Episode 4

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0:00:02 > 0:00:05Over the last decade, £50 million has been spent trying

0:00:05 > 0:00:08to improve the quality of our hospital food.

0:00:10 > 0:00:12- What is that?- You don't know.

0:00:12 > 0:00:15So far though, there's been little sign that change on a national

0:00:15 > 0:00:17level has been achieved.

0:00:19 > 0:00:22That's the reality of the food that's served in the NHS.

0:00:22 > 0:00:27In fact, a recent study revealed that over a third of hospital food

0:00:27 > 0:00:30is still considered unacceptable by patients.

0:00:31 > 0:00:33Just horrible.

0:00:33 > 0:00:35It's not appetising.

0:00:35 > 0:00:39It was inedible, cold. It was vile.

0:00:39 > 0:00:42That's why, for the last four years, I've been working with NHS

0:00:42 > 0:00:45kitchens to prove that serving good food is possible.

0:00:45 > 0:00:4930 seconds. Come on, come on, come on!

0:00:49 > 0:00:51You guys have made it.

0:00:51 > 0:00:52Thank you!

0:00:52 > 0:00:55Together we've demonstrated patients can have tasty,

0:00:55 > 0:01:00nutritious food, without it costing any more money.

0:01:00 > 0:01:03What motivates me more now, is the public's perception

0:01:03 > 0:01:04of the good that we've done.

0:01:04 > 0:01:06That means a lot.

0:01:06 > 0:01:10But it won't be feasible to bring about real change by tackling

0:01:10 > 0:01:12one hospital at a time.

0:01:12 > 0:01:16People deserve decent food in the NHS. It's not a big ask.

0:01:17 > 0:01:21So now, my aim is to introduce a lasting improvement to

0:01:21 > 0:01:25hospital food for every patient throughout the UK.

0:01:25 > 0:01:29- Mmm, yummy! - Yeah. It's lovely!

0:01:29 > 0:01:32I'm massively passionate about food in hospitals.

0:01:32 > 0:01:34Change can be achieved.

0:01:40 > 0:01:44Since starting my campaign to transform hospital food, I've been

0:01:44 > 0:01:49shocked at the reality of what some patients are being given every day.

0:01:49 > 0:01:52Just look at that. What the hell is that?

0:01:52 > 0:01:55The e-mails and pictures you've sent me have highlighted

0:01:55 > 0:01:59an extraordinary disparity in standards across the UK's hospitals

0:01:59 > 0:02:02and given me a real sense of the good, the bad

0:02:02 > 0:02:04and the unidentifiable.

0:02:06 > 0:02:09It inspires you to sort of get in there and to work hard

0:02:09 > 0:02:10and improve it.

0:02:10 > 0:02:14And now, rather than bring about change in just a handful of places,

0:02:14 > 0:02:18I've come up with a plan to help the entire hospital catering

0:02:18 > 0:02:24industry, making all my ideas and recipes freely available online.

0:02:24 > 0:02:27This website actually seemed like a good idea at the time

0:02:27 > 0:02:28and I still think it is.

0:02:28 > 0:02:30But it's a logistical nightmare.

0:02:31 > 0:02:33As well as sorting out all that,

0:02:33 > 0:02:36I'm continuing to work directly with certain hospitals around

0:02:36 > 0:02:40the country to implement those ideas to benefit patients right now.

0:02:40 > 0:02:45- High-five!- Hiya, you all right? - Good to see you, Andy.

0:02:45 > 0:02:48At the Royal Oldham, I've delivered nutritious versions

0:02:48 > 0:02:53of the kinds of food that kids really want to eat in hospitals.

0:02:53 > 0:02:54Best pizza ever!

0:02:56 > 0:02:59In Chesterfield, I'm helping to develop a food service

0:02:59 > 0:03:02for patients after they've been discharged.

0:03:03 > 0:03:07- We want to provide the patients some kind of grocery pack.- Yeah.

0:03:07 > 0:03:12- Do you think it's a good idea? - I think it's a marvellous idea.

0:03:12 > 0:03:14And at the Princess Alexandra in Harlow, where

0:03:14 > 0:03:18the catering department has a sizeable debt, I'm hoping that

0:03:18 > 0:03:21the ideas I'm working on with the team will be enough

0:03:21 > 0:03:22to save their jobs.

0:03:22 > 0:03:25I don't want to put any more pressure on you

0:03:25 > 0:03:28but I want to go down to a one-week menu cycle.

0:03:28 > 0:03:30The look on your face.

0:03:31 > 0:03:35Today is roll out day at Harlow for the new one-week menu I've

0:03:35 > 0:03:39planning with the team and the pressure is on to get it right.

0:03:39 > 0:03:41Well, today is a massive day.

0:03:41 > 0:03:43Not only do they have to streamline the menu,

0:03:43 > 0:03:45doing so, this is the first time we're going to put a weekly

0:03:45 > 0:03:49menu on, but also the same dishes the patients eat are going to be

0:03:49 > 0:03:51the same dishes we serve in the restaurant.

0:03:51 > 0:03:54So, hopefully, if we do all that, it's going to cut the costs

0:03:54 > 0:03:57and streamline everything and make it really nice.

0:03:59 > 0:04:02The Princess Alexandra is £15 million in debt,

0:04:02 > 0:04:06so chief exec, Melanie Walker, is looking closely at the future

0:04:06 > 0:04:10of the onsite catering operation with a view to reducing costs.

0:04:10 > 0:04:13There comes a point where we've got to think very differently

0:04:13 > 0:04:18about how we run the hospital and there isn't an easy answer to that.

0:04:18 > 0:04:21One solution being considered would be to close the kitchen

0:04:21 > 0:04:23and switch to a cook chill food system,

0:04:23 > 0:04:26the most common type of hospital catering in the country.

0:04:26 > 0:04:31It means the food is made off-site, bought in, and reheated.

0:04:31 > 0:04:33Andy from the Princess Alexandra hospital with

0:04:33 > 0:04:35the order for tomorrow for you.

0:04:35 > 0:04:39If Catering Manager Andy and the team is to avoid that, they need to

0:04:39 > 0:04:43turn round their £19,000 deficit and become cost effective quickly.

0:04:44 > 0:04:47Can you drop that in tomorrow for us?

0:04:47 > 0:04:50Yeah, please, that would be brilliant.

0:04:50 > 0:04:52The change to a one-week menu cycle will help.

0:04:52 > 0:04:55By ditching half of the meals they're currently making,

0:04:55 > 0:04:59it should instantly cut the money the team spends on ingredients.

0:04:59 > 0:05:02So, ten of these and ten like that. Yeah?

0:05:02 > 0:05:05Walking into the kitchen today there's a real

0:05:05 > 0:05:08feeling of nervous energy in the air.

0:05:08 > 0:05:11Chefs like Yvonne and Neil are having to adjust to doing

0:05:11 > 0:05:13things differently.

0:05:13 > 0:05:15We'll see on the feedback today because it's the first

0:05:15 > 0:05:18time these recipes are actually going on the wards.

0:05:18 > 0:05:22So we'll find out today what's what.

0:05:22 > 0:05:24I can't see why the patients can't have the same

0:05:24 > 0:05:27as what the visitors or the nurses or everyone else is having.

0:05:27 > 0:05:30Continuity, that's what you need. It's much more exciting, yeah.

0:05:30 > 0:05:33There's been a bit of a buzz about the place.

0:05:33 > 0:05:36So far, kitchen boss, Andy, seems to be keeping calm.

0:05:37 > 0:05:39Try that, John. Try a bit. It's lovely.

0:05:39 > 0:05:43The idea about the one-week menu cycle,

0:05:43 > 0:05:47I'm almost sure will bring dividends.

0:05:47 > 0:05:50I'm hopeful that it'll actually reduce our costs and,

0:05:50 > 0:05:54at the same time, hopefully push up quality a bit as well.

0:05:55 > 0:05:57This is big change.

0:05:57 > 0:05:59You may not think it, going down to a weekly menu,

0:05:59 > 0:06:03but it's fantastic to see all the guys really embracing that

0:06:03 > 0:06:06and I think a lot of that was down to the fact that they

0:06:06 > 0:06:10now know what pressure Andy has been under and he continues to be under.

0:06:10 > 0:06:14They really want to rally around and support him even more

0:06:14 > 0:06:17and what I've seen today is the perfect example of that, really.

0:06:20 > 0:06:23And, of course, there's another reason for the chefs to want the new

0:06:23 > 0:06:25menu to be a success.

0:06:25 > 0:06:28If the department continues to lose money

0:06:28 > 0:06:31they could all be out of a job.

0:06:31 > 0:06:34There's nothing worse than the morale going down

0:06:34 > 0:06:37because you don't know if you've got a job at the end of the month.

0:06:37 > 0:06:41I retire in a couple of years, but these are young lads.

0:06:41 > 0:06:44It's their livelihoods. They've got families and kids.

0:06:44 > 0:06:47They don't want to be looking elsewhere. Oh, yeah, awful.

0:06:49 > 0:06:52With the clock ticking down to lunchtime, there are just

0:06:52 > 0:06:54a few frantic minutes remaining for the team to

0:06:54 > 0:06:58finish off the first meal they'll serve as part of the one-week cycle.

0:07:06 > 0:07:09With everything finally ready, it's time for the kitchen's

0:07:09 > 0:07:12second-in-command, Jonathan, and I to head up to the wards to see

0:07:12 > 0:07:15if the new menu will prove a hit with the patients.

0:07:16 > 0:07:19- James, good to see you. - Good to see you too.

0:07:19 > 0:07:21Knee by the looks of things. Is that right?

0:07:21 > 0:07:25Yep. This one 18 months ago and this one this week.

0:07:25 > 0:07:28Well, what do you think of the food so far, because this is the boss?

0:07:28 > 0:07:31- Be as honest as you like.- The food we've had here has been excellent.

0:07:31 > 0:07:33- Is there enough for you? - There's enough here.

0:07:33 > 0:07:37They come up reasonable portions. It's not skimpy.

0:07:37 > 0:07:39Fantastic. Well, good luck. Look after yourself.

0:07:39 > 0:07:41- Thank you very much. - Thank you very much.

0:07:41 > 0:07:44Don't come in for another one, because you've used two already.

0:07:44 > 0:07:46- I've used them up now. - Nice to see you.

0:07:46 > 0:07:50- What did you have for lunch? - I had the vegetable pasta bake.

0:07:50 > 0:07:52- And you enjoyed it?- Yeah.

0:07:52 > 0:07:55- How many hospitals have you been in, in your life?- Three.

0:07:55 > 0:07:59- About three different ones?- Yeah. - Yeah? And how does this compare?

0:07:59 > 0:08:01- It's good.- There you go.

0:08:01 > 0:08:04My head's getting bigger. I'm really pleased.

0:08:04 > 0:08:07- You've got a friend, anyway. - I've got a friend, yeah.

0:08:07 > 0:08:10- Get better soon.- OK.

0:08:10 > 0:08:13- How you doing, Robert?- Very good. - You're diving into that.

0:08:13 > 0:08:16- I am.- Yeah, you like it? - Very nice.

0:08:16 > 0:08:18And filling as well, is it?

0:08:18 > 0:08:20It is because I'm just thinking to myself,

0:08:20 > 0:08:24I hope he goes in a minute because I won't be able to get all this in.

0:08:24 > 0:08:27And what about... I've got an idea about putting a little recipe

0:08:27 > 0:08:29bank together so all the other hospitals can use it.

0:08:29 > 0:08:33- Yeah.- As you're diving into this everybody around the UK

0:08:33 > 0:08:36- could also have some. - Yeah, I would recommend it.

0:08:36 > 0:08:37Yeah? Out of ten?

0:08:39 > 0:08:40Oh, I'd give it a nine.

0:08:44 > 0:08:48The meal options from the new menu have been given a thumbs up

0:08:48 > 0:08:52by the patients, and Jonathan seems pretty pleased with the reaction.

0:08:52 > 0:08:54We got very good feedback from the wards

0:08:54 > 0:08:56regarding the food today.

0:08:56 > 0:08:58I think we've got a good team here. It's just a case of moving forward.

0:08:58 > 0:09:01Sometimes you can get a bit stuck in a rut

0:09:01 > 0:09:03and basically do the same thing every day.

0:09:03 > 0:09:05It's nice to have a fresh input by someone else giving you ideas

0:09:05 > 0:09:08and suggestions.

0:09:08 > 0:09:11But success with the patients is only half the story today.

0:09:11 > 0:09:14For my new menu to be as cost effective as possible,

0:09:14 > 0:09:18I want it rolled out in the restaurant as well as on the wards.

0:09:18 > 0:09:20- Soup to take away? - Yes, please.

0:09:22 > 0:09:26If the hospital staff that eat here are as enthusiastic as the patients

0:09:26 > 0:09:29then it should result in major cost savings as the team can bulk

0:09:29 > 0:09:34buy the same ingredients to cover both the wards and the restaurant.

0:09:34 > 0:09:37It's nice to have something that's warm and filling

0:09:37 > 0:09:39when you've only got a short snippet of time to eat

0:09:39 > 0:09:42and often we don't get regular breaks.

0:09:42 > 0:09:44So, sometimes it's just a quick five minutes.

0:09:44 > 0:09:47Something like a soup and a roll you can have and carry on.

0:09:47 > 0:09:50It's nice that it's all home cooked, as well.

0:09:50 > 0:09:53It's not been brought in pre-packaged.

0:09:53 > 0:09:55When I see a patient eating something on the wards,

0:09:55 > 0:09:58sometimes I really think, oh, yeah actually I'd quite like that.

0:09:58 > 0:10:01So it would be nice to come down here and get that.

0:10:02 > 0:10:05It's been an encouraging start for the team.

0:10:05 > 0:10:09So have I got anything coming in on the prep side tomorrow at all?

0:10:09 > 0:10:12And if they can keep it up, they now have every

0:10:12 > 0:10:15chance of cancelling out the department's deficit.

0:10:15 > 0:10:18Amazing job. Thank you very much, guys.

0:10:18 > 0:10:20I think great appreciation on the wards as well.

0:10:20 > 0:10:23- Yeah, that went very well.- Yeah, went really well, didn't it?

0:10:23 > 0:10:25- Definitely.- The first day has gone very well for us

0:10:25 > 0:10:29and I like to think that through the rest of the week, it'll carry on

0:10:29 > 0:10:31being as successful as well.

0:10:31 > 0:10:35And, as you saw in here today, we we're all working together for that.

0:10:35 > 0:10:38We'd like to see an increase in revenue from the restaurant.

0:10:38 > 0:10:41What we want to make sure we can do, is put the ideas that James

0:10:41 > 0:10:44has actually brought to us with his salad ideas and grab-and-go

0:10:44 > 0:10:49ideas that he's brought to us and that's really what it's about.

0:10:49 > 0:10:51But this success needs to be sustainable to convince

0:10:51 > 0:10:54the hospital trust to stick with the traditional kitchen here,

0:10:54 > 0:10:58rather than cutting jobs with a switch to a different system.

0:10:59 > 0:11:00Thank you!

0:11:04 > 0:11:06The Princess Alexandra isn't the only hospital I've

0:11:06 > 0:11:08worked at facing that threat.

0:11:08 > 0:11:11York Trust, which runs the hospital where all this began,

0:11:11 > 0:11:15Scarborough General, is also considering the future

0:11:15 > 0:11:16of its kitchens.

0:11:16 > 0:11:19It's already announced the closure of its traditional set up

0:11:19 > 0:11:20in Bridlington.

0:11:21 > 0:11:27It looks from this that Bridlington is going cook chill.

0:11:27 > 0:11:29And Scarborough, where catering manager Pat Bell

0:11:29 > 0:11:33and I first proved that it is possible to give patients

0:11:33 > 0:11:38better food at no extra cost, could be next.

0:11:38 > 0:11:40York Trust is my home county. I'm very proud of that place.

0:11:40 > 0:11:43I'm very proud of the people that it represents

0:11:43 > 0:11:45and the people that it serves. I felt honoured, to be honest.

0:11:45 > 0:11:48A local boy goes back home and helps out the local hospital.

0:11:48 > 0:11:51It was really everything that I ever wished for.

0:11:52 > 0:11:54With York Trust offering few assurances over

0:11:54 > 0:11:57the future of the kitchen at Scarborough, it looks as

0:11:57 > 0:12:00though this may be a battle that I've lost.

0:12:04 > 0:12:10But around 60% of UK hospitals now serve cook chill food or

0:12:10 > 0:12:12other types of off-site catering.

0:12:12 > 0:12:15If I really want to make a difference on a national scale,

0:12:15 > 0:12:16I can't ignore that.

0:12:19 > 0:12:24Up to now, I've never seen exactly how food made off-site is produced.

0:12:24 > 0:12:27But finally that's about to change.

0:12:27 > 0:12:29We've talked a lot about cook chill

0:12:29 > 0:12:32and the effect that it has on catering units that I've been

0:12:32 > 0:12:34working with over the last sort of two-to-three years.

0:12:34 > 0:12:37But thankfully, after those years have passed, the NHS have

0:12:37 > 0:12:38allowed me to come here.

0:12:38 > 0:12:42This is there own Central Production Unit in Wolverhampton

0:12:42 > 0:12:44and they want me to work with them on stuff they're serving

0:12:44 > 0:12:48in the hospital right next door, so I'm looking forward to today.

0:12:51 > 0:12:54This isn't your typical cook chill production unit.

0:12:54 > 0:12:57For starters, it's a little unusual for one to be based

0:12:57 > 0:12:59so close to a hospital.

0:12:59 > 0:13:03Plus, it's run by the NHS, rather than a private company,

0:13:03 > 0:13:06as many of them are,

0:13:06 > 0:13:10although the patients are split on what they make of the food.

0:13:10 > 0:13:12It's a bit bland.

0:13:12 > 0:13:15- I'm quite happy. - It's vile.

0:13:15 > 0:13:19These meals are prepared in a central facility like this one,

0:13:19 > 0:13:22blast chilled in large fridges then transported to

0:13:22 > 0:13:25hospitals in the surrounding area.

0:13:25 > 0:13:28When the food finally reaches the wards, it's reheated using

0:13:28 > 0:13:30a special serving trolley.

0:13:32 > 0:13:33What is that? You don't know.

0:13:37 > 0:13:39I've always believed that the majority

0:13:39 > 0:13:42of off-site hospital catering is of a poorer quality

0:13:42 > 0:13:44than meals cooked in a traditional kitchen.

0:13:44 > 0:13:48Fetching, I know. But there's a lot goes on here.

0:13:48 > 0:13:51I'm here at the unit today, though, with an open mind.

0:13:51 > 0:13:54And Catering Production Manager, Gene, has pledged that he'll

0:13:54 > 0:13:57take on board my ideas and suggestions.

0:13:57 > 0:14:02But first, I need to see exactly how a place like this operates.

0:14:02 > 0:14:04What are we looking at in terms of production?

0:14:04 > 0:14:07What's the average amount that you do a day?

0:14:07 > 0:14:121,000 lunches, 1,000 suppers, so 2,000 meals on a normal

0:14:12 > 0:14:13production day.

0:14:13 > 0:14:15We do a double production day on a Tuesday,

0:14:15 > 0:14:17so that would be 4,000.

0:14:17 > 0:14:21The unit here caters for three hospitals in the local area.

0:14:21 > 0:14:26But producing 4,000 meals on a busy day is pretty staggering.

0:14:26 > 0:14:30Compare that to the kitchen I've been working in, in Harlow,

0:14:30 > 0:14:32which gets through around 900 meals daily,

0:14:32 > 0:14:36and you begin to get a sense of the scale of this operation.

0:14:38 > 0:14:42In my book, mass catering doesn't usually result in quality food,

0:14:42 > 0:14:46but there's no doubt that there are some aspects of the way

0:14:46 > 0:14:49this unit is run, which I wasn't expecting.

0:14:49 > 0:14:50This is the decant area.

0:14:50 > 0:14:53So you can see all our raw meat has come through.

0:14:53 > 0:14:56It's interesting that you use fresh chicken because a lot of these

0:14:56 > 0:14:59much bigger units than what you've got here, might be using, well,

0:14:59 > 0:15:03it could be frozen boneless chicken, it could be anything really.

0:15:03 > 0:15:06We don't use any frozen meat at all. Everything is fresh.

0:15:06 > 0:15:07All fresh. OK.

0:15:08 > 0:15:12That's not the only working practice I'm in favour of.

0:15:12 > 0:15:15There's also close attention paid to the way dishes are produced,

0:15:15 > 0:15:18sometimes with obvious benefits.

0:15:18 > 0:15:22- Each one of these trolleys is basically a recipe, then.- Yes.

0:15:22 > 0:15:25So you basically standardise the recipe exact?

0:15:25 > 0:15:28The recipes have to be standardised because they're all agreed with

0:15:28 > 0:15:29the dieticians.

0:15:29 > 0:15:33So it keeps our dieticians happy.

0:15:33 > 0:15:36It keeps the finance people happy,

0:15:36 > 0:15:39so we know exactly how much we're spending.

0:15:39 > 0:15:41We have a very strict budget to stick to

0:15:41 > 0:15:44and it also cuts down on waste.

0:15:44 > 0:15:48If we're cooking 385 portions of cottage pie,

0:15:48 > 0:15:53we order exactly the right amount of ingredients to cook that amount.

0:15:53 > 0:15:55Sounds good.

0:15:55 > 0:15:58Now this is more like it. Some serious pans.

0:15:58 > 0:16:00You feel a bit more at home in here, then?

0:16:00 > 0:16:03Yeah. I've never seen equipment like this.

0:16:03 > 0:16:06I don't know what these cost, but they are not cheap.

0:16:06 > 0:16:10They're not cheap. However, we do make savings.

0:16:10 > 0:16:14When you're cooking in bulk like this, you need less staff.

0:16:14 > 0:16:17- What are they? Three, four? - Yeah. I was really surprised.

0:16:17 > 0:16:21- It's not many, is it? - No. And it works, James.

0:16:21 > 0:16:23So, I'm intrigued to know what you're cooking today,

0:16:23 > 0:16:26- so can we go and have a look?- OK.

0:16:26 > 0:16:30With only four chefs making up to 4,000 meals a day, it's

0:16:30 > 0:16:33clear that the unit have bulk production down to a fine art.

0:16:34 > 0:16:38But how the food actually tastes is what really counts.

0:16:38 > 0:16:40Home-made soup.

0:16:40 > 0:16:43- Home-made vegetable soup. - Home-made soup.

0:16:45 > 0:16:48If you think it's too salty, you can work on the recipe with us!

0:16:51 > 0:16:53There's pros and cons with everything, really.

0:16:53 > 0:16:55I can see, really, why they do it.

0:16:56 > 0:17:00The negative side, is you don't get any variety, really.

0:17:00 > 0:17:02There is work that we can help them with, absolutely,

0:17:02 > 0:17:06in terms of the soups and the tastes and everything else.

0:17:06 > 0:17:08But the basis of everything is there.

0:17:08 > 0:17:12It's just there's a little bit more frozen veg than I'd want.

0:17:12 > 0:17:15Try and get fresh veg on because they've got fresh meat on.

0:17:15 > 0:17:20You know, most of the time with the NHS, you're fighting for equipment.

0:17:20 > 0:17:23You've got it all. You could have a bath in there, look.

0:17:24 > 0:17:25Albeit a hot one.

0:17:28 > 0:17:30I can see it's a very professional set up here.

0:17:30 > 0:17:34But amongst many of the people I've spoken to in hospitals,

0:17:34 > 0:17:38not just chefs but dieticians, nurses and patients too,

0:17:38 > 0:17:41the quality of cook chill food has a terrible reputation.

0:17:45 > 0:17:49Gene believes the blame shouldn't lie with an NHS unit like this one,

0:17:49 > 0:17:53but with the 35% of hospital catering that's sub-contracted

0:17:53 > 0:17:54out to private firms.

0:17:56 > 0:17:59I don't want to be disrespectful to these other big suppliers,

0:17:59 > 0:18:01but they are profit driven.

0:18:01 > 0:18:06They will have to buy the raw ingredient, produce it,

0:18:06 > 0:18:10store it, transport it and make a profit.

0:18:10 > 0:18:12We're an NHS unit.

0:18:13 > 0:18:16We have a budget to stick to, like any other NHS unit.

0:18:16 > 0:18:19So we spend well over a million on raw ingredients

0:18:19 > 0:18:24and our recipes have all of that money put into the ingredients.

0:18:24 > 0:18:28Yeah. If a meal costs four quid, you'll spend four quid

0:18:28 > 0:18:30on the quality of the food.

0:18:30 > 0:18:33Whereas I find difficult to believe, is a company would spend four

0:18:33 > 0:18:37quid on food, they're not, they're going to spend, I don't know, £1.50?

0:18:37 > 0:18:39We don't have to make a profit.

0:18:39 > 0:18:42It all goes back into the patient experience.

0:18:42 > 0:18:45Well, I've got to be honest with you, I didn't really know what to

0:18:45 > 0:18:47expect when I came in here.

0:18:47 > 0:18:50I was probably anticipating a lot more of a factory environment.

0:18:50 > 0:18:52You know, this is NHS owned,

0:18:52 > 0:18:55so they can control everything in terms of the cost.

0:18:55 > 0:18:58It's kitted out how they want to kit it out, as well.

0:18:58 > 0:19:01Whereas you just get the feeling in a cook chill unit that has to

0:19:01 > 0:19:06make a profit, it doesn't really look as good as this.

0:19:09 > 0:19:12Although I'm cautiously optimistic about what I've seen so far,

0:19:12 > 0:19:16the real test of this food is how it goes down on the wards.

0:19:17 > 0:19:19Bed 22, isn't it?

0:19:19 > 0:19:22So I've come across the road to the New Cross hospital to see

0:19:22 > 0:19:24some of it served to patients.

0:19:25 > 0:19:30So, unlike conventional hospital wards where the food is

0:19:30 > 0:19:33placed in a hot cabinet from the kitchen, wheeled to the wards

0:19:33 > 0:19:36and then the button is pressed to be super-heated, these

0:19:36 > 0:19:41have had probably a lot less time in an oven but on an exact temperature.

0:19:41 > 0:19:45An armoury of waitressing team. Check that out.

0:19:45 > 0:19:47Bed five, please.

0:19:47 > 0:19:50Watching the food being served, there's one issue with it

0:19:50 > 0:19:52that's immediately obvious to me.

0:19:52 > 0:19:54What about portion size? Is it easy to portion up doing this?

0:19:54 > 0:19:56Er, I try my best.

0:19:56 > 0:19:59There's a portion of six on this tray here.

0:19:59 > 0:20:04The unit produces trays with either six or three portions in them.

0:20:04 > 0:20:07But as numbers haven't worked out perfectly today, there seems

0:20:07 > 0:20:11to be quite a lot of waste left over in many of the trays.

0:20:11 > 0:20:14And that's costly for any hospital.

0:20:14 > 0:20:16- So has everybody eaten a main? - Yep.

0:20:16 > 0:20:18What happens to this, then?

0:20:18 > 0:20:22- This all gets thrown in the bin, does it?- Yes. Unfortunately.

0:20:23 > 0:20:27When you're cooking in containers for three and six portions

0:20:27 > 0:20:31and not individually, you're going to have huge amounts of waste.

0:20:31 > 0:20:34They tell me at the hospital that they have 10% waste, but

0:20:34 > 0:20:36based on what I've seen,

0:20:36 > 0:20:39I imagine on some days it's probably a lot more.

0:20:41 > 0:20:45Can I try a bit then, before anyone starts chucking it out.

0:20:49 > 0:20:53- Chicken pie. What is this one? - Beef hotpot.

0:20:53 > 0:20:56Beef hotpot.

0:20:56 > 0:20:58Chicken pie is better.

0:20:58 > 0:21:03Of the food I've tasted, I would say some is good, some just OK.

0:21:03 > 0:21:05And that's what many of the patients think too.

0:21:05 > 0:21:09You've had experience of the food. Six weeks worth of food.

0:21:09 > 0:21:12- Everything you wanted or...? - It could be improved.

0:21:12 > 0:21:16They offer you like jacket potato and cheese and I thought,

0:21:16 > 0:21:19"Oh, that's nice." And I had it the first time and it was really nice

0:21:19 > 0:21:21and then the next three times I've ordered it,

0:21:21 > 0:21:23the potato's not cooked and you're like, "Urgh!"

0:21:23 > 0:21:25Anything you'd like on the menu that's

0:21:25 > 0:21:27not on the menu at the moment?

0:21:27 > 0:21:31No. Because I think, to me, there's a choice of what I want.

0:21:31 > 0:21:33You know, if I don't want it, it's up to me to say,

0:21:33 > 0:21:36- no, I don't want that. - And you're happy?- I'm quite happy.

0:21:36 > 0:21:39When they used to plate them up a million miles away,

0:21:39 > 0:21:42put them on the things and bring them up in the flight trolley

0:21:42 > 0:21:44and whatever, that was just disgusting.

0:21:44 > 0:21:48The way it's presented is much better now, but there are some

0:21:48 > 0:21:52issues with choice, particularly if you're on a restricted diet.

0:21:52 > 0:21:56To improve that choice and raise standards overall,

0:21:56 > 0:21:59Gene and his team will now start trialling some of the recipes

0:21:59 > 0:22:01I'll be putting up on my website.

0:22:02 > 0:22:06If that's a success, they'll start using them for good.

0:22:06 > 0:22:11From what I've seen today, it's very different to what I've

0:22:11 > 0:22:14seen on a bigger commercial scale being served in other hospitals.

0:22:14 > 0:22:18The actual kitchen was a proper kitchen with proper

0:22:18 > 0:22:21chefs in there and cooking real food.

0:22:21 > 0:22:24Having said that, that's the benefit of being owned by the NHS.

0:22:29 > 0:22:32Whether a hospital's meals are provided by an NHS unit or

0:22:32 > 0:22:36a private catering company, I still believe most patients, given

0:22:36 > 0:22:40the choice, would jump at the chance of having some fresher

0:22:40 > 0:22:41food added to their menus.

0:22:42 > 0:22:45The dinner hasn't been very nice.

0:22:45 > 0:22:48That was certainly the case a year ago when I sent a couple

0:22:48 > 0:22:52of my chef mates to work with a large cook chill hospital in London.

0:22:52 > 0:22:54We're at the Royal Free in Hampstead.

0:22:54 > 0:22:58A whopper of a hospital, very, very big one.

0:22:58 > 0:23:00I asked Lawrence Keogh and Paul Merrett to work with

0:23:00 > 0:23:03the team at the Royal Free to see how we could supplement

0:23:03 > 0:23:07the hospital's off-site catering with simple fresh food.

0:23:08 > 0:23:11And once they read the patient feedback forms, one dish stood

0:23:11 > 0:23:13out again and again.

0:23:14 > 0:23:18Soup! Soup! Soup!

0:23:18 > 0:23:21Maybe that's an area we need to look at.

0:23:22 > 0:23:24At the moment, just explain, the soup is made...

0:23:24 > 0:23:2760 miles away in the production kitchens.

0:23:27 > 0:23:31OK, wouldn't it be nice if every day there was a fresh, fresh,

0:23:31 > 0:23:33- fresh soup?- Yep.

0:23:33 > 0:23:37It wasn't long before the boys and I got busy in the kitchen.

0:23:37 > 0:23:40Right, come on, come on, Lawrence. Where are you?

0:23:40 > 0:23:44Paul Merrett, can you please come to the diary room?

0:23:44 > 0:23:45More soup.

0:23:49 > 0:23:53We were making not just fresh soups but salads too.

0:23:53 > 0:23:56And when we tested them out both on the wards and in the hospital

0:23:56 > 0:23:59restaurant, the response was overwhelming.

0:23:59 > 0:24:04I had the carrot and coriander soup and it was beautiful.

0:24:04 > 0:24:06How does that compare with what you've had before?

0:24:06 > 0:24:07Very tasty, yeah. Very good.

0:24:07 > 0:24:10It's the best soup I've had down here, so it's really good.

0:24:10 > 0:24:12Can you just say that again loudly?

0:24:12 > 0:24:14- It's the best soup I've had down here.- Excellent!

0:24:14 > 0:24:15That's the batch I made.

0:24:17 > 0:24:20It was great to see a hospital with this sort of system keen to

0:24:20 > 0:24:24improve the quality and range of the meals they'd bought in.

0:24:24 > 0:24:26And doing it actually saved them money.

0:24:28 > 0:24:32When we left, the soups and salads had been introduced on three wards.

0:24:32 > 0:24:35But Director of Facilities, Jeremy, had big plans to roll them

0:24:35 > 0:24:37out across the whole building.

0:24:37 > 0:24:39We've done the whole floor today.

0:24:39 > 0:24:41We can start planning our menus around delivering

0:24:41 > 0:24:43this across the whole hospital.

0:24:43 > 0:24:45It'll be a bit of a challenge but we'll be able to do it

0:24:45 > 0:24:47and it enhances the meal service we have now.

0:24:49 > 0:24:53So, six months after their last visit, Lawrence and Paul went

0:24:53 > 0:24:56back to the Royal Free to see how things had been working out

0:24:56 > 0:24:59and if we'd managed to make a lasting difference

0:24:59 > 0:25:01to the food there.

0:25:01 > 0:25:05I'm really keen to know how the six months has gone, you know,

0:25:05 > 0:25:09whether they've managed to maintain the momentum.

0:25:09 > 0:25:14It's easy to turn up and do it over a short period but over six months?

0:25:14 > 0:25:17Have they managed to achieve it daily? Have they expanded it?

0:25:17 > 0:25:20Have they disbanded it? I don't know what to expect today.

0:25:20 > 0:25:22I'm a little bit apprehensive.

0:25:24 > 0:25:26The lads are meeting up with Jeremy

0:25:26 > 0:25:28and the hospital's Chief Exec, David.

0:25:28 > 0:25:30For us it's been fantastic.

0:25:30 > 0:25:33It's been just a huge change, actually, to the way that we operate,

0:25:33 > 0:25:35the way we eat, the way we do things.

0:25:35 > 0:25:37Jeremy and his team have been out there.

0:25:37 > 0:25:39We have. The soup has gone down a storm.

0:25:39 > 0:25:42The salads have been absolutely fantastic in terms of patients

0:25:42 > 0:25:43taking them on board

0:25:43 > 0:25:48and it looks so much fresher and more tempting, it really does.

0:25:48 > 0:25:49So the management are happy

0:25:49 > 0:25:54and the word back from the staff on the wards is just as encouraging.

0:25:54 > 0:25:56Patients have been really warm and receptive to the soups.

0:25:56 > 0:25:59It's what they want to eat when they're not feeling very well.

0:25:59 > 0:26:01There's a good variety of soups,

0:26:01 > 0:26:05they're freshly prepared every day using really nice ingredients.

0:26:05 > 0:26:08Best of all, both patients and restaurant customers

0:26:08 > 0:26:11are really feeling the benefit of fresh food on their menu.

0:26:12 > 0:26:17When you're sick, you need all the energy in the world to help

0:26:17 > 0:26:19you to get well.

0:26:20 > 0:26:23It's a number one priority.

0:26:23 > 0:26:24We get the soup every day.

0:26:24 > 0:26:28We come down here every day and it's just really, really nice.

0:26:28 > 0:26:30- Healthy.- Healthy.

0:26:30 > 0:26:32You get your five-a-day packed in there.

0:26:32 > 0:26:36So, it's quick, it's easy, quite nutritious and it fills you up.

0:26:36 > 0:26:39There's no doubt from the management that the changes we introduced,

0:26:39 > 0:26:43just by adding simple additions to the bought-in meals,

0:26:43 > 0:26:44are here to stay.

0:26:44 > 0:26:47The staff eating the same food as the patients makes a huge

0:26:47 > 0:26:50difference in terms of the messages we're giving

0:26:50 > 0:26:53to the organisation about what's important.

0:26:53 > 0:26:55If it's not good enough for us, it's not good enough for the patients.

0:26:55 > 0:26:58So, as yet, you haven't got it right the way through the hospital

0:26:58 > 0:27:00- but that's going to happen very soon, right?- It is.

0:27:00 > 0:27:02There's a plan out there now at the moment.

0:27:02 > 0:27:05All the soups have been rolled out throughout the whole hospital,

0:27:05 > 0:27:08that's gone really well and we're now working down from the 11th floor

0:27:08 > 0:27:10downwards doing all our fresh salads.

0:27:11 > 0:27:13It's good work in six months, isn't it?

0:27:13 > 0:27:16- You're ahead of the pack now. - Benchmark.- Brilliant.

0:27:16 > 0:27:18That's good to hear.

0:27:18 > 0:27:19They've done really well.

0:27:19 > 0:27:22They're running it out throughout the whole hospital.

0:27:22 > 0:27:23The feedback was good, the vibe was good

0:27:23 > 0:27:25and they've maintained that level.

0:27:25 > 0:27:27I tell you what it proves.

0:27:27 > 0:27:31It proves that the model that we worked on here could probably

0:27:31 > 0:27:33be replicated across every cook chill hospital.

0:27:33 > 0:27:37Well, why not? What's preventing it? What's stopping it? Why can't it be?

0:27:37 > 0:27:39Paul and Lawrence have a point.

0:27:39 > 0:27:42Simple ideas like the ones we trialled at the Royal Free

0:27:42 > 0:27:45could work in many hospitals with off-site catering.

0:27:46 > 0:27:49We've done something right, mate. We've done something right.

0:27:49 > 0:27:52It's initiatives like this I'm hoping more hospitals will

0:27:52 > 0:27:56adopt once I've put them all down on my website.

0:27:56 > 0:28:00I want all the recipes and ideas that I've proved can work to

0:28:00 > 0:28:03be available for every hospital to use.

0:28:06 > 0:28:10It's the key to my goal of affecting change on a national level.

0:28:10 > 0:28:13So I've enlisted the help of other organisations also

0:28:13 > 0:28:17pushing for change, such as the Hospital Caterers Association

0:28:17 > 0:28:21and the British Dietetic Association.

0:28:21 > 0:28:23Well, when I thought about the idea of a website, it was really

0:28:23 > 0:28:27important that we got organisations like the BDA involved in this,

0:28:27 > 0:28:30because, really, they are at the forefront of nutrition

0:28:30 > 0:28:34in the NHS and what they say more or less goes, really.

0:28:34 > 0:28:38So when you're devising a recipe and you're devising menus

0:28:38 > 0:28:42and stuff like that, without their really seal of approval,

0:28:42 > 0:28:45it's very difficult to implement this on a larger scale.

0:28:45 > 0:28:49To get that seal of approval, all the recipes

0:28:49 > 0:28:53I plan to share on my website need to be thoroughly checked out.

0:28:53 > 0:28:57So I've sent the details of nearly 60 of my dishes to top

0:28:57 > 0:29:01nutritionists at the British Dietetic Association.

0:29:03 > 0:29:07And now I'm waiting for the call from BDA dietician, Maxine Cartz,

0:29:07 > 0:29:10to let me know whether I've got the go-ahead to describe the dishes

0:29:10 > 0:29:15I'll be making available to all hospitals as nutritionally sound.

0:29:16 > 0:29:17On the whole, everything OK?

0:29:17 > 0:29:18On the whole they're great

0:29:18 > 0:29:21and they certainly look like mouth-watering dishes.

0:29:21 > 0:29:25They look like they're going to be really well received by patients.

0:29:25 > 0:29:29You've got sticky toffee pudding and those soups look really great.

0:29:29 > 0:29:32Great, all right, thanks for all your help on it.

0:29:32 > 0:29:35- Cheers, James, no problem. - Cheers. Thank you. Bye.- Bye.

0:29:36 > 0:29:38How good was that?

0:29:38 > 0:29:41Often, really, when you try and implement change within the NHS,

0:29:41 > 0:29:45they've all got their own sets of issues and rules and regulations.

0:29:45 > 0:29:48And if Maxine says the recipes are great,

0:29:48 > 0:29:50that is a massive leap forward.

0:29:52 > 0:29:55Making available a database of dishes hospitals can be confident

0:29:55 > 0:30:00are both tasty and nutritious, will be a real step forward.

0:30:00 > 0:30:04Staggering as it sounds, there are no mandatory nutritional

0:30:04 > 0:30:07standards laid down for all hospitals in the UK.

0:30:08 > 0:30:10There are for prisons,

0:30:10 > 0:30:14but hospital food has no such consistency or regulation,

0:30:14 > 0:30:17or, at least, not in England.

0:30:17 > 0:30:20There are nutritional standards set out for Scotland and Wales, though,

0:30:20 > 0:30:25as I discovered last year when I was asked to help with a new initiative

0:30:25 > 0:30:26from the Welsh Assembly.

0:30:26 > 0:30:29Leslie, thanks for meeting us.

0:30:29 > 0:30:32Welsh Minister, Leslie Griffiths, set me the task of helping create

0:30:32 > 0:30:36dishes for a single menu set to be rolled out

0:30:36 > 0:30:40across all 115 NHS hospitals in Wales.

0:30:40 > 0:30:42From the end of this year, I'm bringing in the all-Wales menu,

0:30:42 > 0:30:44which, again, I think is really important.

0:30:44 > 0:30:48So the idea is just to have almost like a recipe bank of recipes

0:30:48 > 0:30:52- that people can dive into and come out of?- Absolutely.

0:30:52 > 0:30:55I asked my chef friend Stephen Terry to help me out.

0:30:55 > 0:30:59But when he arrived at a hospital kitchen in Abergavenny,

0:30:59 > 0:31:02he made a discovery that shocked us both.

0:31:02 > 0:31:04You've got a roast chicken dinner. Do you do lamb, beef, pork?

0:31:04 > 0:31:06- We don't do lamb. We don't do beef. - No lamb?

0:31:06 > 0:31:08We do pork, chicken and turkey.

0:31:08 > 0:31:11What has shocked me, really, is the fact, you know,

0:31:11 > 0:31:13because it comes down to budget and cost,

0:31:13 > 0:31:18here in Wales, in a Welsh hospital, we can't serve Welsh lamb.

0:31:18 > 0:31:21I don't understand why that isn't possible.

0:31:21 > 0:31:24Unbelievably, Stephen found the only lamb that most Welsh hospitals

0:31:24 > 0:31:31could afford to buy was from New Zealand or Australia, not Wales.

0:31:31 > 0:31:33Currently, what are they charging? Is it per kilo?

0:31:33 > 0:31:37- £8.10 a kilo.- £8.10 a kilo? - Leg of lamb.

0:31:37 > 0:31:40- And does it say where the lamb's from? Is it...- New Zealand.

0:31:40 > 0:31:44Red tape means Welsh hospitals can only buy from

0:31:44 > 0:31:45their official suppliers.

0:31:45 > 0:31:48None of whom appeared to be able to source local lamb

0:31:48 > 0:31:51more cheaply than foreign imports.

0:31:51 > 0:31:54We were shocked by that and quickly identified local farms

0:31:54 > 0:31:57more than happy to offer a better price.

0:31:58 > 0:32:03On Welsh lamb legs, what's the best price per kilo?

0:32:03 > 0:32:0745 kilos once a week. £6.50 - £6.99.

0:32:07 > 0:32:11£6.50 sounds the better of the two.

0:32:11 > 0:32:14Welsh lamb is the obvious ingredient for the lamb pie Stephen was

0:32:14 > 0:32:17determined to get on the all-Wales menu.

0:32:17 > 0:32:18But without it,

0:32:18 > 0:32:22hospitals would have to use meat from the other side of the world.

0:32:23 > 0:32:27This one can go in just in the tinfoil because they're all right.

0:32:27 > 0:32:28The hope for both of us

0:32:28 > 0:32:32was that, in time, the cost of local lamb from the official Welsh supply

0:32:32 > 0:32:36chain would be reduced, so that in future, these pies could be produced

0:32:36 > 0:32:41with meat from Wales, giving a massive boost to the local economy.

0:32:41 > 0:32:42150.

0:32:44 > 0:32:48But first, all the dishes Steven and I suggested for the new menu,

0:32:48 > 0:32:53including some of my soups, needed to get Leslie's official approval.

0:32:53 > 0:32:55Smells gorgeous.

0:32:57 > 0:33:02- Good enough?- That's so good.

0:33:02 > 0:33:03Now, one year on,

0:33:03 > 0:33:06I want to know what progress has been made, both with the menu

0:33:06 > 0:33:11overall, and in making local lamb affordable for Welsh hospital chefs.

0:33:12 > 0:33:13Welsh lamb was all around us.

0:33:13 > 0:33:16There are millions of sheep in Wales.

0:33:16 > 0:33:20So, I've asked Stephen to get an update from dieticians Judith

0:33:20 > 0:33:22and Jessica, both of whom have played a key role

0:33:22 > 0:33:25in the developing the all-Wales menu.

0:33:26 > 0:33:30We've got a number of recipes being implemented across Wales with

0:33:30 > 0:33:33the standardised recipe and analysis that meets our standards.

0:33:33 > 0:33:36- But it's still in progression. - And how's the feedback been?

0:33:36 > 0:33:39It's been great having some of the signature dishes from last

0:33:39 > 0:33:40year's programme.

0:33:40 > 0:33:43We had some James Martin soups and they've all gone down really well.

0:33:43 > 0:33:46- We tried your lamb pie recipe. - How was that?

0:33:46 > 0:33:47Yeah, it was very good.

0:33:47 > 0:33:50We need to tweak it a little bit in terms of the herbs.

0:33:50 > 0:33:53It's quite difficult to use certain things like fresh bay leaves

0:33:53 > 0:33:55and then remove it when you're doing mass catering.

0:33:55 > 0:33:58- Sure.- Once we finally tweak that, we'll be looking at putting

0:33:58 > 0:34:01- that on the framework.- Great. That was all about Welsh lamb, really.

0:34:01 > 0:34:04It was one of those things that it seemed silly not to have Welsh lamb.

0:34:06 > 0:34:09That conundrum is still not totally resolved.

0:34:09 > 0:34:12While local lamb is available for Welsh hospitals to

0:34:12 > 0:34:15buy from their approved suppliers, the cost of it is still

0:34:15 > 0:34:19around £3 more expensive per kilo than overseas alternatives.

0:34:20 > 0:34:23If I was a cash-strapped Welsh hospital chef,

0:34:23 > 0:34:25I know exactly which choice I'd be making.

0:34:26 > 0:34:28And although that's frustrating,

0:34:28 > 0:34:32the rules on how a hospital sources its food, means simply

0:34:32 > 0:34:36switching to a cheaper supplier isn't always straightforward.

0:34:36 > 0:34:41How much of an issue for contract selection process is local produce?

0:34:41 > 0:34:43Is that something that you're thinking about?

0:34:43 > 0:34:46With the EU legislation, we can't favour somebody

0:34:46 > 0:34:50because they're local but what we're trying to do is work with

0:34:50 > 0:34:55local farmers to explain to them the NHS tendering process,

0:34:55 > 0:34:59so then they can be in a best position to bid for the contracts.

0:34:59 > 0:35:01They're in with a shout, then? They have an opportunity?

0:35:01 > 0:35:04I mean that's what we're hoping. That they'll be in the best position

0:35:04 > 0:35:07and they'll be able to submit the best product.

0:35:08 > 0:35:12It sounds like steady progress is being made on the all-Wales menu

0:35:12 > 0:35:15and it's great that they've kept faith with the dishes

0:35:15 > 0:35:16we came up with.

0:35:16 > 0:35:19But for Stephen, that's still not quite enough!

0:35:19 > 0:35:24My wish is to get a Welsh lamb dish, you know, on the Wales food network.

0:35:24 > 0:35:27It looks like if I want to move this issue forward, I need to go

0:35:27 > 0:35:29back to the Welsh Assembly.

0:35:29 > 0:35:33I've asked the new Health Minister, a guy called Mark Drakeford,

0:35:33 > 0:35:37for an interview and this is the response, which is very much

0:35:37 > 0:35:39a political response.

0:35:39 > 0:35:43"I thank you for the progress update on the all-Wales patient menu.

0:35:43 > 0:35:46"Unfortunately, the Minister has declined to be interviewed.

0:35:46 > 0:35:48"The Minister has asked me to pass on his thanks for your interest

0:35:48 > 0:35:51"in what we're doing in Wales and all the best for the next series."

0:35:51 > 0:35:58So, in terms of a response, that's a firmly closed door, I think,

0:35:58 > 0:36:03and which is the story, to be honest, of the NHS as a whole.

0:36:03 > 0:36:06You know, you almost go one step forward in hospital

0:36:06 > 0:36:07and five steps backwards

0:36:07 > 0:36:11when you're trying to meet with people who make decisions happen.

0:36:11 > 0:36:13And this is the problem that I'm having.

0:36:13 > 0:36:16Nobody from the Welsh Government wants to speak to me.

0:36:16 > 0:36:18When you're getting doors shut in front of you,

0:36:18 > 0:36:22you can't do a lot more than doing what you're doing.

0:36:22 > 0:36:26But if there's one thing I've learnt from trying to improve hospital

0:36:26 > 0:36:28food, it's that while disappointments along the way

0:36:28 > 0:36:30might be inevitable,

0:36:30 > 0:36:33there are still plenty of issues on which I can make a difference.

0:36:33 > 0:36:37- Nice to meet you.- Hiya, you all right?- Good to see you.

0:36:37 > 0:36:40Recently, I was invited to the Chesterfield Royal Hospital

0:36:40 > 0:36:43to hear about an initiative their Head of Retail, Kim, has come

0:36:43 > 0:36:47up with to give patients some help with their food immediately

0:36:47 > 0:36:50after they've been discharged.

0:36:50 > 0:36:54- We want to provide some kind of grocery pack.- Yeah.

0:36:54 > 0:36:58The basics, you know, things that they can be discharged with

0:36:58 > 0:36:59at a reasonable price.

0:37:01 > 0:37:05This idea to extend food service beyond the hospital was

0:37:05 > 0:37:08welcomed by the patients I talked to on the wards.

0:37:08 > 0:37:12If you've got something sort of just bits of staples to go with,

0:37:12 > 0:37:16then, you know, you'd be on a winner straightaway.

0:37:17 > 0:37:20My contribution to Kim's idea was to come up with

0:37:20 > 0:37:25suggestions for the essential items that would be included in the bags.

0:37:25 > 0:37:28It's got to be bread. It's got to be eggs.

0:37:28 > 0:37:29It's got to be milk.

0:37:29 > 0:37:30Yeah. Absolutely. Yeah.

0:37:33 > 0:37:34With only a short time

0:37:34 > 0:37:37until I return to Chesterfield to launch the service, Kim is meeting

0:37:37 > 0:37:42with Discharge Lounge Sister, Susan, to see what she makes of our plans.

0:37:42 > 0:37:45Myself and James just got a list together of the things

0:37:45 > 0:37:46that we thought.

0:37:46 > 0:37:48OK. I don't know.

0:37:48 > 0:37:50There's quite a lot on there that I don't think

0:37:50 > 0:37:53- patients are really going to manage with.- Really, what like?

0:37:53 > 0:37:57You're expecting quite elderly people to be able to open the cans.

0:37:57 > 0:38:00Most of the time, the patients I'm sending home would just want

0:38:00 > 0:38:04the milk to make a cup of tea, perhaps the bread

0:38:04 > 0:38:07and the cheese, so they can make themselves a sandwich.

0:38:07 > 0:38:10It shocked me, actually, because I would automatically think

0:38:10 > 0:38:12when you're poorly, tin of soup.

0:38:12 > 0:38:15Yeah, that's because you're young and you can just open the can.

0:38:15 > 0:38:17- Keep telling me that!- You're young!

0:38:17 > 0:38:21- All right, Lillian?- Yeah. - How's that cake?- It's lovely.

0:38:21 > 0:38:24- Is it nice?- I'm enjoying it. - Are you enjoying it?- Yeah.

0:38:24 > 0:38:28Susan may think our home food bag needs a few tweaks,

0:38:28 > 0:38:32but she's in no doubt that this is an idea with obvious merits.

0:38:32 > 0:38:35I think the service is so important.

0:38:35 > 0:38:38It can potentially prevent readmission into hospital

0:38:38 > 0:38:40for more vulnerable, frightened patients.

0:38:40 > 0:38:42They may go home and feel less inclined to

0:38:42 > 0:38:45ring for an ambulance because they're frightened.

0:38:45 > 0:38:47They know they're supported in their own home.

0:38:47 > 0:38:49They have got nutrition for the next few days

0:38:49 > 0:38:51and an ongoing support service.

0:38:51 > 0:38:54And with Susan's input, Kim can now rethink

0:38:54 > 0:38:57the contents of our bag to better reflect what a discharged

0:38:57 > 0:39:01patient might need after leaving hospital.

0:39:01 > 0:39:05I was looking at it from a young, fit person.

0:39:05 > 0:39:09So, semi-skimmed milk, brown bread, fruit, and I was told that

0:39:09 > 0:39:16the older people prefer full fat milk, white bread, full fat cheese.

0:39:16 > 0:39:20That kind of thing, so that was the main stumbling block.

0:39:20 > 0:39:22The new system will be a reduced bag.

0:39:22 > 0:39:25They can buy the pack at a discounted rate.

0:39:25 > 0:39:30If they wanted any other items then the Discharge Lounge

0:39:30 > 0:39:34and the Red Cross could facilitate that, using the shop at the Royal.

0:39:37 > 0:39:40The British Red Cross has had its own scheme to help newly

0:39:40 > 0:39:43discharged patients get the essentials they need.

0:39:43 > 0:39:46But working more closely with the hospital on a combined system

0:39:46 > 0:39:50will lead to a more streamlined and efficient service.

0:39:50 > 0:39:52- Hi!- Anything for the Red Cross today?

0:39:52 > 0:39:54Yes, I've got this young lady that's gone home.

0:39:54 > 0:39:58She's going to need a hand with her shopping for the next few weeks

0:39:58 > 0:40:00while she recovers from her surgery.

0:40:00 > 0:40:02Red Cross Service Manager, Chris,

0:40:02 > 0:40:05has seen first-hand how more vulnerable patients need help

0:40:05 > 0:40:08with their food when they first leave hospital.

0:40:08 > 0:40:11In the first few days, people have a real problem

0:40:11 > 0:40:13because they've lost probably everything that was

0:40:13 > 0:40:16perishable in their fridge and they've got to get things going

0:40:16 > 0:40:20and they don't need feeding up, they just need the basics.

0:40:20 > 0:40:25Once they can get those things, then things start working out after that.

0:40:25 > 0:40:28Susan and Chris believe the home food bags offer a great

0:40:28 > 0:40:31opportunity for teamwork across the hospital, with a real

0:40:31 > 0:40:35benefit for the more vulnerable patients in the Discharge Lounge.

0:40:35 > 0:40:38If we can work collaboratively with the shop at the front

0:40:38 > 0:40:40of the hospital, then the Red Cross could even visit

0:40:40 > 0:40:43the patients on a weekly basis and work closely with them to

0:40:43 > 0:40:47check that they are safe at home and are getting the nutrition they need.

0:40:47 > 0:40:49I'm quite excited about this project.

0:40:49 > 0:40:53For people who don't have very solid support networks, it could be

0:40:53 > 0:40:56the difference between them staying at home or going back

0:40:56 > 0:40:57into hospital again.

0:40:57 > 0:41:00The more people that we've spoke to love the idea,

0:41:00 > 0:41:05love the service, something so simple and nobody can understand

0:41:05 > 0:41:09why it's never been done before, which is crazy really, isn't it?

0:41:09 > 0:41:11But there's still plenty to be sorted yet for

0:41:11 > 0:41:14when I return for the launch.

0:41:14 > 0:41:17We've got to get the bags back from the printers.

0:41:17 > 0:41:22We've got to get the leaflets back from the printers.

0:41:22 > 0:41:25Really nervous, but I think it'll go well.

0:41:25 > 0:41:27I hope it'll go well.

0:41:28 > 0:41:31While Kim races to get things ready to be rolled out

0:41:31 > 0:41:35in Chesterfield, her idea is another that I'm making sure

0:41:35 > 0:41:38goes on my website so it can be adopted by other hospitals too.

0:41:43 > 0:41:46Seeing the success of initiatives and improvements at all

0:41:46 > 0:41:50the individual hospitals I've been to, is hugely satisfying.

0:41:50 > 0:41:53But it's time now to make a bigger impact.

0:41:53 > 0:41:56I think massive things can come because of this.

0:41:56 > 0:41:59With the blueprint I've laid out on my website, I want to

0:41:59 > 0:42:03bring about change across the entire hospital catering industry.

0:42:05 > 0:42:07And to unveil what I've put together,

0:42:07 > 0:42:10I'm organising a big launch event in London and invited

0:42:10 > 0:42:15representatives from as many hospitals as are willing to come.

0:42:15 > 0:42:18Boys, come on! Fudge, come on!

0:42:18 > 0:42:20As the day of that approaches, my nerves are mounting

0:42:20 > 0:42:24but I'm more determined than ever to make a difference.

0:42:24 > 0:42:27I'm massively passionate about food in hospitals

0:42:27 > 0:42:29and have been for so many years.

0:42:29 > 0:42:31That's why I got involved in this project.

0:42:31 > 0:42:35It is possible to implement change within the NHS.

0:42:35 > 0:42:36It's going to be gradual.

0:42:36 > 0:42:38It's going to be slow and it's going to be painful,

0:42:38 > 0:42:40but change can be achieved.

0:42:40 > 0:42:45And above all else, you can do it on budget, save money, save massive

0:42:45 > 0:42:50amounts of waste and improve the hospital and patient's experience.

0:42:50 > 0:42:52Well, that's what I believe.

0:42:52 > 0:42:55Now, I just need to convince the rest of the industry.

0:42:57 > 0:42:59Next time... I'm back in Chesterfield

0:42:59 > 0:43:03to help launch the hospital's home food bag service.

0:43:03 > 0:43:06- Should we get you home? - Yeah, please.

0:43:06 > 0:43:10There's a surprise for Andy at the Princess Alexandra.

0:43:10 > 0:43:12What this? A guard of honour?

0:43:13 > 0:43:15I said she'd stitch me up.

0:43:17 > 0:43:20And as I get ready to launch my ideas for change to more

0:43:20 > 0:43:23hospitals than ever, the pressure begins to mount.

0:43:25 > 0:43:27Proper nervous. But here goes.