.

They need to understand the issues that you're having.

-But you also need to be accountable for it.

-Yeah.

So if you are over budget, the buck stops with you.

I think the first meeting went well.

There were some positives out of it.

A lot of negatives, which I was expecting anyway.

You just get the feeling that she's down, that the whole kitchen is just down.

You get the feeling here that it's going to be more of an uphill struggle

because even the person at the top

really doesn't have any control

or where they're going or want or need to be able to do it.

So they're going to have to see it from a different point of view really.

Morale is a huge issue here and one I plan to tackle.

But my main priority is to start dealing with the costs

and find out exactly how over budget the kitchen is,

and what will happen if nothing changes.

I'm hoping Emma, who's head of facilities, will give me some answers.

So how are we in terms of the figures?

What is the rough average overspend?

There's got to be an overspend in this place per year.

At the end of month two, so we're two months into the financial year,

we are just short of £5,000 overspent.

What would you like to see from the kitchen

to make your life easier, certainly to fight your corner?

I want to try and build their passion back,

the passion they had from day one after the fire.

I think there's something around the ordering system.

Well, the ordering system is nonexistent.

No, it's pure guesswork.

Is there a limit to what you have to spend per day?

What is it, £3.80 odd or something?

It's something around that

but for me I am quite happy to sit in front of the board of directors

and say my budget's going to go overspent because I'm getting the quality right for the patients.

But nobody is speaking to each other.

You've got a kitchen creating recipes that have...

You can't do costings cos you don't know what...

Do you know what's on the menu and what they're spending per day

and what the ordering system is? No?

They've given me a copy of a menu but I could say...

-I know.

-Nobody has costed it out though!

No, it's not been costed, the dietician's looked at it and had to make rough estimates

because they haven't got the recipes behind it.

Where's it gone wrong? I will ask those questions.

But there are massive issues in terms of the ward.

Now I can't see there being an issue with going back to what was on before, this menu system.

We're now on a different system,

-which to me is just heading straight to the cook chill.

-Yeah.

I get the feeling, I'll be honest with you.

They have been treated like a dog that you kick all the time,

-you know what I mean?

-Yeah.

You kick it, kick it, kick it, one time it'll turn round and bite at you

or it's just going to get smaller, smaller, smaller.

And I get the feeling that confidence in the kitchen

-and the confidence in the team is probably the lowest I have seen in a kitchen.

-Yeah.

99% of my job here, I'm going to find that it's changing people's attitudes

and they are at their lowest ebb, I'll be honest with you.

I know it's going to be tough for the team to face up to these problems

but their jobs are on the line so the stakes are high.

To bring about change here and potentially other hospital trusts,

I've identified some key objectives.

So far I've asked the team to write down their recipes,

putting down in a book the quantities and cooking times they all have to follow.

It's the first step towards putting systems in place

to bring down that huge amount of waste.

But already it doesn't look like they're doing it.

-What do you cook that for?

-About 40 minutes.

-About?

-About 40 minutes, when it's done.

Is it in here?

-A piece of chicken might not cook...

-Why's it not in here?

-To cook roast chicken?

-Yeah.

-Well, it's not really a recipe or...

-You said about, right.

Prove to you. How long do you reckon that takes to cook?

About 40 minutes.

At what temperature?

175.

175, 40 minutes. That's how long you reckon?

-I reckon so.

-I'll show you the importance of this. Vic!

How long would you cook that for on what temperature?

About 45 minutes, 170.

45 minutes. You give it that one, 40 minutes.

Why is it not in here?

It's not a recipe!

-No...

-We probe it.

-Right. Right.

It's in here from now on.

Every single thing that you do,

even if it's boiling veg, is in here.

It's no good saying "about". It's about everything.

Everything in there needs to be in here.

-We know when things are cooked.

-Everything is in this book. Right?

If it's not in this book, you're not cooking it. All right?

James, but you... I know when things are cooked. I've got a probe.

That's fine but if we're going to progress forward

then we have to work together as a team.

That's all I'm asking.

-Yeah...

-About is not good enough.

But what I'm saying is, if one wasn't here and another was,

-they're not going to read the book.

-Right!

You're saying that it takes 40 minutes.

You're saying it takes 45 minutes.

The next person who walks through that door will say another temperature and time.

So put it in the book!

You're not listening to me!

I don't really like your tone, James.

But I'm trying to speak to you.

I understand but you're talking to me

as if I don't know what I'm on about.

I know you've got a lot more experience than what I have,

but to cook a chicken breast, it's only a couple of degrees different

and a few minutes' difference

and you're kind of implying that one won't know how to do it

where another one knows how to do it.

But we all know it comes and goes pretty all right.

I say exactly the same thing about custard. We all know how to make custard, don't we?

-Yeah.

-Why don't you weigh anything out?

Because I don't know how many people it's going to for a start.

-Do you have a recipe for ten litres of custard?

-Not in there.

I'm not going to stand there and let him speak to me like that.

-BLEEP

-unbelievable.

It's all in our heads, you know. They're our recipes, it's what we do.

So annoying.

James just mentioned custard.

That's going to be one of them things that's going to be stuck in my life forever now.

His attitude stinks!

I've always found it hard someone being in my face saying

that's how you do it when I've got my own way of doing it, you know.

Stinks!

I hate losing my cool. And I know Gaz is as keen as I am to see things improve.

But if they can't even get the basics right, I'm worried it won't happen.

I'm annoyed with myself because I don't normally do that,

but erm...

This is the whole thing about this.

It's that I can't change anything unless they're prepared to do it themselves.

And he just can't be bothered,

just doesn't give a damn what I say, just doesn't give a damn.

He knows best and that's it, stuff everybody else.

Well, fine, see you in the dole queue.

Next time, the pressure builds in Birmingham.

At the moment you are 100% to blame.

You are constantly making my life difficult.

You have to help me.

These are the blatant facts. If this doesn't work, you're all out of a job.

And if I'm going to have any hope of transforming food at other hospitals as well,

I can't do it alone,

so I've decided to call for backup from some world-class culinary stars.

Gather round. Here's the bomb that I'm about to drop on you.

I need you guys!

Cos I suddenly realised, having been to Birmingham,

I can't do it on my own.

I just want you on board first.

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