Episode 3 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 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.

I've made it my mission to put better

food on the plates of as many patients as possible.

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

It was very good.

And the campaign is now really gathering pace.

Patients do deserve great food for hospitals.

And we're doing a call-out.

People can e-mail their experiences, but also pictures.

'As part of my strategy, I invited over 20 NHS chefs

'and catering managers to my home...'

How you doing? You all right?

'..to recruit them

'to take the battle to the front line, where they work.'

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

This is a huge, huge step forward.

'It made me realise that for my plans to succeed,

'I need to find a way to make the recipes

'I demonstrated easily available to as many patients as possible.'

And for that to happen, I need to give ALL hospitals access

to my template for change...online.

It involves a website.

So I need to speak to somebody of how to develop a website.

But I understand that not every hospital is the same.

This is our children's unit.

In Oldham, Lancashire, I've taken on the task of delivering

nutritious versions of the food that kids really

want to see on their menu in hospital.

Cheese pizza.

-Cheese pizza.

-Burger?

-Yeah.

-You want a burger?

-Chicken nuggets.

-Chicken nuggets.

And in Harlow, Essex, where the kitchen's overspend is

threatening the team's jobs, the recipes are already

winning over patients and staff.

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

Really scrummy.

But the shadow of possible job losses still looms large.

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? Then we're all going to be here in a year's time.

And as my campaign continues, it's not just the staff

feeling the pressure.

I think it's a monumental task, to be honest, of what we've set

ourselves up to do, but trying to do this on a national scale

is going to be harder than even I anticipated.

If a reminder were needed why all this is so important,

I've been horrified to see the food some hospitals

currently serve their patients.

Come on, boys.

'After an appeal on TV and radio asking people to tell me their own

'experience of patient meals,

'e-mails and pictures have flooded in.

'It's obvious that, like me, most people want things to change.'

People are passionate about the food that they're eating.

And it's how I want it.

I want to give the patients a voice

and this is kind of the perfect opportunity for people to do it.

This one's come in yesterday. What the hell is that?

Macaroni cheese and potato. That's just what you want, innit(?)

Carbohydrate, carbohydrate.

Somebody that was given an omelette, and I know what this is going to be.

The frozen omelette. There are some really horrific ones in here.

You know, you shouldn't have to live on that while you're in hospital.

What is great is that we're seeing a little insight of exactly

what's happening with the NHS.

There's some great things that's happening and I've witnessed some of that myself.

But there are some pretty horrific things in terms of food.

So, on one hand, I'm kind of shocked.

On the other hand, I'm not surprised.

There's hospitals that I've been to and helped

and we've managed to achieve fantastic results and great things.

But they've actually got to let you into the hospital in the

first place to be able to do it.

It's a big risk for them, I know, but it's a positive change.

One of the hospitals that has allowed me

in to work with the team, in Harlow, is the Princess Alexandra.

Do you want to play around with the soup?

Catering manager Andy is running a kitchen that operates with

the smallest patient food budget I've ever come across.

We're working off £2.72 a day to provide the patient with

everything they eat and drink in that day.

To sort of keep it within budget is extremely difficult.

Six months into the financial year, they're already £19,000 in debt.

To get them back into the black, I started with the hospital restaurant,

introducing some new

but affordable dishes that have already got the cash tills ringing.

The Moroccan salad, it's just something different.

Makes a change from the usual salads we have.

It's nice to have something home-made.

I've also challenged Andy

and his team to cut their menu cycle from two weeks down to just one week.

If they do that, they can become much more cost-effective

by buying most of their ingredients in bulk.

I want to get rid of one week.

The look on your face... All right?

'With not long to go until the new one-week menu is rolled out

'to the patients, I want to check on the team's progress.'

What happened since your last visit - we sat round and we picked

what we think are the most popular dishes to keep on the menu.

You've got your chicken chasseur, which is your recipe,

we put the vegetable pasta bake, we put sticky toffee pudding on.

We've got the cottage pie, which is your recipe.

All very popular dishes.

I really think there is scope to make savings on a one-week menu cycle.

I really do.

I'm impressed with the way Andy's team is embracing

such a change in the way they work.

This is full of calories and protein.

You've got cream, butter, the lot.

We'll feed up 'em up today!

But if the finances can't be brought under control,

the hospital trust may decide to close the kitchen down

and switch to a cook-chill catering system,

where the meals are made off-site before being heated on the wards.

To me, that's a heartbreaking prospect,

as there's no doubting the passion

that chefs like Neil and Yvonne bring.

As a local guy that's lived here for 44 years,

you do want it to be the best, and because you work here,

you have a certain amount of pride.

If it's all for nothing, it's quite upsetting, really, you know?

-A lot of hospitals have a lot more staff than us.

-Yeah.

A lot more staff.

And we still turn them meals out regardless.

We're here, we're dedicated.

I mean, I bet there's not anyone in here that didn't start 10 minutes,

-20 minutes before their time today.

-Yeah.

I'm hoping that my ideas will boost the team's chances of being able

to stay cooking in this kitchen for many years to come.

I'm trying to streamline everything

so we've reduced the menu down to a weekly menu cycle.

We've put on their favourite dishes, some of my dishes as well,

and that should be more cost-effective.

But the most important thing is to make the restaurant more profitable

and by doing that, you have to actually serve the food

that the customers want.

A few pieces of chicken on there.

After speaking to the staff who use the restaurant,

I've come up with some fast and healthy recipes

that I think will generate extra cash.

We've just made a salad for 55p.

And you're going to sell it for about three quid.

Andy's second-in-command is Jonathan

and he's been overseeing my plans for the restaurant.

-How's it been going, then?

-Very well, actually.

I mean, the salad you made up, the bulgur wheat salad, went very well.

-Yeah.

-So it's nice you've introduced some different types of salad.

Put chicken in here, you've got a chicken salad, and then I've got a Chicken Caesar...

-Right, OK.

-..for people as well, so...

They do look very nice. I imagine they'd go down very well.

So has anything changed in terms of the profitability of the restaurant yet?

The takings have gone up.

People are enjoying what's going through the restaurant. Definitely good feedback.

That's good.

Out in the restaurant, I'm also pleased to see

that Jonathan has listened to my advice to drive up profit

by focusing on the sandwiches.

Cutting down on the bought-in varieties

and making fresh ones on site is much better.

These should sell well,

bringing much more money to the catering department.

And this has been great. You've dramatically cut down on this.

We reduced the amount of sandwiches, like you suggested.

Home-made rolls have gone down very, very well.

These are selling. I've just been here a couple of minutes

and we've already sold three of these off the shelf.

Every day we run out of them. So they're very popular.

And cost-wise, you're selling these at £2.40.

These must cost £1.20, £1.30?

There's a 50% mark-up on the sandwiches we buy in.

And what about the ones that we're making?

I reckon, well, 150%.

We're making definitely more profit on the ones we make, definitely.

It's great to see the team so enthusiastic about change.

But they've come up against a problem that could scupper some of our plans.

They're having trouble getting hold of the ingredients they need from their usual suppliers.

Sometimes we can't get the food you suggested from the suppliers.

-I end up going to supermarkets to get it.

-Why is that, then?

They don't stock it. Basically, they don't stock it.

Yeah. Can you drop that in tomorrow for us?

Yeah, please, that'd be brilliant.

Also, the key ingredient for my favourite soup recipe

is proving particularly tricky to track down.

The suppliers, some of them are running out of bits and pieces?

We know that butternut squash is not an easy product to get hold of very quickly.

But the soups we've put on are the ones that we can get quite readily.

But it's been very interesting and it's a work in progress.

The issue of procurement, how and where a hospital sources its food,

is one I've come up against before.

Kitchen staff can feel they have no flexibility or bargaining power.

And local suppliers are often put off pitching for business

because of red tape.

That's a shame, as I believe if hospitals work with producers

in their area, it can boost the local economy.

All of these are out of stock at the moment.

For the team at Harlow, procurement problems are getting in the way

of them making the changes we've agreed.

And I find it unacceptable

they're being forced to pick up things from their local supermarket.

That will cost me more money, unfortunately.

I don't understand why it should be so hard for them

to get hold of what they want.

So I'm keen to find out more about the challenges hospital

caterers face with their supply chain.

Well, I've heard so many stories about procurement in the NHS

and how difficult it can be to get supplies,

so I've taken it upon myself to come to a wholesaler

and find out just how difficult it really is.

Roger Coulston is the boss of a fruit and vegetable wholesalers in Lancashire.

His company specialises in providing prepared veg to the catering industry.

You name it, he can dice it.

And you can do... I mean, I've seen you've got sliced, you've got diced.

You can do whatever shape you want?

Yeah. We do anything from 2mm up to 20mm on diced.

You've got cauliflower in there, so you can do cauliflower,

squash, anything.

-Anything.

-Anything.

-Anything.

Roger's company is on the list of approved NHS suppliers,

which means it should be straightforward

for a hospital caterer to buy what he has to offer.

It's just a shame he doesn't deliver as far south as Harlow,

as he has exactly what the team at the Princess Alexandra

have been struggling to find.

One of the main keys to what I've doing with the NHS

for the last, certainly three to four years,

is this soup, and that's diced, ready made veg.

You know, when you're catering for 300, 400 soups, for instance,

you don't want to have to pay somebody to peel it,

stand there peeling it all day.

Our facilities here are far superior to what they'd have in hospitals

for doing this job, so it allows them to produce...

I can vouch for that.

With Roger's company offering prepared veg like this,

it shouldn't be an issue for Andy that his regular supplier

can't provide the diced butternut squash he needs.

If this place is anything to go by, it sounds like he should be

able to find plenty of other wholesalers capable of stepping in.

If I got five hospitals now picking up the phone

and ordering 40, 50 kilos of diced veg...

They'd have it tomorrow morning before lunch.

Getting through these supply issues can be easier for hospitals than they realise.

But it can be frustrated by something that, in my experience,

isn't a strong point of the NHS, and that's the communication.

Just brought a bit of produce.

The likelihood is that Andy in Harlow has no idea

that there are suppliers like Roger who are able supply him

with exactly what he needs.

If I was to look at other hospitals, you could supply them.

-Yeah.

-You could supply them as well.

-Yeah.

And it'd be so easy for them to pick up the phone to you

because you've already got the accreditation.

Basically, the NHS supply list, if you look on it,

there's about 25 different companies the length and breadth of Britain.

Helping hospitals get through the procurement process

is one of the things I'm hoping the website I'm setting up can address.

That's a serious bit of kit as well.

-Yeah. Yeah.

-I can place on there all the information

hospital caterers need to know about the supply options open to them.

Because it doesn't have to be as inflexible as they think.

What's fantastic about coming to a place like this, it gets chefs excited.

And stuff like these, we've got carrots, we've got this.

You know, both of these come from my neck of the woods in Yorkshire

and it's right on our doorstep.

And having it pre-prepared like what they do in a factory like this

is just such a bonus for the NHS.

And I only wish more hospitals would know about places like this

because if they did, maybe we'd get soup right across the country.

Knowing how to find their way through issues like these

is vital for hospital caterers trying to get their patients

the best food they possibly can on a tight budget.

There's a cherry cheesecake there.

Bed 24.

Until now, like most people,

I'd always assumed that's a responsibility that finishes

as soon as a patient goes home.

But in the next hospital I've been invited to,

the staff have something in mind that's making me think again.

Well, since I started this project,

a lot of hospitals have come in contact with me

about different ideas that they've got.

And an interesting one that I'm about to go and visit is in Chesterfield.

And it's going to show where, hopefully,

where does food service in the hospital end?

Does it end in the ward, does it end when you go home?

I don't know and I'm intrigued to find out exactly what it is.

With over 600 beds, Chesterfield Royal in Derbyshire

is a busy hospital, treating around 40,000 in-patients a year.

The staff here have come up with an initiative that would take

the provision of good quality food beyond the wards

and into the homes of patients once they've been discharged.

They've asked me to help them crack it, and I want to find out more,

so I'm here to meet head of retail Kim

and director of facilities Andrew.

-Kim, nice to meet you.

-Hi. You all right?

-Andrew.

-Hi.

-Good to see you.

This is all pretty new, by the looks of things.

May 2012 we opened it.

So what do you want my help on?

Right, what we're trying to look for,

we want to provide the patient,

any elderly people that have been in hospital for some time,

the facility when they're discharged from hospital

that they can have some kind of grocery pack.

-Yeah.

-Obviously, when they leave hospital,

they won't be able to go to the supermarket,

-they might not have family.

-Yeah.

So we want to see if we can provide the basics. Bread, milk,

things like that, that they can be discharged with

-at a reasonable price.

-So the fundamental thing,

-we've got to have a look at what you've got first.

-Come on, then.

So the plan is to offer patients about to be discharged

a simple bag of groceries from the on-site shop.

My instinct is that this is an idea with real potential.

But for it to work, the shop will have to stock

the sort of essential items you'd need

if you were leaving the wards to continue your recovery at home.

It really is like a mini supermarket.

You've got everything you need.

With bread, milk and all the other basics you'd expect,

it looks like this place has it covered.

The thing is, we need to be able to provide to the patient

-whenever they're discharged. People can be discharged at any time of the day.

-Yeah.

So whatever we decide to put in the bag, the box,

whatever you want to call it,

we need to be able to pick it and pack it from the shop.

So who decided on this? Whose idea was it, and why?

We were thinking that there's a lot of people,

at the point at which they're discharged,

particularly around winter when it's not easy to get out and about,

who may not immediately have food provisions in at home.

I think it's a fantastic idea. And how many of these boxes or bags,

or whatever we're going to call it, do you think we're going to sell?

-That's a good question.

-We don't know.

-Right.

Because we've got nothing to go on,

because nobody's ever done it before.

-Never say never, that's the thing!

-Yeah.

If we can pull this idea together, it could make a big difference

to many of the people passing through the hospital.

But what to offer in the bags depends on the sort of patients

who'd take up the service.

So it's up to the wards to have a chat with Gary,

one of the matrons here,

who's probably best placed to know who this offer might appeal to.

What is the age of the patients, roughly, that you're looking after?

I mean, it can be very mixed,

but the main age range is between 80 to 90s.

A more older clientele.

I'd suspect the idea you're coming in with would benefit them,

obviously, more than the younger people.

And their average length of stay, what is that?

Would it be weeks, would it be days?

Some people are days, some people tend to be longer.

You know, it's about a patient being safe and that we're happy

and they're happy when they go that they're going to be able to manage.

Quantity wise, how many do you think would take it up?

From my ward, I would think you're talking maybe ten a week.

That's quite a lot of people across the wards.

We'd better meet some of the patients, then.

With the hospital treating around 15,000 over-65s a year,

it sounds like there's a big potential market

for Kim's home food bags.

But until we speak to the patients, we don't know if it's a service

they'd be interested in, and willing or able to pay for.

What we're looking at trying to do is provide patients the bare essentials

to have a cup of tea, maybe a sandwich

and something to eat, but the same price as a supermarket.

That's fair. That's a good idea.

It could be absolutely anybody.

If your family is at work and you got discharged today,

"I ain't got no milk, I can't have a drink until..." You know?

It's looking at the patient care all the way.

All the way through.

Price-wise, what do you think people would pay for it? A fiver?

I should think so.

A fiver for a basket of food?

Because it's going to last two or three days, or something like that.

Yeah, yeah.

What's the average length of stay for you?

Average, probably six or seven weeks.

That's a long time, then.

You'd need basic food items, wouldn't you,

like you say, just to make a cup of tea and sandwich, a slice of toast.

Roger, what have you got at home to eat when you get back home?

When I get back home, I'll have to rely on someone

getting me some gear in or organise something,

which isn't easy.

Right. This is where Kim might step in.

You know, if you've got something, sort of...

just bits of staples to go with,

then you'd be on a winner straightaway.

People on their own don't do big shops, Mr Martin.

-It's little and often.

-Little and often, that's for me, anyway.

But, obviously, with your knee like this, you're going to struggle

-for the first couple of weeks.

-I am, yeah.

So I should get stocked up a little, yeah.

So that would actually benefit you.

-If we did maybe two different ideas.

-Yeah.

So if you wanted to spend, I don't know,

-20 quid, then you've got enough for 6 days.

-That's right, yeah.

-Quite good, isn't it?

-Excellent.

-You think it's a good idea?

I think it's a marvellous idea.

So both the patients and the staff

think the home food bag idea could work.

But the success of a service like this may hinge

on the willingness of the hospital's transport services

to carry not only discharged patients home,

but also their shopping.

Non-emergency transport at Chesterfield Royal

is provided by a company called Ambuline.

To find out if they would support the idea,

Kim and I had a chat with Sean, one of their care assistants.

-Most of the patients we take home are of an older generation.

-Yeah.

So mobility is limited

and sort of getting out to do the shopping, you rely on other people.

-A lot of them are worried about going home and being left alone.

-Yeah.

So we have to reassure them that, you know,

care services are in place, but they're very limited.

It sounds like Sean sees the benefits of the idea

for the patients he takes home.

And it might even make the job that he and his colleagues do

a little bit more straightforward.

One thing that we do come across quite often,

especially patients who have been in quite a while,

-is that we're very often asked to call for provisions.

-Really?

-So bread or milk.

-Yeah.

So if they've limited mobility then, yes, it's a very good idea.

Is there no issue with room or anything like that?

Sometimes we have issues with room, but we often work round that.

-Oh, good.

-Something for two or three days would help massively, I think.

-Definitely.

-Certainly for the instant bit when you guys have gone.

Definitely, yeah.

With the hospital transport behind it, it looks like Kim has

the logistical support she needs to make this service happen.

So now it's over to me

to help work out how to make the home food bags a reality.

Well, Kim, you have people that definitely think it's a great idea.

Yeah, and that would definitely use the service.

I would pitch two ideas.

-I would do a £5 box and a £10 box.

-Yeah.

-The second choice is more money, but there's more in it.

-Yeah.

Some people are in here a week,

so they've got certain things at home

they might have in their fridge.

Some people have been walking round who are in here six or seven weeks.

-Yeah.

-So they've then got nothing.

-So five quid's worth of food is not a lot.

-No, no.

Some of these people, as you know when we walked round the wards,

are not going to be able to move even when they get home

for another week.

I certainly think in the offer there needs to be probably a soup,

probably a pasta.

It's got to be bread. It's got to be eggs.

-It's got to be milk.

-Yeah.

And I think you're not far off your five quid.

Yeah, absolutely.

And they're easy for you to get as part our current contract,

which is great.

How you package that is something that we can work on.

I think you're probably going to sell 20, 30 a week.

But I think it's one of those things that when people know about it,

it's going to grow.

20, 30 people we've helped, if you look at it that way,

-that's a massive number.

-Better than nothing, yeah.

If it improves the patients' experience,

-it's worth doing for any number of people, to be honest.

-Yeah.

I think the project that they're doing here is a fantastic idea.

The one group of people it is benefitting is the elderly

and I think that's of vital importance.

You know when you get dropped off that evening,

at least you've got a meal you can eat, whether that's a soup or some bread.

It's going to benefit those patients so much when they get back home

and the door closes - it can be quite a lonely existence.

At the opposite end of the age spectrum to the patients

who need help in Chesterfield are the children on the wards

of the Royal Oldham in Lancashire.

Yesterday, I visited the hospital to see if I could improve the food

being served to the young patients,

as a way of lifting their spirits during their time on the wards.

This is our children's unit.

After speaking to the kids,

I was left in no doubt what they'd like to see on the menu,

given the choice.

-Chicken nuggets.

-Chicken nuggets.

Cheese pizza.

You want a burger?

In fact, the ward's chattiest patient, Harry,

was very clear that a certain sort of cheese pizza

should be served at meal times.

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.

A diet of kid's classics like those might not sound

the healthiest on menus,

but the hospital's dieticians believe with the right recipes,

I can give the children a treat

whilst still keeping things nutritious.

We need to be promoting healthy eating,

but you also need to think that these children are poorly

and we need to be giving them food they are familiar with

and that they will eat.

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

-It is!

Today, I'm back in the kitchen with head chef Chris

and catering services manager Stephen.

With lunch just a few hours away, we need to come up

with fresh, nutritious versions of the dishes

I've promised for the kids' menu.

Right, Chris, I feel like we're both going back to school now.

The chicken nuggets and burgers should hopefully be no problem,

but the pizza could be a challenge.

The food is transported to the children's ward

using a heated trolley.

If pizza is overheated, it can dry out quite quickly,

which means it could be ruined when it comes to serving it.

The pizza is going to be a little bit of an issue.

I'm not quite sure if it's going to come out OK.

But that's what the kids really wanted, so I thought we'd have a go with that,

we'll play around with it, see if it works in the oven.

And I've got a little trick up my sleeve

that I'm hoping might just help.

300g of semolina.

Should help it when it gets to the hotplate.

I'm pretty confident with it.

The great thing about semolina flour is that the recipes it's added to

bake on the outside, but stay slightly moist on the inside.

That means when the cooked food is loaded onto the serving trolleys,

my semolina-dough mix should buy the pizzas

a little bit of extra time to stop them from drying out.

That's the plan, anyway, although I'm not sure Chris

and Stephen are convinced it will work.

The crust of the pizza could dry up, the cheese, again, could dry up,

so we'll just have to have a look at it.

It's going to have to stay under the lights for a while, as well,

while the kids are coming in and ordering the food, but we'll see.

You doing it more of a deep pan?

I thought we'd go for a thin, really.

-Thin?

-Unless you want to go for a deep...

The thin one is going to dry out, isn't it?

I'm going to split the difference and go for a medium one.

I can't believe we're having a conversation about

should we go deep pan or thin and crispy.

THEY LAUGH

I'm using all the techniques I know to ensure these pizzas make it

up to the ward looking and tasting as fresh as possible!

That's better!

And if we succeed, there's no reason why pizza can't become

a regular feature on the menu.

-This is something we can do, though, isn't it?

-Yeah.

It's pretty straightforward, isn't it?

Yeah. It's simple enough, isn't it?

A bit of cheese. Sprinkly cheese.

I'm just going to put some green stuff on, just to annoy Harry.

See, all we want now is a motorbike with a little box on the back

-and we've got a secondary business.

-Yeah, definitely.

-Comes in and just takes the glory, doesn't he?

-There you go.

Did you see that? He's just basically sat there and watched us

and he used to work in a pizzeria.

I know. He worked for about five years in a pizza place.

With the pizzas done, it's time to switch our attention to the

other favourites we hope will lift the kids' spirits

and ensure they eat while they're in hospital.

When was the last time you made nuggets, chef?

It's been a while, to be honest.

People are going to be watching this going,

"Chicken nuggets?" But that's what kids want to eat.

Really, particularly when they're in this ward, when you asked them,

that and pizza and burgers.

If you do make it yourself, you know exactly what's in it.

So flour, egg and breadcrumbs. There's nothing else.

Chicken nugget.

Yeah. It's all natural. Natural breadcrumbs.

So our deceptively healthy chicken nuggets are being made

with all fresh ingredients,

and it's the same story for the burgers.

The great thing about these is that they've got no salt,

-just black pepper.

-Yeah.

-No egg. Nothing.

So we're not only delivering the food that the kids want,

we're also making sure they get the nutrition that the

dieticians in the hospital have asked for.

So all we've got to do now is cook the burgers, cook the nuggets

-and then done.

-Yeah.

While we're getting busy in the kitchen,

up on the children's ward,

the fiercest critic I'm ever likely to cook for

is waiting to see if I can deliver.

James asked me yesterday what my favourite food was and I said pizza!

I've eaten lots of pizzas in my time

and I know what the difference is between a good pizza and a bad pizza.

Bad bit is if it's burnt. Good if it's not burnt.

With my reputation on the line,

let's hope Harry's impressed by what we've done for him.

Mmm!

The weird thing is, we could make that, put it in there,

walk it to the ward, put it onto the worktop and it would be great.

But it goes into this trolley. That's what affects these things.

As our food is loaded into the dreaded serving trolleys,

it's wheeled up to the children's ward,

and we've got an anxious wait

before finding out what condition it will be in

when it's served to the kids.

I've got to say, it's burnt, I'm not having it.

You told me yesterday...

You told me yesterday, what pizza did you want?

Cheese, ham, pepperoni.

-See, I thought it was pineapple, so I put pineapple on it.

-No!

-And olives.

-Eugh! Yuck, yuck!

Before the food can be served,

it's given one last boost by the trolley

to get it back up to the right temperature.

And it's this part of the process that

I fear will dry out the kids' pizzas.

-You're just pressing the button.

-Yeah, we've got about three minutes to warm it up.

This is the bit that ruins it. We've got one minute!

-One minute?

-I don't know who's more nervous. Me or these two.

When the food is finally ready, it's good news.

It looks like the semolina flour I added to the pizza dough

has helped it to survive the reheat.

And the kids can't wait to get stuck in.

Oh, pizza! Yummy! It looks good.

Does that look all right for you?

Yeah. I know exactly what bit I'm going to have. That bit.

-Can I have that slice?

-Which one?

The one in the corner.

Chicken, mushy peas and gravy.

Where should I sit?

Mmm! Yummy!

Best pizza ever!

Amazing!

Now, they seem to be really enjoying it in there.

Now, I know it's only burgers, chicken nuggets and pizzas,

but it really is so important to put a smile on their young faces.

They're going through so much at a young age, being in hospital,

and to see them eat something that they really enjoy

makes this job more than worthwhile.

While the kids tuck in, I invite the hospital staff to try the food.

Made with all fresh ingredients, I want them to appreciate that

there's plenty of sound nutrition to be found in recipes like these.

Try one. Just try one.

Normally, when you get chicken nuggets, it's reconstituted chicken.

Oh, that's lovely. That's chicken breast, that.

-Can I try one, Jamie?

-Yeah, course you can.

And Harry's enjoying it so much, it looks like I've found

a way of almost silencing him for once.

-What do you think of the pizza?

-Mm-hmm.

-Would you come back for it every day, then?

-Mm-hmm.

-Just pizza?

-Mm.

So, if we just called it from now on Harry's Pepperoni Pizza,

-would you be happy with that?

-Mm-hmm.

So it's job done.

I've managed to deliver the familiar foods that the kids love

and also that the staff here recognise as being vital

in providing comfort to their young patients at a trying time.

High-five!

By using fresh ingredients,

we've kept the emphasis firmly on food, and it's not only tasty,

but nutritious too.

The really great news for the children here, though,

is that it looks like the new menu is here to stay.

The ideas that James has put forward are well doable.

They seemed to go really well on the wards.

The kids seemed to really like them.

So there's no reason why we can't introduce that to the menu.

The kids have enjoyed it.

They've come in and they've left with smiles on their faces,

and that's all we really want.

Out of all the stuff I've done for the last four to five years

in the NHS, that was probably the hardest criticism

that I was going to get from the kids.

They're honest, and that's what you want. Above all else, you've got to give them what they want,

so people sort of tuning into this going.

"Burgers, pizzas, chicken nuggets?"

But you've made it yourself, you know exactly what's in it.

The nutritionists say that's OK, that's what they want

and, let's face it, give the kids something to eat.

Far better having that than having nothing.

Pizzas won't solve everything,

but ideas like that, as well as the food bag initiative at Chesterfield,

show that alongside all the bad stuff with hospital food,

there are plenty of creative solutions

already happening within the NHS.

There we go.

But it's no good keeping all that to myself.

I'm keen to give these ideas a wider platform,

putting them alongside my own techniques and recipes

for every hospital to share.

That's the point of publishing my plans for change online.

But there's a lot to do to get things off the ground.

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

and I still think it is, but it's a logistical nightmare

to try and put together, cos I've got organisations that all really

need to speak to each other and be a part of this happening, so the

Hospital Caterers Association, the Royal College of Nursing,

as well as all the hospitals that I've been working

with up and down the country.

And when it's ready to go, I'm going to make sure everyone

knows about it.

So I'm going to invite representatives from as many

hospitals as possible to come to an event

where I can launch the website, and bring together as many of them

as I can to properly discuss the future of hospital food.

Nobody has actually brought all those organisations together

and into one place to talk.

Doing it is easier said than done,

and, I've got to be honest with you, it's an organisational nightmare.

The thing about this is hard work's going to pay off.

If we can get all these organisations together

in one room, I think massive things can come because of this.

One of the key issues that will be up for discussion at the event

is the increasing shift within the NHS to off-site catering.

Around 60% of UK hospitals now feed their patients by bringing

in pre-prepared meals from facilities

that aren't traditional kitchens.

Bed five, please. Yeah.

The main off-site method most hospitals use

is the cook-chill system.

Meals are made in a factory kitchen,

then blast-chilled to increase the shelf life

before being delivered to a hospital,

then reheated on the wards.

Cream potato.

Traditional kitchens like the one I'm working with in Harlow,

the Princess Alexandra, are in decline.

And the possibility of a switch to cook-chill, which trusts

can assume is more cost-effective, is something that

catering manager Andy and head chef John have to live with every day.

How do you see the future of this unit here?

Hopefully, I'd like to think it will stay traditional.

With the ideas you're coming forward with,

we can progress the restaurant and make it more profitable.

But you've constantly got that threat?

You're always going to have it, James. I don't think that will ever go away.

-You don't think it will ever go away!

-I don't think they'll just park it and go away.

Every year, they will want you to be making sure

you're running a cost-effective department.

So how much do you know about this issue with the trust here

and the cook-chill situation?

Mainly, it's a cost-cutting exercise.

I don't think it does save money, to be honest.

The negative of it is, I think when it changes, you'll never go back.

I mean, if you have a cook-chill unit,

this all goes and it'll never come back

because it's a big investment to put it all back in again.

-Once it happens...

-That's it.

-..that's it...

..which is detriment to the patients and the staff who work here.

The catering staff obviously believe that the food produced

in a traditional kitchen like this is a much better way

of providing for patients in the hospital.

After the successes I've had elsewhere, I agree with them.

And it shouldn't have to cost any more money.

-There you go.

-Thank you.

-All right?

-Yeah, lovely.

It's not just the catering staff

who want to preserve Harlow's traditional kitchen.

The hospital's dieticians would also be sorry

if it ends up having to close.

We don't actually favour cook-chill at all.

We're very, very proud of our team here in Princess Alexandra.

They do a fantastic job and one of the things that we get reported

back to us constantly is the fact that we have the flexibility.

Nutrition's so important for people's clinical outcomes.

So if they eat well, often they do a lot better clinically.

And if this unit went cook-chill,

you wouldn't be involved in the recipes at all,

because they would be made off-site, brought in, reheated -

-you don't have a choice.

-No.

I'm assuming this is in a plastic tray,

it's cooked, then it's chilled and then reheated without stirring.

So when you pull that lid off,

it's not going to be the greatest gastronomic experience

in your life, is it, really?

No. That's where you come in. You're the expert.

That's not where I come in. That's where I go home!

THEY LAUGH

I think what you've got here is so beneficial to you.

I think the guys in there

and the team in there are just absolutely off-the-scale.

You're so lucky.

Look after these guys in here, because they do an amazing job.

Other hospital staff also recognise the contribution

that Andy's team makes to patient welfare.

Nancy is the director of nursing here at Harlow.

Now, tell me about cook-chill,

because I haven't really experienced it as yet.

In terms of nutrition,

does it benefit you in terms of doing what you're doing in your job?

I would say, and I've had lots of tasting sessions with patients

and public representatives and staff members,

what it says on the packet invariably is not what's delivered.

It doesn't taste like that.

It's also quite inflexible with what we can offer.

How do you feel about the importance of having your own kitchen here?

I wouldn't swap it. Many organisations, years on,

are moving back to wanting to cook in their own hospitals.

For me, that means we are delivering the service that the patients

and the local population expect us to.

It is a measure of quality.

It seems most of the people I speak to about hospital food

much prefer a traditional kitchen to meals made off-site.

As yet, I haven't had the chance to see for myself exactly

how cook-chill food is produced.

But now, finally, that's about to change.

I've been trying for the last three to four years,

trying to get into one of these cook-chill units,

to really see what it's all about.

There's been a lot written about it, there's been a lot talked about it -

some negative, some positive.

We have got some good news. One unit in particular

has allowed me to go through the doors,

so I will get to see first-hand what the issues are

and whether I'm able to help them.

It's one of the most exciting things for me throughout this campaign,

because we didn't want to leave them out,

because it's an integral part of the NHS.

Nearly 60-odd per cent of all the food served in the NHS

comes from one of these units.

And if you can get through the door and change a little thing,

you're going to change a whole big part of the picture.

Next time,

some of my chef mates return

to lend a hand in my battle to improve patient meals.

Soup has gone down a storm.

The salads have been absolutely fantastic.

The feedback was good, the vibe was good

and they've maintained that level.

In Harlow, the pressure grows as the team gets ready to roll out

the new one-week menu.

There's nothing worse than the morale going down,

because you don't know if you've got a job at the end of the month.

Oh, yeah, awful.

And I find out for myself if cook-chill food

is really as bad as I've always believed.

This is traditional cooking on a large scale.

The negative side of it is, you don't get any variety, really.