Episode 4 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 patients confined to a hospital ward but that it can be a medicine, too.

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

-The food's awful.

-We thought it was a joke to start with.

-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 has been spent in the last decade

'trying to improve the quality of our hospital food,

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

'I took up the challenge to bring healthy, tasty food

'to the wards of Scarborough General Hospital.

'And patients who had been previously turning away their food

'are now looking forward to mealtimes.'

-I think the food's excellent.

-No complaints whatsoever.

-The soups now are brilliant.

'So I've proved it can be done.

'Now the challenge is to 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.

'After I proved at Scarborough it is possible to improve the quality of hospital food

'and stay within the budget,

'I was determined to bring about similar change in hospitals right across the country.

'But when I began working with a team at Birmingham's Royal Orthopaedic,

'it quickly became clear that I have a huge task ahead of me.'

You haven't measured it. I reckon they've got about

ten litres of custard still sat in there.

'The team had no idea of how many people they were cooking for.

'They were just guessing the numbers and the recipes, leading to shocking levels of waste.'

Tell me the recipe for 100 portions of cottage pie. Off the top of your head.

I'll be honest, I don't know. We're just used to the way we do it and I will do that now.

'To show how things could be done, I took over as head chef.'

The boiled potatoes for the trolleys, please.

One minute! Come on!

Ready 15 seconds early. Brilliant.

'But with effecting change in this one hospital a major job in itself,

'it was obvious that my plan to do the same throughout the UK was going to require some backup.

'So I've enlisted a team of world-class chefs to help

'and sent them out to hospitals in their local area,

'where each of them has been given their specific task.'

You've got Galton Blackiston of Norfolk. He's based in King's Lynn.

He's doing vegetarian options

and trying to increase the turnover of the restaurant, so that's quite difficult.

The reality is massively sinking in. This is really taking me out of my comfort zone.

In Cornwall, the Tanner brothers are doing fork-mashable food for stroke patients.

Not only has it got to be nutritious but it's got to taste good, as well.

We didn't know what we were coming into.

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

Stephen Terry's got to create a lamb dish for the entire NHS in Wales,

which is a pretty tall order, in my opinion.

Wales is synonymous with lamb.

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

And then you've got Lawrence and Paul, who are based at the Royal Free in London.

It's quite unique that they've gone partly cook-chill

and they want to go back to where they were before and produce freshly cooked food.

-At the moment, the soup is made...

-60 miles away in the production kitchens.

-OK.

Wouldn't it be nice if, every day, there was a fresh, fresh soup?

'And back in Birmingham, to get head chef Tracy to understand how she can perform her job more efficiently,

'she worked a shift with Michelin-star chef Glynn Purnell.'

-Two egg course.

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

'So with a more motivated Tracy now taking control over her kitchen,

'I can now move onto examining the books

'and making sure we can bring about change within the budget.

'The kitchen here is currently heading towards a yearly overspend of £27,000.

'But I can immediately see another way we could cut costs.

'By making sandwiches and not buying them in.'

-No-brainer, that. Do we realistically spend 90 quid a day on sandwiches?

-Easy.

-Easy?

-That's just patients. We have staff, as well.

-And the price is higher.

-Oh, so it's that and that?

-Yeah.

We used to do them all ourselves.

We spend 1,000 quid a week on sandwiches?

It's madness!

I've figured out if we make them,

that will half that bill,

brings me a £14,000 a year profit

just by making them themselves.

'The overspend is one of the reasons why the team here are under threat of losing their jobs,

'so it seems crazy that they're wasting so much money

'buying in ready made sandwiches.

'Making their own wouldn't just save them money, it's a way that they could make money, too.

'I have an idea I need to run past head of facilities Emma.'

-This is quite a big thing.

-Yeah.

-The sandwiches are costing £1,000 a week.

-Right, yeah.

-All right?

-Mm-hm.

I'd like to make most here.

We've got the ability to do it in there, we've got the staff,

but we need some form of selling... Two things I want to ask you.

One is, I want to ask you about a baguette bar. Can I have some money for that?

You can see quickly how much I can generate.

So we stop selling these. If you want to go to the trust with that...

-I can go and walk into an office.

-You can explain.

-OK, I'll go and walk into an office. And that, thank you.

-Take that

-and then go beg.

-I'll go and work my magic, then.

-Yeah.

'At the moment, the restaurant generates £600 a day.

'But Emma's already told me that we need to reach our daily target of at least £800.

'So if she can convince the trust to invest some money,

'I know we can achieve this by selling fresh baguettes to the staff and visitors.

'While I'm waiting for an answer, I talk to the team about my plans.'

So we're going to make our own baguettes.

Currently we're spending £1,000 a week on sandwiches.

-That's madness.

-Mm.

-Madness.

The fact of the matter is, we need £800.

£850, ideally, so it gives us a buffer.

So if we can do another £200 a day,

when words gets around, I think we'll easily do it.

'I introduced a baguette bar while I was revamping the hospital restaurant at Scarborough

'with Pat and her team. It's been a huge success

'and has created a whole new revenue stream.

'Hopefully we can replicate that here in Birmingham.

'Another success at Scarborough was to have identical menus for both the restaurant and patients.

'This helped streamline the kitchen, gives them greater control over costs

'and ultimate reduced their waste.

'I'm confident that it will work here, too.'

With the menu we're going to write now,

the idea being all the patients get exactly the same food

as what we serve in the restaurant.

All right? I want you to make sure that we've got recipes for everything for when I come back.

I'll send you the bits and pieces I'm going to add to it,

like the sticky toffee pudding recipe and stuff.

But I want you to make sure we've got a new book

and that new book has got every single recipe that was on here.

-Lunch and dinner.

-Yeah.

-Any questions?

-It's not a step, it's more like a leap jump.

-Why not?

I have every confidence in you, but I need your help on it.

So although I'm going to start to add more work onto you,

I need you to understand the reason why I'm doing it.

'As a result of everything I was able to accomplish at Scarborough,

'I believe real change is achievable across UK hospitals, despite failed initiatives in the past.

'But each hospital has its own unique issues

'and they don't all need a complete overhaul when it comes to their food.

'Some might just need help with one particular thing.

'So my band of fellow chefs are here to help.

'One of my volunteers is Michelin-star chef Galton Blackiston.

'I've sent him to his local hospital in King's Lynn

'where they want our help to create some new vegetarian dishes

'and also increase the profits of the restaurant

'to generate money that can be spent on the patients.'

Well, day two, massive day.

Back at King's Lynn Hospital. Last time I came,

we set a few things in place.

The restaurant has capacity to serve a lot more meals than it does.

There's 3,000 staff alone

coming into the hospital on a daily basis.

They're sending out less than 200 meals.

So I had an idea last time I was here

to think that we'll go and walk around with a trolley and see if we can bring food to them.

Hopefully we'll be OK, but these things can go badly wrong.

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

'On Galton's last visit, he left the hospital a to-do list

'he believed was needed for them to reach their goal of increasing the restaurant's revenue.

'So first stop is to see head chef Stuart

'to find out how it's going.'

Last time we were here, we were going to try and put into place the baguette bar

and, also, have we got the trolley in place to go round?

We haven't purchased the trolley yet to go round the hospital,

but we have got a cold box where we can put rolls in, and a trolley that we can actually use.

We've looked into the baguette bar.

We have been in contact with a local supplier.

The hardest part about purchasing and getting equipment from the NHS

is the process we've got to go through.

So we've got soups going on the trolley. What sort of soups?

We haven't got any soup going on the trolley

but we're taking out the sandwiches and salads today.

Can we not get a soup on there today?

No, because the health and safety of us taking...

-You can't carry a soup.

-..hot liquids round the hospital.

Ahh.

'It's frustrating that the hospital's red tape

'is currently preventing them taking soup out onto the trolley to staff,

'as I think this would be a fantastic source of income.'

I'm very frustrated I can't get soup down into the offices.

That's not in place because you have to go through rules and regulations,

health and safety are being a real pain about it.

If it was me in my kitchen, I say something, it gets done and we work towards it.

Here you have to go through certain procedures to make anything happen.

And you should be able to achieve these things. We just need to do it.

All this talk...

'But determined to push forward with my plans to increase the department's turnover

'and raise money that can be used to benefit patients,

'Galton arranges for soups to be sold in the restaurant

'before heading out with his makeshift trolley service

'to see if he can entice the staff to buy some lunch.'

You can have a baguette, if you want, look. Come and have a look at them.

I know it's a first. Come on.

Would you mind me disturbing you for two seconds, guys?

Would it be of interest if a trolley came round here?

-That would interest you?

-I think it's a good idea.

It's quite helpful to get food brought to you.

I'm particularly keen on the soups, as well.

You guys are so far away from the refectory.

There will be a trolley coming round to you.

-Ladies. Do you think it would be of interest?

-Yeah.

-Ladies, don't go wandering off.

'Word quickly spreads of the new trolley service

'and the hospital staff are keen to part with their hard-earned cash.'

-I would like a ham one, please.

-Perfect.

-Can I have the plain salad?

Would you be interested if we, at a later date, brought soups around?

-Yes, definitely.

-Yes, definitely soups.

-Soups would be good.

This is just a trial. We'll get the soups in, more variety of salads.

This is definitely a good move. I know it.

-We've had a long day.

-'So how much extra money has been made in just one day?'

-I've got some figures for you.

-Right.

And I hope you'll be as happy with them as I am.

The rolls and the salads that we took round on the trolley,

-we sold 35 of those.

-Good.

-And the baguettes, we sold 57.

-Oh!

Anyway, profits. We've done some working out.

-THEY LAUGH

-So, on the 57 baguettes,

-on a monthly basis, the profit was £1,400.25.

-Oh, right.

-Very good.

-On the units on the trolley, £700 a month.

-£8,400 a year potential.

-Oh, right.

-It's a no-brainer to me.

-Yeah.

There is definitely, definitely a call for the trolley service.

-I'm absolutely delighted with some of those sales figures. I really am.

-Yeah, I'm pleased with that.

-Very.

'Generating an income has become vital in every hospital in the UK

'as the NHS has to make tens of billions of pounds worth of efficiency savings by 2015.

'Back in Birmingham, one way the trust is considering saving money

'is by losing the in-house catering team altogether

'and outsourcing the food to external companies, who make it off-site.

'But I think fresh food made on the day in the hospital is best.

'So I've been working with the kitchen department here to try and turn things around.

'If I can make the operation more cost-effective, hopefully we can save their jobs.

'So far, most of the time has been spent trying to change the mindset when it comes to food.

'Although this hasn't been easy.'

What you've done is create recipes.

You've photocopied out of cookbooks, you don't even use it.

Those scales haven't been used.

You're making stuff without even thinking about it.

From now on, this is the bible.

-Use it.

-Yes, chef.

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

That's five litres of custard for lunch, five for dinner, that's ten litres, 365 days a year.

'But I think we've come a long way since I started working with the team.'

Every time I turn round in this kitchen,

you've got a whisk in your hand, whisking custard.

-HE LAUGHS

-Yeah, there's something going on between me and the custard.

-Yeah.

-I think I've got a point to prove.

Do you remember when I first walked in here?

-Well, I'm not going to forget that.

-When you got the double cream and the vanilla essence

-and threw it all in?

-I'm was trying to impress.

'I can see the staff are starting to turn a corner

'and producing better food and working well as a team.'

This is a great thing. We're now, what, quarter past 11.

The pies are going in. Eight weeks ago, this would be done at eight o'clock in the morning.

'But now it's crunch time. I want to roll out some major changes

'which I firmly believe will improve the hospital's food and increase their profits,

'pulling this department out of the red and back into the black.

'As part of that, I'd like to install a baguette bar

'and head of facilities Emma has heard back from the board

'about whether they can give us the money to do it.'

Just brown them for about another five minutes.

-Ah!

-Hello!

-How you doing? You all right?

-Yes, thank you.

-Good.

-I think I've secured the funding.

-You think, or we have done?

-I would say 99.9% there.

-OK.

Cos I think we can actually upgrade it a bit, rather than just having a stand-alone counter.

Right. Even better.

'It's great news that Emma's managed to secure the money for the baguette bar.

'But there's a much more fundamental problem to fix, too.

'From the start, the biggest shocker for me and the root of most of the wastage here

'has been the ordering system, or lack of ordering system.'

Right, guys, we've still got a bit of issues throughout all this.

One of the main issues that we brought up was waste.

So I've put this little idea together.

We go back to how... Most of the wards and certainly the hospitals I've worked for so far

-have a menu system.

-Yeah.

To help you, I'd like you to call Pat at Scarborough.

-Yep.

-If you look at your spend per year on food, it's quarter of a million quid?

-Yep.

So your spend on food is quarter of a million pounds.

40 to 50% of it is going in the bin.

-That's depressing, isn't it?

-BOTH: Mm.

So between now and our final day when we'll implement all this,

I need all the recipes written, new file, costed, everything.

-Yep.

-All right? So no pressure.

-We're just going to be living here.

-THEY LAUGH

'Meanwhile, over 200 miles away at the Royal Cornwall in Truro,

'two more of my band of volunteer chefs, the Tanner brothers,

'have a difficult job on their hands.

'James and Chris have been asked to develop a fork-mashable menu

'so that stroke patients aren't just eating puree food.

'It can be hard after a stroke to swallow food,

'so coming up with tastier dishes that the patients won't choke on is a real challenge for the lads.'

Last time we left the hospital, a loads of boxes and some notes,

some mental notes that we'd taken of the kind of food we wanted to do.

And all I've been thinking about is crushing things with forks.

We've come up with some recipes

and we've tested them out

and we've brought a load along today.

There was just so much information to take in

and you look at all the dietary side of it and stuff like that.

There's a bit of jeopardy today, cos we don't know what they're going to come out like.

'So with their prototype frozen meals in tow, the Tanners make their way to begin the cooking process

'that all cook-freeze dishes go through.'

-How are you, James?

-Yeah, good to see you guys.

'But will their meals hold up to it?'

-This is a typical regen oven.

-Yep.

-So these are used on all the wards throughout the hospital.

-So when you're ready...

-Right.

-Number one.

-Yeah.

80 minutes. And that's it.

-Bless this trolley...

-THEY LAUGH

Just get down on your knees and do it properly.

-I'm James. This is Chris.

-Hiya.

'While their dishes are being cooked, the boys grab a chat with three recovering stroke patients

'who are going to be tasting them.'

-Was food something you looked forward to?

-Yes.

But it was also frustrating, cos if you didn't like it,

you couldn't actually tell anybody. It came out garbled.

-Right.

-So they would sometimes say, "He doesn't want it," and take it away.

If you had something like sausage and mash and peas,

-and you can't cut the sausage up.

-Yep.

So they take it away and they put all of it in a blender.

So that's great, I can swallow it,

I can cut it, but it's just a mash.

-For the first four weeks, I didn't have any proper food.

-Yeah.

So, erm, after that,

it was just the choking.

-It's just...

-That's something you still face today, 20-odd years on.

-Not as bad.

Listen, it'd be good to gauge...

Cos obviously you've all had very, very different experiences of that.

Just to see what you think with the food.

'The taste test is crucial in getting the dishes approved and onto the hospital's menu.

'If there are major changes, it will mean the boys are back to the drawing board.

'On hand to see how it goes are one of the hospital's dieticians

'and a speech therapist.'

All right, here we go.

Taste-wise, it was good. Some of the dishes I would pay for in a restaurant.

It's just little bits that need tweaking.

There's quite a lot of chicken,

but I still found that a little bit...

as though I was going to choke a bit.

No, I think you're right. It's stranded a bit.

There was genuine responses. Everyone is very, very different.

The fish is proper soft and flaked.

The mashed potato's very soft and creamy, so it's not dry at all. And it tastes lovely.

-It's actually better than I thought it was going to go.

-It was really good.

The mashed potato is just perfect.

That's perfect. Keep that one coming. We like that.

-And that flavour's all right, yeah?

-Lovely.

OK, well, for the next stage, we do our little minor tweaks

and then the dieticians have to go through all of the recipes we've done.

That all gets approved off and then the guys at the factory

make it en masse and serve it to the patients on the ward, but all of the patients, which is fantastic.

'My goal has always been to help as many hospitals as I can,

'but it's obvious I couldn't have done it alone.

'And on top of drafting in my chef mates to help,

'I still have one more favour to call in.

'This time it involves Pat and Sharon at Scarborough,

'where our mission to improve hospital food first began.

'I've arranged for Tracy and Emma to visit and learn how their kitchen in Birmingham could benefit

'from introducing an ordering system like the one used in Scarborough.'

I think it's seeing what they've already been through and then how they're using it now.

So basically, what's going to happen once we've finished working with James temporarily and moving on.

But also looking at what they went through,

because I think it'd be nice to share it with the team back at the Orthopaedic.

-What are you making, Big Bird?

-Topping beef and mushroom pies.

-Oh, well done.

I feel quite honoured, and I think the whole department does,

that James has come back and asked us for our help.

So he must have been pleased with what we did whilst he was here.

-Hi, Emma! Nice to meet you!

-Hello. And you.

-I'm Tracy.

'Pat gets straight to business and shows Tracy and Emma her ordering system.'

So there's all our wards that we have.

So Chestnut Ward, that's the menu that we've got on for lunch today.

So all my patients fill out an individual menu card.

-Do you not send menu cards out to your...?

-At the moment, we don't,

but as part of the roll out, we're going to go for the full sending out menus.

So that's the total, so you know how much you've actually got to cook.

-And the average cost of the meal today is £1.25.

-Right.

-So you can tell how much it costs before you actually serve it.

-Brilliant.

I found it really useful coming today. I'm glad I came.

-It was nice meeting Pat and Sharon.

-Yeah.

-Talking through the process.

-We've had a chance to have a good chat

and understand what they've been through and the fact that there is light at the end of the tunnel,

-and we can take that back to the team and it'll be really positive.

-Definitely.

'After seeing first-hand how an effective ordering system can make things run more smoothly,

'Emma and Tracy head back to Birmingham,

'ready to put into practice what they've learnt.

'But that won't be the only change this morning.'

Today's a big day for the team. Not only have I implemented a new menu system...

Well, it's not really a new menu ordering system,

it exists in every other hospital I've worked at,

but we're trying it out on one of the wards to reduce that waste,

but also I've given them two new dishes to try

for the new menu, so fingers crossed.

-Have you made this before?

-Never.

-Never?

'If we don't prove that giving the patients an individual menu

'will massively reduce the amount of waste

'then everything I want to do here looks doomed to fail.

'So I need to make sure the team keeps it together and doesn't make any mistakes.'

-What are you with? Sticky toffee pudding?

-Yeah.

OK. That's the wrong amount of sugar.

This is the one I sent you for six portions.

So, yeah, 150 grams for six.

-Yeah?

-Oh, so that's definitely not right, is it?

-Yeah.

-1.25 kilos you're missing.

-Yeah.

I thought it didn't look right. That's your only mistake you're allowed today. That's it.

-So 33 eggs, yeah?

-33 eggs.

Just going to check that.

'The lack of an ordering system

'has been one of the issues that, so far, despite my best efforts,

'we haven't been able to change. I tried to get the wards to phone down

'with the patient numbers by a certain time, but it hasn't worked.

'So if we can't crack it today, we're in trouble.

'Added to that, there's the pressure of seeing if the patients like the new dishes we're trying out.'

It feels like it's real cooking again.

I'm coming in and it feels like I'm actually stepping again.

Cos before, it became quite robotic.

So to do something like this, and alongside James, as well, it's pretty cool.

'And what's also pretty cool is today we're trialling the new menu system on one of the wards.

'For that ward, at least, we know exactly how many people we're cooking for.

OK, everyone, I've got the numbers! Yee-hah! Got the numbers off Ward 2.

Oh, my God!

'Those words are like music to my ears.'

Fruit juice, 12. Chicken chasseur, eight.

No broccoli quiche.

Three sweet corn, five baby carrots.

Six egg sandwiches. Three sticky toffee pudding.

-And nine fruit cups.

-How good is that?

-OK?

'Exact numbers from the ward where we're testing the new system.

'Let's just hope we don't see any waste.'

Because it's one of our biggest wards,

-we would've sent them about 15 pieces of chicken.

-I know.

-And we would've sent some flan for the vegetarians.

-Yeah.

Hey?

-Eight chicken chasseur for one of our biggest wards?

-Yep. That's what they want.

OK, this is for Ward 2. This is what happens when we get the order beforehand.

Now, Ward 2 is a big ward, so what they would normally do is send a whole tray full,

uncut, of sticky toffee pudding.

But...things are going to be different today.

Now, this is for the other wards

that haven't been issued the new menu system.

And I reckon a good 40% of this is going to come back.

And when it comes back,

I can't use it and it goes in the bin.

Which is nice.

-1, 3, 12...

-'The moment's arrived to send the food up onto the wards and into the restaurant.'

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

'My greatest fear now is we still see loads of food come back from Ward 2,

'despite the patients being able to choose which dish they wanted.

'If that happens, we're back to square one

'and I'll be running out of time to turn this department around.

'So I can't help being nervous when lunch is over and it's time to compare the waste.

'First of all, checking what's come back from the wards still using the old system.'

So that's nine portions of chicken. That's Ward 3.

And how many? Six puddings. Ward 12?

Five portions of that left, two portions of pudding, yeah?

Ward 1? Even more.

Six puddings. How much chicken? Five chicken.

I want to check number 2. I did genuinely not open this

so I'll be interested to find out.

So you've got zero pud.

What, half a chicken? I think somebody's had the other half.

There's half a portion.

So really, you've got £1.40 waste on Ward 2.

Ward 1 has brought you in

£21.80 waste.

Ward 3 has brought you in 34 quid waste.

Ward 12 has brought you in £16.60 waste.

Right, my waste on one ward is £1.40.

That's what it would cost you in the restaurant.

Your waste on other wards so far,

£72.40.

-Times by seven.

-Yep.

£506.80.

Times by 52.

£26,353.

And that is by changing nothing

other than the way we take the orders.

I reckon if we did implement the ordering system,

we would go from 50% waste, which is I think what we're doing at the moment,

to ten.

And the good thing is, we're on budget.

-If we do that.

-Brilliant.

-And not this.

-Yep.

-All right?

-Yes.

Well, we've got positives and negatives from today.

The positives are that I think Emma and the team are well aware of waste

and I think it was a good exercise in proving that

and seeing how much food, physically, in terms of what you see,

but also in terms of what it costs,

I think is vital when you do put it down on paper,

particularly when you start handing it in to Emma and the guys who work in the office.

To actually see it was quite, you know, quite astounding,

and I think it's just really, you know,

putting the message through that this is something we need to do.

And it's not a maybe, it's not, "Oh, it'd be nice to do," it's something we've got to do.

-Now you see how it's all going down the... It's heartbreaking.

-That's just mental.

'It's always been the process of how they do things that's been the biggest problem here in Birmingham.

'So proving that the ordering system works is a major part of the solution

'and feels like a real breakthrough.

'It's a good moment for me to catch up with how things are going

'at some of the other hospitals that have agreed to work with us, starting at the Royal Free in London

'where Lawrence Keogh and Paul Merrett have been looking at how to supplement the catering operation

'that's currently cook-chill, meaning that meals are bought in ready made and heated up on site.'

As you know, when I started this project, it somewhat snowballed.

And as such, we've got different satellite hospitals right around the country

and I've managed to pull support from a load of mates of mine who are chefs.

-So we've got Lawrence and Paul.

-Morning.

-Thank you so much for giving up your time on this.

-I'll remember that, standing here freezing!

-You didn't realise you'd be doing this.

-What have you found so far?

-They currently use the cook-chill system,

which was interesting. We spoke to nurses, a lot of patients.

One thing came out time and time again. The word fresh.

That's what they want. Salad, soups, that kind of thing.

When they go to this system, there's almost no going back.

-So what are we doing today?

-We're going to test-drive some soups and salads and bring them to the wards.

No time like the present. Good job I brought my chef's jacket with me.

-They're your recipes, mate.

-Exactly.

'The Royal Free stopped serving freshly cooked meals and turned cook-chill in 1988.

'However, they do still have a functioning kitchen,

'which prepares food for the on-site dining room.

'So we're hoping that from now on,

'it can also be used to start cooking fresh soups and salads for the patients.'

The idea of this soup is, what we've certainly done with the other hospitals is try and do it...

Obviously look at cost. So this is the same soup as we serve in the restaurant to serve to patients.

'Today we're testing out whether the plan will work,

'and taking some soups up to the wards to see what the patients think.

'So it's all hands on deck to get them finished.'

-Come on.

-We're going to have a cup of tea, Paul, while you're doing that.

Can we do the omelette challenge after this?

I want a cup of tea with the chef. Push on.

Do you want me to squeeze these, chef?

I was only brought into this show to cut parsnips.

That's the only reason you're here. I'm only here to squeeze limes.

-I don't know what I'm doing here.

-Chop, chop.

'The great thing about this hospital is that everybody is fully committed to making this work.

'Especially executive head chef Graham.'

I'm going to introduce fresh soups, which has got to come from this kitchen,

-cos it's the only kitchen in the hospital.

-But then if we get all the veg diced for you,

-then you have no...

-There's no problem at all. No. No.

-It's just hot stock, hot milk...

-And currently, we only serve soup in the evening.

It's only one service a day.

-Not lunchtime?

-No.

I'd want a bowl of soup for lunch, wouldn't you? On a day like today, it's freezing outside.

It is freezing outside, by the way.

For you at home, it may look actually a big kitchen,

but this is actually really small considering the size of the hospital.

Sadly, the hospital has gone cook-chill

and there's very, very few times when it'll actually revert back to fresh food.

Certainly, what the fresh soups can bring, and what the guys have been working on with the compound salads,

it could be a great start and certainly fill a niche in that market that they want to look for.

It's going to be done with ten mil dice.

He gets to work with the pots. I'm squeezing limes. He does all the fun stuff.

-All the legwork...

-And he turns up and takes the glory. HE LAUGHS

-Oh!

-Now you look like you've been in the kitchen.

-HE LAUGHS

I'm not playing.

'Right, the soup's made. Well, just about. The lads get started on making their coleslaw.'

Do you remember when I used to work in customs?

'And I grab a moment with director of facilities Jeremy

'to chat about how introducing some freshly made dishes will improve their service.'

-You've done a bit of research on this.

-We have.

-While the guys have been in.

We went back to look at what we were serving for our patients

and found that we were buying in a product that was packaged up

and it just didn't look that appetising on the plate.

This is a bought-in product that arrives to your door pre-done.

-Travels 60 miles, plastic packaging.

-Right.

-And it's just a basic composite salad.

-Right.

And it really wasn't bright, it wasn't colourful,

it didn't offer that temptation if you really needed your taste buds tempting.

Now, in terms of cost, how would that vary between what these guys have come up with

to what's currently on your... what you're spending?

Clearly, we're spending money on food miles and on the packaging,

which needs to be recycled, and that's not including the salad,

so, actually, it makes more sense that we do the salads ourselves,

reduce wastage, and also build that into making a product

that's more exciting and tempting for our patients to eat.

'Getting hospitals to constantly examine their practices has to be the best way forward.

'Doing things differently here will give patients an instant benefit, without costing any more money.

'There's no reason for freshly cooked food to cost a fortune,

'as we're aiming to prove at all the hospitals I'm working with.'

-Lovely.

-Crunchy. It's fresh.

-Lovely.

-So if this was offered, you'd go for this?

-Yeah. Yeah.

-Excellent.

-Are you happy?

-Yeah, I like it. I think it's great.

How does that compare with what you've had before?

Very tasty, yeah. Very good.

-Hi, Gladys. Lawrence.

-I haven't done my hair at all.

-You haven't done your hair? Don't worry, Gladys.

-I haven't done mine.

-I see you've eaten the soup.

-Yeah, it was lovely. Yeah, very nice.

And how was the food since yesterday? How's it been?

Well, the dinner hasn't been very nice.

I didn't have soup yesterday. I missed it, you see, I had to have...

-Would you always have soup if it was there?

-Oh, I would, yeah. I love soup.

-How long are you in for?

-I'm going home tomorrow.

I don't like to say this, but I'm glad you're leaving tomorrow.

-The soup made me better, it cheered me up.

-THEY LAUGH

'It's brilliant to see the soups and salads going down so well with the patients on the ward.

'But we also need to make sure that the soups will sell in the staff and visitors' dining room.'

-Well, we're in the restaurant. It's a big restaurant for a big hospital.

-It's huge.

-Upstairs went well, I thought.

-Yeah, really good.

-Really good positive results from it.

-I think they were honest, James.

We want them to be honest, that's the key to it.

What I'd like you guys to find out, really, from the people eating here

is what they think of the soup, because this is the same soup as what's served to the patients.

-We've been busy in the kitchen all morning...

-Yes.

-I have, not him.

-..making soup for the patients, as well.

-Right.

So we wondered what you thought of the parsnip and rosemary?

It's great. It's the first time I've had it.

-Good. Good. Is it worth the money?

-Yes.

-How's lunch?

-Great.

-Really good.

-Really nice.

Soup eater, soup eater, where's yours?

There's your spoon. Dip it in and have a taste.

Or you can't join the conversation. Have you seasoned that, by the way?

-Yes.

-Have you added pepper?

-I have added some pepper, yes.

-I told you it needed pepper.

-I told you.

-No, you didn't.

Well, anyway, sorry about the seasoning. But apart from seasoning, how is it?

-I think it's great without the pepper, actually.

-Well done.

-We'll focus on you, I think.

-Thanks!

-Is it good soup? You enjoy it?

-Great.

-Really nice.

It's the best soup I've had down here, so it's really good.

-Sorry, can you just say that again, loudly?

-Yeah, it's the best soup I've had down here.

-Excellent.

That's the batch I made.

Now, we've tried it today on a small ward.

The big step is obviously rolling this out to the entire hospital.

That's the big thing. I think, in terms of equipment,

if we could sort that out between now and when you guys come back,

the next time you're here, we'll press the green light.

-Yeah.

-It's going to be a big challenge. We're going to have a go.

The logistics are going to be challenging for us throughout the whole of the hospital.

It's 500 patients. But we're going to have a go.

-If it benefits one group...

-There's a lot of soup, a lot of salad.

THEY LAUGH But no problem. That's good.

-You're going to wish you'd never said that.

-No, no, no. Not at all.

'If we accomplish our goals at the Royal Free,

'this could be a model for other hospitals across the UK which rely on cook-chill meals.

'So the pressure's on for what we're doing here to be a success.

'But for now, I'm travelling to Abergavenny

'to meet another member of my brigade, Stephen Terry.

'We've been set the task of creating dishes for a menu

'that's going to be used in all 115 NHS hospitals throughout Wales.

'But Stephen's been amazed to discover that currently

'the only lamb most Welsh hospitals can afford to buy is from New Zealand or Australia, not Wales.

'We both reckon local lamb could be sourced more cheaply.

'But the red tape surrounding procurement

'means hospitals are tied to their existing supplier contracts.

'And changing them may not be that simple.

'So as we meet the health minister, Lesley Griffiths, to update her, we're hoping she can help.'

Right, you gave us a brief to come up with not only a main course,

using, obviously, lamb.

-We've got the soups, as well. We think we're about there for you.

-Good.

Certainly in on budget. There are a couple of issues we'll bring up once you've tasted it.

But you can explain what you've done with your dish.

This is just a simple...using Welsh lamb, Welsh lamb shoulder

with some root vegetables, some carrot, and then we've got celery

and it's got potatoes in there. So it's a complete dish, really.

So the calorie content of this would be good for patients,

-cos obviously you've got the pastry, as well.

-Absolutely.

And most... Well, all hospitals now

-are serving gravy, as well, by the side of it.

-As well as. Thank you.

See what you think. It doesn't detract from the flavour, certainly not.

Smells gorgeous.

Mm.

-Good enough?

-Mm. That is so good.

-Approve of that one?

-I approve of that one.

-Thank you very much.

-Thank you.

-This is butternut squash and lime.

-Erm...

-Lime?

-Six minutes to make.

-Delicious.

It's literally just the ingredients go in, six minutes, done.

-That's so tasty.

-There is one big key problem with all this.

-OK.

-What we've discovered is procurement.

-Yeah.

As far as we know,

you cannot buy Welsh lamb

and put it on a menu in a hospital in Wales.

Well, I'd very much like to use Welsh lamb, obviously,

-but we've got to stick within budget.

-Yeah.

So, that is obviously an issue that we'll have to look at.

I've done my research. I can get you two suppliers,

-which I've got on here, that will do Welsh lamb...

-Mm.

-..on average...

-Mm.

..at £3.50 cheaper than what you're currently buying it per kilo.

It's certainly something we can look at within the procurement rules.

-I think the whole lot needs investigating.

-Yeah. It's certainly something we can look at.

-You're going to have big issues when it comes to buying stuff, because you're handcuffed.

-Mm.

-Are you happy?

-Yes, very.

-£1.25, then, for a portion of soup.

'I'm really pleased that Lesley approved our dishes,

'and they'll be on the menu across all of Wales.

'I hope that she can look into the issues around the purchasing processes

'and manages to get Welsh lamb back on the menu.

'But it really does feel that everywhere my brigade of chefs are,

'we're all moving in the right direction.'

Now, this is a huge task for us to take on.

Changing the hospital food in one was hard enough,

and the previous experience that I had at Scarborough,

but trying to do five at the same time is proving quite difficult.

But I really do believe if you can change one thing,

it really makes a massive difference to the bigger picture.

And looking back at the initiatives that the previous governments have done in the past,

spent millions, up to 50 million quid in recent years,

on trying to change the hospital food,

that we've proved at Scarborough that we can do it.

We've come under budget, we have great food,

it benefits not only the staff here but, most importantly, the patients.

So, I really do believe that this can work.

But implementing it is the difficult bit.

'Next time, it's make or break for the team in Birmingham

'as we roll out my plans to transform the hospital's food.'

This is the moment, where... you're going to get judged now.

We came in quite confident

and everyone now seems like a bag of nerves.

I've got a funny feeling it's going to be quite a day. I can feel the vibes.

'And I reunite my brigade of chefs as we bring together

'some of the most influential decision-makers in the NHS

'in the next step towards revolutionising hospital food.'

All these people on board this boat are all passionate about one thing

and that's to make the food in the NHS better.

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