Episode 3 Operation Hospital Food with James Martin

'People in hospital are already at their most vulnerable

'without getting unhealthy, unappetising food.'

All people want is good food.

'I believe that good, nutritious food not only lifts the spirits

'of patients on our hospital wards,

'but it can be a medicine as well.

'Patients are simply not getting the food that they deserve.'

-The food's awful.

-We thought it was a joke.

-Tasteless.

-Atrocious.

-Quite bland.

'In a recent survey, a third of people called the food unacceptable

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

'instead relying on food from family and friends.

'£50 million has been spent in the last decade

'to improve hospital food,

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

'I took up the challenge at Scarborough General

'and patients who had been previously turning away their food

'are now looking forward to meal times.'

-Excellent.

-No complaints whatsoever.

-The soups now are brilliant.

-'I've proved it can be done.

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

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

but I'm creating good, simple food.

'My goal of improving food in hospitals nationwide

'quickly hit a stumbling block

'as it became clear that the first hospital,

'Birmingham's Royal Orthopaedic, had bigger problems.'

-Do you have a recipe for 10 litres of custard?

-Not in there.

You've got no ordering system, no recipes to work off.

Nothing.

'With my hands full here, I've roped in a group of fellow chefs

'to take this project forward

'to other hospitals wanting my help.'

Here's the bomb I'm about to drop.

I suddenly realised I can't do it on my own.

I need you guys!

'Luckily, they agreed. In fact, I had more chefs keen to help

'than hospitals willing to let them in,

'but I got some of them working in hospitals in their area,

'leaving me more time to get to grips with the issues in Birmingham,

'which today I'm tackling head-on.'

Today's going to be a big day. It's 10 to 7 and for the first time,

this kitchen will be run how I want it.

-Which should be fun.

-'It's 7 o'clock.'

Tired. Rushing to get here.

Don't want to be cleaning pots and pans.

Nervous today. Really nervous today.

What I am expecting really from the brigade

is confidence, it's timing and, above all else,

thinking about what they're doing.

I'm not worried. I look forward to the challenge.

'Today I'm going to be running this kitchen

'very differently from the way that they're used to.'

-Morning.

-Morning.

-Morning.

-We're all here?

-Yeah.

What are you standing away from me for?

Right, this is what I'd like you to do. Stuff for the morning.

-I need to know what everybody's doing.

-I'm on prep today.

In the other room?

-- I'm in here.

-In here?

-- In here.

We're doing steak and mushroom pie.

The pastry, we made yesterday. And dessert. That was a Bakewell tart?

-Yeah.

-Bring it over here. All of it.

Have we got more of these tins?

-Tracey might know.

-They're normally up there or in the cupboard.

He's going to throw them in the bin.

-When was this taken out of the freezer?

-Yesterday.

-Yesterday.

'I hate waste and they've already got a big problem with it here,

'but those Bakewell tarts have been sitting in a hot kitchen

'since yesterday morning.

'They're not suitable to be served.'

Now the pressure's really on.

You've got no dessert for lunch.

-I'm here to help.

-I'm going to be busy.

-You are now.

Don't forget also, which is not on here, you've got a soup to make.

-Happy?

-Yeah.

-Great stuff. Off you go. Let's go for it.

Get me some more tins, please.

He's just thrown our dessert in the bin

that we need for today, but it was left out all night, so...

They should have been in the fridge.

We've got to make them all again,

as well as all the food and the soup of the day.

So we're going to be very busy now. Very busy.

'There are two reasons why I'm running the kitchen today.

'I want them to work more efficiently,

'but I also want to give Head Chef Tracey a needed confidence boost

'and inspiration on how to manage the kitchen differently.'

The basis of being a Head Chef is to lead from the front.

-Mm-hm.

-All right? So I'm sending you

to Birmingham's Michelin-starred restaurant, Glynn Purnell's.

-Wow.

-Glynn's a great friend of mine. I want you to listen and learn.

-See how he takes control over it. Ask questions.

-I will.

He'll put you through the paces, but you'll love it.

-Thank you.

-Enjoy it.

'I hope Tracey grabs this opportunity

'and uses it as a chance to run the kitchen more efficiently.

'One of the biggest issues she and her team face every morning

'is that the wards haven't been calling down

'with the number of patients that need feeding.

'It's a main reason why 40% of the food made here is left uneaten.

'On my last visit, I had to get tough and ask Emma,

'the Head of Facilities, to tell the ward staff

'how important it was for them to phone those numbers down by 8am.'

I need somebody like yourself to speak to them and say,

"From now on, if we haven't got the order from the ward at 8 o'clock,

"nobody gets nothing."

They get nothing.

'I think at last, the message may be getting through.'

Cool. Cheers.

That's interesting. It took eight weeks to get this implemented.

I've threatened that if I don't get the numbers by eight,

nobody gets anything. And at 7.15,

we've now got the first ward that's phoned up.

Funny, that, isn't it?

'We're off to a good start. Let's hope the rest call down, too.'

We've just had Ward One phone up. Quarter past seven.

-I take it that's not the norm?

-I'm not saying anything!

'Today is all about cooking the dishes in the right order

'at the right time

'so the food served to the patients and staff is of a higher quality.

'I'm not using any different recipes or ingredients.

'It's all about running the kitchen better

'and part of that is weighing everything.'

Do you feel happier doing this?

-Yeah, it gives you a bit more of a buzz.

-Good, it should be.

Put the pressure on you doing the dessert as well, but...

We all like a bit of pressure.

-Have you got the rest all measured out?

-Yeah.

-Good.

'Now all I need is for the rest of the wards to call down

'and tell me how many patients we have.

'It's already 8.30, so the team need to start cooking the dishes now

'if the patients are to get lunch.'

-What ward?

-As soon as it comes to the boil, six minutes.

And then off.

-How many wards have called up?

-Two, I think.

-Two?

-Yeah.

Four more wards not even phoned up?

They're going to go hungry, then, aren't they?

This has been the annoying thing about this project.

I really feel that food is a medicine.

People should look forward to great food,

but you've got to help each other. If they want nice food on,

give me the amount of people I've got to cook for.

It's not rocket science.

We're about to cook £300-worth of beef

and I don't really want to waste it.

OK, bye. Ward 12, they've got 14

and possibly another three coming in.

'I've no choice but to start cooking the beef for the steak pie

'or we'll be well behind schedule,

'but I'm worried we're still going to see a lot of waste coming back -

'exactly what I wanted to avoid.

'Waste isn't just a problem here.

'A staggering 9 million hospital meals across the UK

'are returned to the kitchens untouched every year.' Morning.

Morning. How many have phoned?

-Er, Vicky? Who have we got to come?

-Two.

-And HDU.

-OK. I'm going to go for a wander.

I'll leave that with you.

-Thank you.

-Explain to them why they'll all be having sandwiches.

-No, they'll be eating.

-They won't.

-They will, please.

-They won't.

-I'll sort it.

'I'm not trying to be unreasonable,

'but I need everyone to start working together

'to turn this around.'

Incredibly sleepless night worrying that my patients wouldn't get fed

because we're so reliant on the wards ringing in,

but it's also getting the balance right.

The wards have to ring in so catering know what they're doing.

We haven't had a call in the kitchens about the numbers.

But I've got to feed the patients, so that's my priority.

OK, no worries. He's about to cook £300-worth of beef

and then he's threatened sandwiches.

'And, funnily enough, down in the kitchen the phone starts ringing,

'but only just in time.

'We're really up against it.'

If you can finish off those other jobs,

make sure the food's ready today. I don't want to be late.

This is my first day in charge. I do not want to be late. 10 to 12.

'It soon became clear when I arrived here

'that trying to implement change would take up almost all of my time

'and my ambition to roll out change

'into other hospitals was unrealistic, at least on my own.

'So I've recruited back-up from a band of top chefs,

'each sent into one of four other hospitals

'in Wales, Norfolk, Cornwall and London.

'Each has its own particular issues

'rather than needing improvements across the board,

'but the areas they want help with are echoed across the country.

'The first two chefs are the Tanner brothers, Chris and James,

'at the Royal Cornwall Hospital.'

We need to take what we've done with our business into this environment,

which is completely unknown to us.

If anything, we're going to learn from it and I'm all up for that.

The most important thing is the quality of life for these patients.

It might be a great standard

and they might want to tweak it.

Or it could be terrible. It's the unknown.

So here we are at the Royal Cornwall Hospital. It's a massive place,

lots going on, very, very busy.

What are we going into?

'Meeting the boys to explain the task ahead is Mike Pearson,

'Head of Hotel Services.

'There's one specific area he needs help with.'

We'd like your help with something we're passionate about.

It's looking after our stroke patients.

If you're poorly in bed and you can't eat properly,

you're not getting nutrients and you lose a lot of dignity

because you tend to dribble or get it all over you.

Part of the thing we want you to look at

is the consistency of the food.

'Every year an estimated 150,000 people suffer a stroke.

'Creating dishes that are suitable during their recovery is complex,

'so the brothers need to understand the issues.

'The hospital's speech and language therapist Carrie

'and dietician Becky give them some advice.'

We have a soft diet and a pureed diet,

-but we want a fork-mashable one.

-Sort of in-between.

That would make a big difference to patient care.

So foods that can hold their natural flavour

-and are breakdownable.

-Yeah.

Can pass through a fork.

-That is basically the bottom line.

-Fork-friendly.

-OK.

Our patients are struggling to eat and they don't always manage to get

an adequate amount of nutrition.

They eat smaller amounts, so sometimes what we have to do

is give them an energy-dense meal,

but with a person who is acutely unwell, the most important thing is

that they've got nutrition to give them strength.

And the energy to aid them.

'This is a huge test of the brothers' skills

'as they've never worked with such specific criteria.

'On the frontline is Ward Sister Kate,

'who knows all too well the benefit of good food to recovery.'

Any pointers you could give us?

Yes. From a therapy point of view, if they're eating well,

they've got more energy to partake in therapy. They get better quicker.

-They don't have to spend so long in hospital.

-Help the rehabilitation.

It's a huge factor.

A lot of patients may not be able to eat anything to begin with.

As swallowing improves,

what they can eat changes, but they have to start really slowly,

-so it needs to be appetising for them.

-And something familiar.

-Yes.

'If they crack this, there's huge potential

'to make a real difference in their local area

'because this kitchen unit supplies meals for stroke patients

'throughout Devon and Cornwall.'

I've got plastic containers.

-I've got homework.

-We didn't know what we were coming into.

We do now! It's been a big eye-opener.

I think the next stage is lots of homework and research.

Test it, freeze them in these and then try to reheat them

and see if they work. It might be great when you freeze it,

but if it doesn't work when you reheat it,

you've got to put it in the bin.

'While the Tanner brothers go away to work on their recipes,

I'm in Birmingham running the kitchen,

'so I can show the team how to work more efficiently with better food.

'The first setback this morning was throwing away the Bakewell tarts.

'They'd been left out overnight

'so they weren't fresh and I didn't want to serve them.

'Vicky's in charge of making new ones.'

I feel more proud of these ones compared to the other ones!

They just look completely different

and hopefully, they'll know that they're fresher.

And it makes you feel better about what you're giving out.

-You get 12 out of a tart.

-We needed this push to change us.

Definitely.

We've just got to keep at it

and just got to never ever go back to the old way.

Never ever. I don't think any of us would, to be fair.

We're all enjoying it a lot more.

It's more satisfying. You do feel like more of a chef, definitely.

'It's great to see the difference in morale in the kitchen,

'but the stakes are high.

'If the food doesn't improve,

'the catering could be outsourced, putting them all out of work.'

OK, guys, we've got... just under an hour.

So potatoes in, steaming. Rice is on.

Gravy's happening. Custard made? Rice pudding on?

Lovely.

'As time draws closer,

'this is the moment when the team needs to pull together the most.

'All the food has to be served at the same time

'to keep it as fresh as possible.

'Working as a team is crucial.'

Gaz, do the boiled potatoes for the trolleys, please.

-Vicky?

-Yeah?

-At 10 to 12, put the peas in, please.

-Yep.

-Four minutes.

-OK.

Thank you.

You haven't missed some, have you?

This is... This is the busy bit now, mate.

It's all happening now.

The last five minutes is the busiest time.

How many is a kid's one?

Kids, kids, kids, kids. Where's the kids' numbers?

-One minute!

-30 seconds on the fish!

Gaz, you've got to dish up the mash for the ki...

30 seconds, please! 30 seconds! Come on, come on, come on.

They're ready 15 seconds early. Brilliant. Just brilliant.

Go to the restaurant. Tell them how you want the food laid out.

You've got the boards.

Make sure they have the correct labelled descriptions.

They ain't going to listen to us.

It's your food. Off you go. Enjoy it.

Does it say home-made soup? No. They was asked.

'If the staff and patients aren't happy with the food,

'we're back to square one.

'But I'm not the only one feeling under pressure.

'In Wales, another chef I've deployed

'is Stephen Terry.

'We've been asked to come up with dishes to go onto a new menu

'that's rolled out across all 115 NHS hospitals in Wales.

'It's a fantastic idea

'and a great way to effect change on a big scale,

'not one hospital at a time.'

It's massive. They feed thousands. It's a very responsible position.

Food is my life. This is what I do.

To be part of something that will change things for the better...

We can change the way food is produced and delivered

to patients in hospital in Wales.

'Stephen's come up with some great lamb dishes

'which he hopes will be approved for the new menu.

'The team with the power to decide if that happens

'are on their way to taste them.'

A prime objective today is to get my lamb dish on the all-Wales menu,

so I've brought two prototypes. I've never made like this before.

-This one can go in in the tinfoil.

-What temperature do you want?

I've done two styles of it -

one with braised lamb, one with diced lamb, both the shoulder.

150.

So I want to present those dishes to the guys today.

They can give me some feedback,

get the nutritionists involved, but I think we're on to a winner.

'But we've been shocked to discover

'that Welsh lamb is unlikely to be on the menu

'in Welsh hospitals,

'as they can't afford the price from their suppliers.

'Instead, the option is to buy lamb from New Zealand or Australia,

'which, at the moment, is supplied more cheaply.

'We're determined to show them that their suppliers

'could source Welsh lamb at a lower price than they currently pay.

'That would make a real difference to the menu

'and be a lifeline to struggling local farmers.'

So what I've got here is two examples.

This is with the diced lamb and this is with the lamb

that's been braised and layered between the potatoes.

Any feedback is very valid and valuable for me.

Just thinking how this would work on a larger scale, that dish,

because we're catering in large volumes,

then perhaps we'd have to look at

maybe not using the bottom of the pie.

Keep the ingredients loose, with a topping.

It did cross my mind.

First and foremost, I wanted this to be a taste test.

We haven't got that many lamb dishes

on the list of dishes that we want to produce.

And I think all patients would find more lamb dishes

more appealing on the menu.

'It looks like this group of NHS professionals

'is coming round to our way of thinking.'

It smells lovely. He's sliced it, and then you scoop it up onto the plate.

It's too impractical on the ward.

This is with the lamb and the potato more layered.

You'd serve a bit of gravy with this?

Or put some gravy over the top. Exactly.

The lamb is surprisingly moist.

Anything you only eat with a fork or spoon is good.

Whether it's hogget, mutton or lamb, Wales is synonymous with lamb.

It's very important for me that we serve Welsh lamb.

We shouldn't look at New Zealand because I know from my suppliers

that I can come in right on budget from getting lamb locally.

I want a Welsh lamb dish on the network.

'Stephen and I are both optimistic we can cut through all the red tape,

'so the procurement team can source local lamb

'instead of having to get it from the other side of the world.

'Meanwhile, across the UK in King's Lynn, Norfolk,

'another one of my army of chefs,

'Galton Blackiston, is determined to make a difference too.'

The NHS do a fantastic job.

The budget for people on a daily basis is very, very small.

That doesn't mean you can't still put really tasty food on a menu.

The idea of not being able to do it would be horrific.

I can't wait, on the one hand, to get in there, but on the other hand,

I don't know what I'm going to see,

so yeah, reality is massively sinking in.

This is taking me out of my comfort zone.

There are two key things

the hospital I've sent Galton to want him to look at.

First, they want help improving vegetarian dishes they offer,

so to kick things off,

Galton tries what's currently on the menu with head chef Stuart.

So these are your vegetarian options at present.

Yeah, I cooked these earlier on.

-So the vegetable chilli there...

-That's got a bit of spice to it.

There's a rule with vegetarian cooking

that you have to pack in flavour, and that's got flavour!

-If you want to come through this way, the dining room's through here.

-OK.

The other thing the hospital wants Galton to tackle

is boosting the profits in the hospital dining room.

With NHS budgets under strain, this is an increasingly important way

for hospitals to generate money to benefit the patients.

The more money made in the restaurant

means the more money that is spent on patient food.

So, on a daily basis,

how many people would you think that you'd serve lunch to out there?

At lunchtime, about 150.

Tell me, how many people work within King's Lynn Hospital?

There's about 3,000 staff working around...

-3,000, did you say?

-3,000 staff working around the hospital.

For some reason,

the dining room just isn't enticing many staff to come and eat.

Would you think the decor needs changing here?

It's a bit depressing when you look at the ceiling.

Is it a matter that the people are working that hard,

they don't leave where they're working to come through here?

A lot of the clinical staff just grab a sandwich on the hop.

Yeah, just coming out into the service area,

you can just see all this is very, very old.

Oh!

People work long hours here.

They tend to probably work through their breaks, at their desk,

or, I don't know, in surgery, wherever.

Maybe something could be taken to them. We've got our work cut out.

There's no doubt about it.

Galton has plenty of ideas to improve the dining room,

so all he needs to do is convince the Trust boss,

Patricia Wright, to fund them.

Luckily for him, she's up for a change,

so he gets straight to the main question - money.

What sort of budget could we realistically look to work with?

This is a great opportunity.

We accept that we can't continue to let it be tired and drab.

I agree with you that more people would use it

if it was a more welcoming environment.

Actually, we don't have many places in the hospital

for staff to have some downtime.

-I've got a figure of somewhere around 10,000.

-Right.

That does not mean that if you came up with something

that was more that would give us a positive benefit

that we wouldn't consider more, so it depends about what your ideas are.

I think... Yeah, I'm quite excited about this.

-We just need a green light to say, "Go...go for it."

-Go!

'Back in Birmingham at the Royal Orthopaedic,

'my day as head chef is nearly over.'

Unbelievable.

It's one o'clock and we've sold out for lunch, even in the restaurant.

-You thought it went fantastic.

-Yeah.

-Good compliments?

-Yeah.

-To push those compliments even further,

the most important people in this hospital are the patients.

Now, probably for the first time for many of you,

I'm going to send you upstairs to the ward.

'It's fantastic that all the food has sold out.

That's the way it should be.

'But I'm hoping the patients will have seen a real difference

'in the meals they were served today.'

-Hello.

-Hello.

-Are you all right?

-Yes, thank you.

-What did you have?

-The Indian meal.

-Yeah, saag aloo.

I felt not up to eating until today,

so it was a good day to be feeling better.

-Did you try the home-made soup?

-Yes, that was beautiful.

I'm vegetarian, so it's nice when you get something special

on the veggie menu.

-Thank you.

-Thank you very much. Bye-bye.

-Bye.

-Hiya.

-Hello.

-All right?

It was beautiful, really nice.

-What did you have?

-I had the steak and mushroom pie.

Definitely better than the hospital where I work.

Oh!

It's nice to hear the good comments, so...

-And when you put the food out and it looks nice...

-It looks nice.

The Bakewell tarts were lovely!

I feel like I've earned my money today and yesterday.

It's all just falling into place.

It was just like a jigsaw today.

We're all really working well together as well.

-How was that upstairs?

-They really liked it.

-Any negatives from today?

-No, no. Not with me anyway.

What about the people that didn't get fed in the restaurant?

Yeah, well, OK.

Well, we sold out a lot earlier than we expected,

so we're going to have to probably do more.

Yeah, so have a think about that.

On the whole, I'm chuffed to bits with today.

I thought you did amazingly well. Don't let this slip.

Don't become too confident.

-Gaz...?

-And don't become too complacent.

For the first time ever, I've seen you work as a team. Well done.

-Brilliant job.

-Cheers, James.

'Today's results have proved to me that change here is achievable,

'but I'll be handing the reins back to head chef Tracey,

'who will need to keep herself and her team motivated,

'so to give Tracey a boost,

'I've sent her to a restaurant of a friend of mine, Glynn Purnell.

'I'm convinced it will give her the confidence

'to come back into her kitchen a stronger leader.'

-I want you to come into my kitchen. We're going to shout at them.

-OK.

'So Tracey can see how Glynn's kitchen operates,

'he starts her with the basics and gets her prepping desserts.'

-OK?

-OK.

Spray away. Same level.

Oh! Don't film that!

Are those chocolates ready yet, Tracey?

-No, chef.

-How long?

-30 seconds.

-30 seconds, chef.

-30 seconds.

Just scoop the mango on there.

-Come on, chocolate away! Tracey...

-Yes, chef.

-Come on.

'Not a strong start, but tonight is about learning to exert authority

'and how take the lead in the kitchen.'

-Right, OK, Tracey...

-Yeah.

-So now we've called the first cheque on...

-Mm-hm.

It's not about shouting and being aggressive.

Call it out, project your voice, so everyone on the team understands.

-OK, Tracey, so...

-Yeah.

-There you go.

-OK.

-You've got to call it out.

Oh, sorry. I can't read it.

-Two eight-course.

-Two A-course?

-Two eight-courses.

-Two eight-courses.

-Oui.

-Try again, a little bit louder.

-Two eight-course!

-Oui!

There you go. They're listening now, you see?

Two royal away.

-Two royal away.

-Oui!

Richard, are the gougeres ready? Haddock, please, chef.

-How did that feel?

-All right.

-Do you feel big?

-Yeah.

'It's great to see Tracey really embracing her new role.

'Let's hope it's the shape of things to come.'

-You do one, I'll do the other.

-It's all about the pressure.

-That's enough.

-I don't know my own strength!

It's really motivated me being here tonight.

I can't wait to get in the kitchen tomorrow.

'So now I have all the team fired up

'and showing a new-found passion for the food they're cooking.

'I want to introduce them to local producers

'and the food that's available right on their doorstep.

'Tracey's budget for food at the hospital is £250,000,

'so there's a massive opportunity

'to inject some much needed cash into the local economy.'

We want to know where we're going.

-It's outdoors, so it's got to be a farm.

-Fish market.

-It's got to be Birmingham, hasn't it?

-Yeah.

It's got to be Birmingham.

'Not a farm, but a local market not far away in Lichfield.

'It's only a 30-mile drive from the hospital,

'but it feels like a world away.

'This is a brilliant opportunity to see what great, fresh produce

'they can easily get their hands on.'

I'd love it if it was Jay Kay's house, out of Jamiroquai.

He grows all his own stuff.

'I'm afraid not, Vicky, but hopefully, it will be as memorable.'

It's twofold, bringing them here.

I want them to meet the farmers to understand about the local produce,

but also to understand how hard it is to produce that produce.

I was a farmer's kid for 20 years of my life before I became a chef,

so I understand how difficult it is

to produce the food that's available on your plate

and I think that will make them think when it comes to wastage

and weighing everything out

and it's the essence of what I've been talking about for two months.

I don't know if many of you have been out to food markets recently,

but here it's where you'll get the essence

of what's around your area in particular,

so have a wander round the market,

taste stuff, enjoy it, ask questions and have fun, basically.

-I just want to eat it.

-Has it given you ideas?

-Yeah.

I've had crocodile, I've had zebra.

-Zebra?

-Yeah.

The worst thing I've ever eaten was camel.

-Oh, you've got camel!

-Yeah.

-Oh, come on!

This is what I wanted to show you - these ones.

Manor Farm, which is pretty local to you, all right?

You think of soft fruit, you think of expensive, all right?

And also, you think of seasonal.

The strawberries are wonderful, but look at the price of these.

Three for a fiver. There's nothing wrong with those?

There's nothing wrong with them.

When we're packing for supermarkets or local customers,

the fruit that is just slightly overripe, we have to take out

and we sell it as a jamming quality,

but for any kind of sweets, jams, preserves, freezing,

there's nothing wrong with them at all.

So if you supply it to the supermarkets,

-a local NHS hospital is easy?

-Easy, yeah.

We'd be delighted to get involved with that

and you can't beat getting local produce on the menu.

'I have to agree, and what a great way to support local businesses

'whilst giving the patients delicious and healthy meals!'

Now, I wanted to bring you here,

purely the fact that to understand about food,

you've got to understand about the basics of food.

Animals need feed.

Feed has almost doubled in price over the last few years.

The menus that you write four years ago,

the prices that you're costing it at

are totally different to what they are now.

Here's a pork producer. A local chicken producer as well?

Yeah, a free-range chicken producer not far away,

-about half an hour from here.

-Half an hour from here.

We're just a small, local, family business, really.

We talked about the feed prices. It's rocketed for you.

It's the worst thing for us. It just cripples us.

If a Birmingham hospital decided to buy produce from you,

it would be a life-saver for you?

It would be. Everything helps to keep businesses like ours afloat, really.

This is really working more than I anticipated.

And they've really got what it's all about.

It's been really, really good,

learning about where the stuff comes from

and about how it affects other people with their businesses

and I've really liked it.

Great pumpkins as well, look.

When you look at prices,

cos that's one of my biggest areas that I've got to look at,

there are opportunities

and we need to look at those opportunities a little bit more.

No, it'll be really, really good.

-He hasn't worked in a restaurant since...

-Make some connections.

It was twofold today - get them here to inspire them about food,

but get them to understand...

Food isn't just available.

It doesn't suddenly just appear from anywhere.

It requires a lot of work

and they've got to learn to respect it a little bit more.

-Just delicious.

-It's winking at me.

-It's winking at you, yeah.

It's good. Today's a good day.

We don't need wine. We don't need wine, no.

As good as it is... Come on.

'Bringing the team to the farmers' market

'has really fired up their enthusiasm for food,

'but more importantly, got them to think

'about the impact they could have on their local economy.

'This trip has lifted their spirits,

'but one fear that's never far from their minds is losing their jobs,

'which is on the cards

'if the catering department turns into "cook-chill",

'bought-in meals made off-site, then reheated on the premises.

'Once a hospital has decided to rely on this method,

'there is usually no turning back

'as the kitchens are made redundant.

'I believe there is a way to improve cook-chill meals

'by supplementing them with fresh dishes.

'And taking on this particular challenge

'at the Royal Free Hospital in London are two of my cheffy mates

'who have agreed to help with my plans -

'Lawrence Keogh and Paul Merrett.'

I think it's going to be a logistic shocker.

I think it'll be a bit of a rude awakening.

I think I'll have to dig deep at times.

It needs sorting out. They are throwing money down the drain.

They need that support from all of us. It'll be tough,

but I'm looking forward to it.

Right, we're at the Royal Free in Hampstead,

a whopper of a hospital, a very, very big one.

I think, personally, when we were all stood in James's kitchen,

there was a little bit of bravado.

"I'll do that, I'll do that!"

But now we're here, it's huge. There's a real challenge ahead.

Today is not all about an investigation.

We're not coming in like the culinary police.

I don't want to make any mistakes, I don't want to let James down.

-I want to make sure we come out of here really positive.

-Yeah.

To find out about the hospital's catering systems,

Lawrence and Paul meet up

with two men with responsibility for the food at the Royal Free -

Director of Facilities Jeremy and Patient Satisfaction Manager Colin.

We work on a cook-chill programme.

We have a central production unit that prepares all of the food,

it comes in to us, it's picked and packed in trolleys,

it goes up on to the wards, then it's reheated at ward level.

Where do you think our energy could be used

to its full advantage in this process?

One thing we'd like to look at is vegetables

and we'd also look at our fresh soup option as well.

Is that vegetables to supplement a meal?

Vegetables that go with the meal, yes.

They've been overcooked and destroyed?

When you see the regeneration process in the oven,

everything goes in there together,

your hot entree and vegetables and potatoes,

and are reheated for the same length of time.

One's going to cook quicker and it's different degrees.

What's positive about the Royal Free

is that even though they're buying in their patient meals,

they're still looking at ways of improving the food

with the resources available to them.

What we'd like to do is look at integrating our main kitchen

where everything is cooked conventionally daily

and we'd like to integrate that with the services on to the ward,

so the patient feels they are getting a very good, wholesome meal

that is served fresh.

Mince steak, creamed potatoes, cauliflower and gravy.

-Come on, push on, Karen.

-Oh!

You wait till I have you making beds.

After witnessing how the patient meals are prepared,

the guys sit down to try some of the food

and read some of the patient feedback forms,

which reveal a recurring theme.

Soup.

Soup.

Soup.

There's quite a lot of soup coming up,

as in either it wasn't there or it wasn't very good.

"The soup is poor."

"Was there anything that could be improved?" "Soup."

"Was there anything that could be improved?" "Soup."

Maybe that's an area we need to look at.

At the moment, just explain, the soup is made...?

60 miles away in the production kitchens.

Wouldn't it be nice if every day,

there was a fresh, fresh, fresh soup, maybe with some crusty bread?

What I'm thinking is more fresh salads, crisp salads,

like a rocket and tomato salad on the trolley.

It's about doing something that makes it more appetising,

whether that's with colour,

whether that's embellishing it with a side salad,

something very quick and easy to do,

and we've got skilled personnel in the building. Our chefs can do that.

It says here, "Anything that could be improved?" "More seasoning."

I'll take that with a pinch of salt!

ALL GROAN

Words fail me, Lawrence, but back to the task at hand

and next, the guys meet up with executive head chef Graham

to see what facilities could be made available

from the in-house restaurant kitchen.

You're running the big restaurant out here.

-You don't cook any food that goes up to the wards?

-No. Not at all.

-But you think the team could take on a little bit more?

-Absolutely.

What about, say, a coleslaw or a rocket salad

or a little sort of tomatoey salsa to accompany something?

No problem at all.

We've got the capability and the equipment to do that.

-It can be done fresh every day.

-And soups, that doesn't frighten you?

No, we've got the utensils and the capability.

-You've got a stick blender and a boiler?

-Yeah.

Could we try and make one soup

-for one ward for one lunchtime shift?

-No problem.

-Yeah.

-Shake on that?

-Yeah.

-Right.

'It's been a good start for Paul and Lawrence

'and they're keen to fill me in.'

We've just been to the Royal Free in Hampstead.

Definitely a need for, I think, fresh produce.

Definitely a need to see some of the quality

of the downstairs public restaurant going up to the wards.

So it certainly seems it would benefit...

The bottom line, James, is that the core product,

the core cook-chill product is perfectly reasonable,

but what they need is to embellish the meal, just bring it to life.

-Wicked! See you later, boys.

-Thanks a lot.

-See you later.

-We need a beer.

-Yeah, it's your round.

'Lawrence and Paul have identified soup as a simple, nutritious way

'of introducing fresh, healthy ingredients to patients,

'exactly the same thing I discovered

'when I began this project in Scarborough,

'and it's equally true at the hospital in Birmingham.

'Helping the team to improve the catering is more than a job for me.

'I've become far more attached to them all than I thought I would.'

That kitchen is full of characters. They've got their own personalities.

They're now my friends.

The thought of them all losing their jobs

has got to be taken quite personally, really,

because, you know, the pressure is really on.

The most important thing is that these guys still get to work here.

'Next time, I'll be trialling a new ordering system

'in an attempt to tackle Birmingham's massive waste issues.'

OK, there you go, Ward 2, that's your new system.

Fingers crossed, that new order system should save,

I reckon, about 25% waste.

'But if it doesn't work, we'll be back to the drawing board.

'I catch up with some chefs who are helping me out in other hospitals.'

The hospital has gone cook-chill

and there's very few times when it will revert back to fresh food,

but fresh soups could be a great start.

'I take my mission to get Welsh lamb on the menu right to the top.'

-There is one big, key problem with all this.

-OK.

You're going to have big issues

when it comes to buying stuff because you're handcuffed.

Subtitles by Red Bee Media Ltd