Episode 2 Operation Hospital Food with James Martin

Over the last decade, £50 million has been spent trying

to improve the quality of our hospital food.

What is that? You don't know.

So far though, there's been little sign that change,

on a national level, has been achieved.

That's the reality of the food that's served in the NHS.

In fact, a recent study revealed that over a third of hospital food

is still considered unacceptable by patients.

Just horrible.

It's not appetising.

It was inedible, cold. It was vile.

That's why, for the last four years, I've been working with NHS

kitchens to prove that serving good food is possible.

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

-You've guys have made it.

-Thank you!

Together, we've demonstrated patients can have tasty,

nutritious food, without it costing any more money.

What motivates me more now is the public's perception

of the good that we've done.

That means a lot.

But it won't be feasible to bring about real change by tackling

just one hospital at a time.

People deserve decent food in the NHS. It's not a big ask.

So now, my aim is to introduce a lasting improvement to

hospital food for every patient throughout the UK.

-Mmm - yummy!

-Yeah. It's lovely!

I'm massively passionate about food in hospitals.

Change can be achieved.

Over the course of my campaign to improve patient meals in the NHS,

I've worked in a number of individual hospitals around the UK.

But I want to affect change on a much larger scale -

and my challenge now is to work out how to do it.

James, we can bring you in now.

To kick-start my plans, I've been on a media blitz to find a way to

give patients a voice, asking you to share your stories of the food

you've been served in hospitals.

People can e-mail their experiences but also pictures.

Why are you on this programme this morning?

What I'm asking people to do is either e-mail or send

via my Twitter a selection of photographs and information

on meals that you're currently having in hospitals at the moment.

It wasn't long before the responses came flooding into my inbox.

What is that?

It confirmed my belief that it's not just me

who thinks things have got to change.

Why do we have to put up with this rubbish?

I've also come to work with another hospital kitchen team.

This time it's the Princess Alexandra at Harlow, in Essex.

Good to see you, Andy.

To my surprise, catering manager Andy revealed he has the smallest

daily patient food budget that I've ever come across.

We're working off £2.72 a day.

The kitchen staff are struggling to stay within budget

and the overspend means their jobs could be in peril.

It's like a cloud hanging over you.

It's a real worry and morale does get hit by it.

But helping the team in Harlow to turn things round is just the start.

My ultimate goal is to bring about widespread and sustainable change.

What I'm hoping to achieve, this time, is a bigger voice.

I'm hoping to progress this forward.

As the first step in getting my ideas to as many hospitals

as possible, I've come up with a plan that I hope will allow me to

implement real change by enlisting some people on the front line.

I've invited the chefs of the NHS down to my house.

Now I'm either expecting four or 4,000.

I want to, basically, tell them what we've been up to

and hopefully transform a few more hospitals in the process.

If I can get all the people talking to each other

and get their backing, more than anything else,

we can hopefully change things for the good.

It's the day of my hospital chefs' cookery class -

and 20 caterers have answered my call to try

and make a real difference to the food we serve to NHS patients.

-Nice to meet you.

-How you doing, buddy? You all right?

Gathering at my home are catering managers, chefs,

and industry professionals from all across the UK.

I'm Andy Bickle. I'm from Barrow-in-Furness.

I work for University Hospitals of Morecambe Bay.

Andy Jones, Hospital Caterers Association.

Denise Clifford, Milton Keynes Hospital.

Along with familiar faces from a hospital I'm working with right now.

Andy Slade from the Princess Alexandra Hospital

at Harlow in Essex.

With the help of my old friend Mike Duckett - himself a former catering

manager of an award-winning London hospital kitchen - my plan today is

to share the ideas, and the tried and trusted recipes, that I've

already demonstrated can improve the food we serve to patients.

It's not like school. You can actually sit at the front.

Nice to see you.

I'm hoping that the people who've gathered here today will be able

to take this template for change and roll it out to their own hospitals.

First of all, I want to say thank you very much for you all coming.

The whole point of today is an informal

conversation about the issues you guys face.

My main emphasis about this is to help - help the NHS.

It's so easy to throw mud at it.

I decide to begin by talking about

one of the biggest issues facing these chefs.

60% of hospitals now buy in factory-made meals.

Many of them use a system known as Cook Chill - and it soon becomes

clear that not everybody really feels the same about it as me.

There is a big black cloud over the NHS at the moment - Cook Chill.

I disagree with that.

I've done traditional and Cook Chill and don't disrespect,

because what we serve to the patients, Cook Chill, is

actually, I think, better quality than what I've worked on in other

hospitals that have done traditional.

I'm going to disagree with you on a national level.

-You may do.

-Cook Chill is not a money saving exercise - it can't be.

For your restaurant where does the food come from? Is that Cook Chill?

No, we make it fresh. We have two different systems.

-There we are.

-You see, I don't understand that.

That, to me, is absolutely false economy madness.

That is way costing you more money.

Cook Chill is one thing,

then you have a kitchen with chefs in it providing...

It's a little tiny kitchen.

But you're still providing stuff for the restaurant!

From my point of view I'm a head chef.

There's no comparison between Cook Serve and Cook Chill.

You would not serve Cook Chill food to paying customers

because they wouldn't buy it.

Whatever system each chef's hospital uses,

they all agree on one thing - the daunting prospect of slashed

budgets now that the NHS has been told to find efficiency

savings amounting to £20 billion by 2015.

You guys obviously know your budgets per-patient, per-day. What's yours?

-Mine's £3.75 a day.

-£3.75?

-£2.90.

-Oh, my God.

There's worse to come.

-£3.75.

-£3.75?

-£3.62.

-£3.62?

-£2.72.

-£2.72?!

I've experienced first-hand how tight the budgets are in many

NHS hospitals but Andy and his team are particularly pressed.

I've already proved though, that it's possible to work within budget

and improve quality by using simple

and economical recipes such as nutritious soups.

I think if you've got fresh soup on the menu patients would rather

have that for lunch than a protein menu that's cost you 65, 70 pence.

So you'll sell less of those, more of this.

It's better for your budget at the end of the day.

A more streamlined menu is also vital in keeping costs down.

The key to it working is not by putting this on as a one-off.

The whole way you can afford to do this is by doing this

weekly menu cycle and streamlining everything.

That way you'll get a much better deal on this.

Working off the same menu every week,

unlike the two or three-week cycles most hospitals run,

means a kitchen can bulk buy ingredients and cut costs.

And one of the chefs here has already got his own

twist on the same idea.

When you said about the one-week menu, we do the two-week menu.

We've just got off the one-week menu and onto a two-week menu

but we use the same ingredients to do a different dish each week.

Say, for example, one week you could do a beef lasagne.

Using the same ingredients, apart from the pasta,

you could do a pasta bolognaise the next week.

There's so many people doing some amazing stuff in the NHS.

I think if you are, in terms of your menu,

flexible and you're willing and you can adapt more in-house

and be flexible I think it's going to help the NHS.

This is a rare opportunity for these

hospital chefs to get together, swapping ideas,

and it's been really motivational.

How do you feel we could progress this forward and do it better?

James, one of the things that's missing in the NHS is the "N".

There's no "national" in the NHS.

We're all independent. We all do our own thing.

Prisons and schools have set regulations...

-And specifications.

-There's no standards.

-There's nothing in the NHS.

-Do you know why?

I've written to all the ministers and the reply I've got is that

if they put standards in it will increase costs.

-It will reduce costs, surely?

-It's got to reduce costs.

If we all had the same recipes surely we're going to save money.

We need to stand up

and be professionals rather than being dictated to by other people.

Until we join together as one I don't think there's much

room for moving forward really.

The message from the room is that the views of hospital

caterers as a group will only be heard with more co-operation.

But they need the tools to help them work closer together,

and I'm starting to realise that's something I can help with.

To me, there must be a system in place where we could go to

somewhere and find the information that we need or a forum to

discuss that information to make it easier.

If I was to go away and think of some way that we could get

everyone that was here talking,

plus anyone that wasn't here, interested...

It's not going to be an easy fix. Don't get me wrong.

This is a huge, huge step forward.

It's reassuring for me to see the passion in the room for good

hospital food - and the appetite of some of those here to

introduce my proven recipes onto their own patient menus.

I think we do need to come back together and work as one

and if James can actually champion that and take us

forward then I think it will be a great success.

It's all about getting together and making sure we learn from each other

and we take this forward and improve the food to the patients.

I think passion's back, James has sparked it and

we need to build upon that.

It's great to get this sort of positive feedback from the 20

hospital caterers here.

It's a real breakthrough knowing that so

many of them are ready to roll out my ideas in their own NHS kitchens.

If we can change it in regions to start with

and then nationally it will make it much better.

With over 2,000 hospitals in the UK though,

the bigger challenge is how to get through to the rest of them.

It's impossible to visit every kitchen in person.

But there is one way I can get my thoughts

and recipes out to a wider audience.

My plan is to publish a template

that serves as a resource tool for all of the NHS.

I think people have learnt a lot today. I've learnt a lot.

I've learnt it involves a website.

So I need to speak to someone on how to develop a website,

but today was a good day.

I believe creating a database of ideas for all hospital caterers

will be a huge step forward for my mission to improve patient food.

And after asking you to contact me

with your own experiences of patient meals,

I'm discovering I'm not the only one who thinks change is long overdue.

The response from what we've had has been incredible really.

Just goes on and on and on.

This is exactly what's happening right now.

Chilli-con-carne with a mound of rice.

You shouldn't be serving food like that.

There's another one here.

A lady who's seen her sick husband in hospital get given that.

I mean, can you imagine getting served that?

Just this packet of mush.

One of the worst ones I think of all the messages I've got is toast -

and it was mouldy.

Literally you could see the green mould on it.

Which is inexcusable really. It's disgusting.

And somebody has taken that toast out of the toaster

and buttered it and served it.

That's the thing. They've seen it. It's just horrendous.

If this is an insight, in terms of the bigger picture,

then you don't want to be ill.

Put it that way.

The shocking pictures that some of you have sent me are all the

encouragement I need to continue on this journey to make things better.

And one hospital definitely up for embracing my ideas for change

is the Princess Alexandra in Harlow, Essex.

The last time I was here I met the kitchen team -

catering manager Andy, second-in-command Jonathan

and head chef John.

I learnt that the team are overspending

on their patient food budget

and also losing money in the hospital restaurant.

As a result, they already have a total debt of around £19,000,

just six months into the financial year.

Unless they can turn this situation around

there's a very real chance of job losses.

I don't want that to happen - so it's time to roll my sleeves up.

Well, it's the second day back in Harlow

and we're going to put the soup on the menu really.

We've got the butternut squash soup.

We're going to give that a go for lunch and also try

and do a little compound salad.

So the idea is to put a bulgur wheat tabbouleh, something like that,

on that's full of flavour, full of spice and tastes really good.

I think the key to saving the kitchen staff's jobs is to

get the restaurant making a profit.

If that happens, the money it generates will not only put

it back in the black, but hopefully provide extra cash to

pay for the overspend on patient food.

We're going to do the soup, which I'm going to do in a second.

The soup and salad that I'm introducing

to the kitchen staff today are two quick

and easy recipes that I think will drive up restaurant takings.

Both of these dishes will appeal to the customers,

mainly hospital staff, who last time I was here,

told me they want fast, fresh and healthy food to go.

The compound salads. Use this as a base. This is bulgur wheat.

It's different to couscous when you're making large volumes of it.

It stops it from being sticky and heavy.

What we're going to do is flavour this with quite strong flavours.

This is ras el hanout.

It's like a spice blend.

The great thing about this salad is that it's very inexpensive to

make and the spices in it really fire the flavour.

It's also so versatile,

giving chefs plenty of opportunity for experimenting with the recipe.

You can bulk this out even more. You've got almonds in there.

You've got sultanas in there.

Lime juice or lemon juice it's up to you.

You want to put protein in it too you can do.

They can go in as well.

The whole idea of this is to pick stuff that's non-expensive

but crammed full of flavour.

So herbs like mint, coriander.

You try this now.

There you go, chefs.

That seasoning just brings it out, doesn't it?

When you ask the staff what they want, they want healthy.

It don't get any healthier than that. Is that a winner then?

-That is a winner!

-Very good.

-Cheers, buddy.

-That's really nice.

We offer couscous in the restaurant, which is

different to bulgur wheat but it's not as nice as that,

I have to be honest with you. That's a lot nicer.

I think that will go down very well in the restaurant.

It's so versatile, you can add all sorts of things to it.

You can change it,

you can do a different one every other day.

Add mint to it, coriander, parsley.

You can just do anything with it really.

It's going to be an extremely popular product

and at the same time it's actually going to save us money...

and actually make our profit a lot better for the restaurant.

As well as the salad, I'm introducing an old favourite of mine

to the menu here at the hospital - freshly-made butternut squash soup.

So how many portions are we looking for today?

Well, I reckon you got to be looking towards 400 portions of soup.

At the moment, the hospital relies

on packet-made soups to give to the patients.

But the beauty of making soup in the kitchen is that it's fresh,

economical and time effective.

Putting the soup on the menu for the patients, I think you'll get

a bigger uptake on soup and you'll get less on your main meals.

Because of that you're becoming this cost-effective scenario.

So you're not having to spend so much money on your proteins

and everything else.

Generally, if people just want a bowl of soup it's cost you ten pence.

The other benefit of the soup being low in cost to produce is that it

can be sold in the restaurant for a considerable profit.

But Andy is concerned about the price of the ingredients.

I think we'll sort of have to look around for the suppliers

because I had quite a difficulty getting prepared butternut squash.

-Yeah?

-Yeah. A lot of people won't touch it. It was extremely expensive.

Andy might be worried, but if the soup proves a hit

and becomes a menu staple then the cost of the butternut squash

will come right down as the team begin to bulk-buy their ingredients.

One further advantage about this soup

is that it's very quick to make.

Does anyone want to taste this?

It's very nice. It just needs cheaper butternut squash.

Yes, chef. I'll leave that one to you. Yes, chef!

James is going to help us with the suppliers as we just need to

bring the costs down a wee bit of that but there again

an extremely nice product, a really nice soup which will actually

add something to the patient menu and the restaurant menu.

As well as the potential boost to cash flow in the restaurant,

the addition of fresh soup to the patient menu should improve

the food being served on the wards too.

So it's time to find out what the people who really matter make of it.

It's nice.

I really enjoyed it and I could eat some more of it honestly.

-It's very good.

-It's very nice.

It was nice because obviously it's cooked on site.

It's not brought in. It wasn't runny. It wasn't too thick.

It was nice.

Yeah, it's lovely.

I'm not used to having two cooked meals a day so I probably

prefer a soup at dinner time and then at supper I'd have my main meal.

The consistency of that soup is lovely. It's like proper soup.

It sort of oozes ingredients,

whereas the soup yesterday just oozed water, basically.

The soup may be proving a hit with patients

but there's a long way to go before the kitchen staff's jobs are saved.

-Enjoy that.

-It looks lovely.

Their fear, that many of them will be out of work

if the hospital moves to cheaper off-site catering alternatives,

is one that's shared by many NHS kitchens.

Last year, when I worked at

Birmingham's Royal Orthopaedic Hospital,

I walked into a catering department facing a very similar crisis.

Well, here goes.

I don't know what to expect, to be honest.

When I first arrived in the kitchen, just as at Harlow,

I discovered the staff's jobs were under serious threat.

Fundamentally, some of you are out of work. Is that right?

But here in Birmingham, the problems had been caused

by an enormous overspend and a shocking issue with waste.

Another one.

Bear in mind, this is a small hospital,

we're not talking about a massive hospital.

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

If I told you this was just the waste I could salvage.

There was more than this.

Now this was going to go in the swill.

-Wow.

-Things weren't helped by the lack of

efficient working practices in the kitchen.

-I've just seen you make that - how much have you got?

-Portion wise?

You have no idea. You've not measured it.

There is no way of measuring it.

Course there is. The fundamental thing is about costings.

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

Worst of all though, was the feedback from patients.

-We thought it was a joke to start with.

-Mushy and tasteless.

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

Atrocious would be a good word.

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

And away from the wards, the restaurant just wasn't

bringing in enough money.

But by adapting their working practices,

we soon brought about a total transformation.

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

And the difference in staff morale was massive.

Gaz, I suppose, has changed more than anybody.

And that fire in his mouth has turned to fire in his belly.

He's got a passion for work

that I've not seen in any young kid for a long, long time.

A new ordering system that I introduced cut the mammoth

waste problem right back.

It's probably about a fifth compared to what was there before.

And best of all, the fresh recipes we worked up in the kitchen made

the restaurant a success and were a hit on the wards.

I know they're home-made soups and they've been absolutely delicious.

-It was gorgeous.

-Absolutely lovely.

-Can't fault any of it.

-Right.

In actual fact I said to the physiotherapist,

"Any chance of staying another week?"

There's been a whole lift in this place in terms of,

not just producing the food,

but serving it and an appreciation that it is an essential part

of getting better, really.

Because you are what you eat,

and on the basis of what I've seen, it's positive.

In fact, so positive were the changes at Birmingham

that they resuscitated a catering department

with a future that had looked terminal.

Excuse me, please.

And now, a year on, there's been even greater progress.

We've really taken some of the basic foundations that James set us

and the tools he gave us and it's fantastic.

From a financial point of view, we're coming in on budget.

The waste has continued to reduce.

On a bad day, it's ten per cent,

On a good day we can get it as low as six or seven per cent.

The restaurant is doing really, really well.

On average, we're taking an extra £1,000 per month,

on top of our targets.

We're now reinvesting that back into our catering department.

And the patient feedback has been absolutely amazing.

Loads of compliments.

I can't remember the last time I heard anything negative, as such...

and the patients are happy.

I like it. I'd come again. I've put weight on.

Everything that I've had in here has been first class.

I was hoping for seconds. That's the only fault I've got.

I'd stop in a bit longer if they'd let me.

I'm chuffed with everyone.

We're all a team and I think we've done great.

The sort of lasting change I've helped to bring about in Birmingham,

is exactly what I'm hoping to achieve here in Harlow.

So far, my freshly-made soup has already proved a hit on the wards.

It was really nice.

I don't generally have soup but I enjoyed that.

Now it's time to see

if the restaurant's customers will take to the new menu.

If my fresh, healthy options appeal to them,

it will give Andy's team a much-needed boost in cash flow.

-This is a bulgur wheat salad.

-Bulgur wheat salad.

Moroccan bulgur wheat salad with harissa, ras el hanout.

-Very nice actually.

-Delicious with the soup.

We do it in bulk as well.

If you want a gallon of it we can help you out.

Chickpeas, almonds, full of flavour, coriander.

It's a lovely colour, isn't it? Would you like some?

Yeah, they just gave me some up on the...

Ward? And it's lovely, isn't it?

It's great news - the new menu is a hit.

I had the butternut squash soup today.

Definitely something that I'd have every day.

Absolutely fantastic, really nice.

The Moroccan salad - it's just something different.

It makes a change from the usual salads we'd have.

It's nice to have something that's home-made.

I had the soup and I thought it was absolutely yummy.

Really scrummy.

We'll sell out the soup today I should think, won't we?

Andy is due to retire in a few months' time,

and he's determined to leave knowing that the kitchen

is financially sound and that the jobs of his team members are secure.

Just all fresh. Just fresh butternut squash, milk, vegetable stock, onion,

bit of lemon juice, lime juice through it. Super.

Changing the NHS is very, very difficult but without the help of

somebody like Andy, who's so focused, who's made this catering department his own...

And it's going to be such a sad loss when he goes,

I cannot tell you, because without him this never would've happened.

And his enthusiasm for the job is second to none.

Selling out on the soup and salad means Andy and the team

have made more than £100 in profit.

If those sort of figures are repeated every day, it will

cancel out the restaurant's debt in less than three months,

and any extra revenue they continue to make after that

can be used to clear their overspend on patient food.

I think the sales went up by threefold of soup today,

which is absolutely brilliant. And that will obviously help us

make the profit that the Trust are looking for for the future.

But there's more work to be done to be sure I can save

Andy's kitchen staff from the threat of job losses.

It will mean big changes, though, and I'll be challenging the team

to radically rethink how they run their entire operation.

In the meantime, I've been invited to help yet another hospital.

And this one in Oldham, Lancashire, is home to some of the most

important patients I could ever hope to meet.

Well, in all the years of doing hospital food,

there's one area I've never really looked at, and that's the kids' menu.

And it's probably going to be my toughest task yet,

because I've been invited to the Royal Oldham hospital

to have a look at their menu and have a look at a way of improving it.

But I've got a feeling it's going to be a pretty difficult one today.

The kids here at the Royal Oldham are on the wards

for a variety of different illnesses.

Most of them stay for an average of just one day.

But before I find out what their idea of good hospital food is,

it's off to meet Associate Director of Facilities Pam,

and Catering Services Manager Stephen, to learn a bit more

about the challenges of feeding children in hospital.

Tell me about kids' menus, then,

cos I don't really get that in the restaurant,

and it's a first for me here in a hospital.

Even though we say it's a children's ward, we're feeding children from...

Well, we're feeding breastfeeding mums on the same ward cos they're maybe in with a baby.

So we can be feeding breastfeeding mums right up to teenagers of 16.

-So...

-A big cross-section, then.

-Massive, massive.

-So pleasing everyone is not easy.

-Yeah.

What issues do you face with that? I'm presuming taste.

Yeah, we've done surveys with children.

We've asked them what they like to eat.

The usual things like fish fingers, beans, pizzas, stuff like that.

-Can I go?

-THEY LAUGH

An overnight stay in hospital is an anxious time for any patient,

and even more so for a child.

So I've been asked to come up with some recipes for comfort food

that's nutritious too, in order to make the kids' time here

pass a little bit more pleasurably.

This is our children's unit.

Mealtimes here currently involve Stephen's team preparing

trolleys with a range of options for the kids to choose from.

Though there are guaranteed winners like fish fingers and sausages,

there are also options from the adult menu

in case anybody queuing for their lunch is feeling a little bit more adventurous.

Fish fingers, southern fried chicken...

-Chicken.

-Would you like a potato?

-No, chicken.

The choice is a good thing.

They're already deciding what they want as they walk up to it.

Oh, yeah, yeah. Well, they've already got the menu,

so they can see beforehand, if they can read the menu.

-And then, yeah. Most of them are quite vocal about what they want.

-JAMES LAUGHS

As you can see.

-Gravy?

-Yes, please.

This is one of the good things about this.

When you give them the choice, they're actually trying a variety of different foods

that they wouldn't normally go for if you just gave them a menu.

It's actually a good point. The disadvantage with this,

you're going to end up with a little bit of waste, but you can forgive that

if the kids have something at least to eat.

-He's enjoying it.

-Oh, no! I forgot my drink.

-Oh, dear, what would you like?

-Blackcurrant, please.

-Blackcurrant?

-Yep.

In some hospitals, getting children to eat anything at all can be a battle.

So it's encouraging to see that the patients are

tucking into the food served to them.

But my task is to give the kids a treat to help them through

what can be an unsettling time,

so I want to know what they'd choose for their perfect menu.

-So, Harry, can I grab a seat near you?

-Yeah.

-Why do you get that one and I get this one?

-HARRY LAUGHS

What would you like to see, if I could do you anything?

-Hot!

-It's hot that is it?

-If I could cook you anything right now.

-Anything?

-Well, I've got my chef's jacket on.

-Pizza.

-What type of pizza?

-Cheese pizza.

A cheese pizza. There's a lot of cheeses in the world, though.

-What cheese do you want on your pizza?

-The sprinkly one.

-The sprinkly one?

-Yeah.

Anya, nice to see you.

-Nice to see you.

-How are you?

-OK.

Now, if I could make you anything you wanted, what would it be?

Um...pizza.

A pizza? Have you been talking to Harry?

-No. What would you like on your pizza?

-Cheese.

Cheese pizza? Would that be grated cheese?

Yeah.

-How you doing, Matthew?

-Good, thanks.

You all right? You're diving into that. What have you had?

-Turkey dinner.

-Turkey dinner?

-Yeah. So what do you want to be when you get older?

-Footballer.

-Is that because of this?

-Yep.

Would you want to play for Man United or Man City?

-Man United. I'm allergic to City.

-You're allergic to City?

But until he signs for Man United, Matthew still has school to

worry about, and he wastes no time calling on my professional

expertise to help out with his homework.

Studying France, you've got to design a French recipe, haven't you?

-Yeah.

-Cook it, and then do the recipe.

I've got to make it, then take pictures.

OK, I'll give you a recipe.

Pate a choux with a creme chiboust filling.

-Sorry?

-Right?

What?

I've not heard of that recipe ever.

Don't worry. It's profiteroles filled with cream.

Put that on there, you'll get an A star. Sorted.

-Do you mind if I sit here, Cory?

-Yeah.

-So what's your favourite food?

-Chicken.

-Chicken? It's not a chicken pizza, is it?

-No!

What do you want me to do with the chicken?

-Do you want me to just bring it in?

-Yeah.

-With the feathers on?

-No! Chicken nuggets.

-Chicken nuggets? So, fresh chicken nuggets?

-Yeah.

The message from the children is clear -

if they could choose what to eat, it would be a diet of kids' classics -

burgers, chicken nuggets and pizza.

Not what I'm usually asked to cook, but it seems what's required here

is tried and tested dishes that reassure younger patients,

rather than unfamiliar meals that might add to their anxiety.

You've got a lot of variety on there.

Is there anything that you'd like to see?

Based on what children say, pizza. Based on what children say.

Pizza. But is pizza nutritious for them?

It's not necessarily about nutrition.

It's about giving... Getting kids to eat something.

-Pizza again.

-Pizza. I know.

I have to go with what the kids keep saying.

Despite the demand,

pizzas and nuggets haven't featured on the menu up to now.

Pizza's proved tricky to serve with existing equipment,

and the team hasn't been impressed with the quality of the frozen nuggets available.

But done properly, using fresh ingredients,

there's no reason why kids' favourites such as these can't also be nutritious.

Sponge and custard.

So, the challenge is for me to come up with recipes

that are healthy to eat but also keep the kids happy.

To be sure I'm on the right lines,

I'm keen to hear what the children's dietician in the hospital thinks.

What do chefs like me need to be looking at when they're devising a menu for kids?

Well, we need to be promoting healthy eating, but also you need to

think that these children are poorly, and we need to be giving them

-food that they are familiar with and they will eat.

-Yeah.

So, it needs to be nutritious, but also

if you try to impose a healthy diet on a child who is poorly, you won't.

-It's never going to happen, is it, really?

-No.

You need to get as many calories in as possible.

Right. It's a difficult one, this, isn't it?

It is. BOTH LAUGH

So the key to a child's diet here at Oldham is combining sound nutrition with familiar flavours.

With chicken nuggets and burgers getting the green light from the dietician,

the next step is to figure out how to deliver the menu that the kids want.

And there are technical reasons why pizza remains a worry.

To see what I'm up against,

I've come to the main kitchen to meet head chef Chris.

With the pizzas, I'm presuming you've still got to cook them

in these ovens and then you've still got to trolley them.

-By the time they go to the ward...

-That's the problem. They dry up.

They're going to be rock solid, aren't they?

I've got to think up, somehow... How to make them last in these hot cabinets.

Yeah. That's going to be the problem, isn't it?

Do you have to keep them covered or do you just leave them open?

-No, leave them open.

-So, we'll try the pizzas.

Do them a burger, I think, and then I'll have a work on this chicken thing for them, as well.

Maybe do something like that.

Even though I'm worried about the heat from these serving trolleys

drying out my pizzas, I'm determined to give the kids what they want.

So I need to come up with a solution that means the food reaches the wards

tasting just as good as it did when it left the kitchen.

For now, though, the news that pizza may be on the menu

has gone down well with Harry, the ward's chattiest patient.

-Would you like a pizza?

-Tomorrow?

-Possibly.

-Yay!

And if I could do you something else the following day, what would it be?

-Cottage pie.

-Cottage pie?

-Yeah.

-Now we're talking.

Cos I like Cottage pie, and I like fish pie, and I like...

Here we go. The list is... Here we go, you see? Shepherd's pie?

-Yeah. Cheese and onion pie. Meat and potato...

-Pie?

What other pies do I like?

What do you want to be when you get older? I've got a good job for you.

-I've got three things.

-What?

-A football commentator,

-a Lego designer and a footballer.

-A Lego designer?

No. I've got another thing for you.

-Restaurant critic.

-What's that? What?!

Today's gone about as well as I thought it was going to do.

Now I know how to create a kid's menu.

Pizzas and burgers. Chicken nuggets.

Nobody wants to see kids in hospital,

and for the unfortunate few that are in hospital,

what we can do is to give them something that they enjoy.

And that's, I think, what the dieticians are on about

when they say "Just get them to eat something".

And I think that's what we're going to try and achieve tomorrow.

Slightly apprehensive, to be honest, as it's probably the most

honest group of customers you're ever going to cater for, isn't it, really?

I'll be returning to roll out the kids' new mealtime menu at the Royal Oldham tomorrow.

At least that will buy me some thinking time before I put my cooking to the test

with the fiercest critics I'm ever likely to face.

Unfortunately for the grown ups in hospital, pizza and burgers

aren't really an option - although given some of the food served to them,

I'd be forgiven for thinking it might be better if it were.

Ugh!

Part of the problem with quality, I believe, is that there is

no consistent approach to standards throughout the industry.

And that's an issue I'm hoping to tackle by setting up my own website,

where one of the things I can do is make the same

set of recipes available for every hospital to use.

For that to work, I've arranged a meeting with Maxine Cartz

and Sian Porter from the British Dietetic Association,

the professional organisation for food experts across the UK.

The rules and regulations in this game confuse the hell out of me.

Tell me how England differs to Scotland and Wales?

Scotland and Wales have got mandatory standards,

but in England we haven't.

So, take, for instance, a dish in Wales.

It would be the same in the North as it is in the South, nutritionally wise?

Yes, it would, it'd be a standard recipe.

That sounds pretty sensible to me. Is it?

It is. It makes it much easier for dieticians

because you've got a known recipe, known nutritional value.

Why aren't we doing it in England?

Well, we do have guidelines but they're...

Quite flexible, aren't they, guidelines?

And they're self-assessed, so that's the big difference.

I think the standardisation is important because it gives you

better consistency and it also saves reinventing the wheel.

If you've got 100 catering managers up and down the country

all doing their own thing, then theoretically you're going to have...

A lot of different cottage pies, aren't you?

My aim is to challenge this inconsistency by using

the website I'm developing to offer NHS kitchens some set weekly menu plans they can all follow.

But to have real credibility within the industry,

I need an organisation like the BDA to approve my recipes as nutritionally balanced.

Doing a thing like this, I've learnt that when you're trying to implement change in a menu,

it's really the dietician that has the final say. Am I right saying that?

We try as dieticians in a lot of cases to work with the caterers

because it's in everybody's interests to work together

to get the best food for the patient, to get it into patient.

-You're a big hurdle for us lot to get across as caterers and chefs.

-THEY LAUGH

All right, from the past experience that we've had, I've put together

almost like a food bank of recipes, all right?

What I would like your help on is really your stamp of approval on those recipes.

If you could have a look at it from your point of view.

So when I go out into the wider world,

I don't then have any negativity saying, "Oh, well, I've got issues with this and this".

Without that logo on top of those recipes, I'm kind of stuck, really.

-We're happy to help, aren't we?

-Yeah. Definitely.

-Yeah?

The willingness of the British Dietetic Association to help out

on a weekly menu plan for my website is a major breakthrough.

I think that working hand-in-hand with food industry professionals

like dieticians is part of the united approach needed

to genuinely make meals better for UK hospital patients.

And while I've only taken the first steps in setting that up,

there's no reason why a one week menu cycle can't make a difference

in a hospital like the Princess Alexandra in Harlow right now.

In fact, the instant difference it can make could even help the staff there to save their jobs.

You're a rarity in the NHS, and you're becoming more rare.

I don't want to come back in two years' time and it's all full of chiller cabinets, all right?

And the way that we're going to do that, I think,

is we need to streamline everything, because

that's your current menu cycle at the moment, that's what we've got.

-I presume this is week one?

-Yeah.

-Week two? All right.

I want to get rid of one week.

The look on your face! I want to get rid of one week,

so we just go down to a one-week menu cycle.

All right?

The advantage of this change is that the team can bulk buy ingredients

to keep the prices low - yet another way of reducing their £19,000 deficit.

It's a big change from how they usually work, though,

so they'll need to adapt quickly to give themselves a chance of survival.

I don't want to put any more pressure on you,

but the key to it is to make it continue to work, all right?

And get rid of this black cloud of this cook chill thing once and for all.

If we're doing exactly on budget in terms of the patients,

then we're all going to be here in a year's time, all right?

And the patients are going to be all happy.

This is the best NHS kitchen I've ever worked in, all right?

And I'm saying that because I mean it.

All credit to you.

Switching to just a one-week menu may not sound much,

but it means transforming everything about how they work,

and after years of doing things a particular way, that won't be easy.

Well, I've told them how good they are compared with other

hospitals I've been working with in the NHS.

And let's face it, if the Trust is faced with a decision with

a loss-making business, then they've got no option other than to close it down.

And this is the story of so many different establishments

and different catering outlets in the NHS.

With me on board... I don't know whether there's hope.

I think it's a monumental task, to be honest.

And trying to do this on a national scale is going to be harder than even I anticipated.

The team at Harlow come out fighting as they bid to save their jobs.

As a local guy that's lived here for 44 years, you do want it to be the best.

We're here. We're dedicated.

We'll feed them up today.

In Lancashire, it's up to me to deliver

for the most outspoken patient I've ever cooked for.

I've got to say - it's burnt I'm not having it!

And the pressure to publish my template for change begins to grow.

This website actually seemed like a good idea at the time,

and I still think it is. But it's a logistical nightmare.