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Hospital food and

beverage services
Food
Beverages
Food service

 Menu planning
 The Food Chain

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Menu planning

 An inclusive process
 Requires in depth knowledge of
the needs of the patient
 Menu requires structure
 Menu requires content
 Menu is complemented with non
-meal food and beverage servic
es
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An inclusive process
 Nutritional value of food not eaten is nil
 Need to involve the consumer at the
planning stage
 Need to involve the producer and make
sure that plans can be delivered
 Need to include service staff to engender a
pride in the product
 Need to check nutritional content and menu
capacity
 Need to check cost and affordability

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In depth knowledge of the
needs of the patient
 Age and gender
 Ethnicity
 Food preferences
 State of health
 State of dentition
 Mental health

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Menu requires structure

 How many meals per day?


 How much choice on offer?
 Range of accompaniments etc
etc

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Menu requires content
 What is the most  How will specification
suitable range of be met?
dishes?  Standard recipes
 What specification of  Standards of
dishes? procurement
 What is the most  Menu testing
suitable portion size?  Feedback from
 What is the nutritional patients
specification?  Feedback from staff
 What are the  Nutritional capacity
ingredients
testing
specifications?
 What are the cost
 Nutritional analysis of
specifications? menu
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Menu is complemented with non-meal
food and beverage services
 Ward issues of:
 Milk, breakfast cereals, bread, butter, sugar,
preserves, tea, coffee etc
 Suitable items for between meal snacks
 Supplements

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The Food Chain

 Patient orders food


 Food order communicated to kitchen

 Provisions procured
 Provisions delivered and receipted
 Provisions stored
 Food produced
 Food distributed
 Food served
 Food intake monitored and appropriate acti
on taken
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Patient orders food

 Ordered at time of service


 Ordered using menu card
 Ordered using hand held device
 Ordered using bedside terminal

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Food order communicated to the
kitchen
 Ward order predicted by forecasting
 Card collated at ward level
 Card collated centrally
 Hand held linked on ward or centrally
 Bedside terminal linked by ward or centrally
 Systems can be linked to nutritional
databases

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Provisions procured

 Ingredients and product specification need


to be determined
 PASA system provides data
 PASA manages specification of NHS
contracts
 GM free
 Compliance with salt model
 Allergen information
 Nutrition information available

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Provisions delivered and receipted

 Availability is critical to success


 Critical control point with regard to hygiene
and cost control
 Food bill in typical 1000 bed hospital
c£1.5M per annum
 C£4,100 per day of perishable goods
delivered

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Provisions stored

 Responsibility for food safety begins with


delivery
 Food poisoning killed 19 people in
Wakefield 1985
 Poor storage adversely affects nutritional
content
 EHO enforces food hygiene regulations

 EHO can shut kitchen down with immediate


effect
 Breach of regulations can lead to
prosecution
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Food produced

 Standard recipes are vital:


 Nutritional quality control
 Cost control
 Quality assurance

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Food distributed

 Any hospital with more than 300 beds will


need to consider distribution technology
 Cook chill
 Cook freeze
 Sous vide
 All distribution technology requires
regeneration at ward level

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Food served

 Protected mealtimes
 Essence of care – food and nutrition benchmark
 HCA food service at ward level
 Ward prepared for the meal
 Patients prepared for the meal
 Right meal to the right patient
 Appropriate equipment available
 Appropriate assistance available and planned for
 Arrangements in place for last minute changes

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Food intake monitored and appropriate
action taken
 Responsible Registered nurse must be
aware of patients intake
 Systems in place to record food intake for
vulnerable patients
 Systems in place to record missed meals
 Systems in place to trigger action when
food intake deemed inadequate
 Regular communications with dietitian and
clinical team about food intake

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