I am a big fan of Prue Leith, 79, pictured, and have no doubt her knowledge of souffles and fondants is unsurpassed, I’m not sure if the same can be said of her medical experience
I am not alone, I’m fairly sure, in being mildly obsessed with The Great British Bake Off. I can name just about every past winner, and – I know this is controversial – I’m a big fan of the new team, especially Prue Leith. That vaguely sarcastic smile. The Brains-from-Thunderbirds specs and permanently quizzical look. I love them both almost as much as I loved Mary Berry’s soggy bottom and Paul Hollywood’s… well, I don’t really love you, Paul. Sorry.
Prue, 79, the founder of Michelin-starred restaurant Leith’s and author of numerous recipe books, is great television. But I wasn’t the only one slightly surprised by the news that she has been made ‘star’ adviser to a Government review of NHS food standards. While I have no doubt her knowledge of souffles and fondants is unsurpassed, I’m not sure if the same can be said of her medical expertise.
Prue will be assisting the review’s chairman Phil Shelley, who previously led the Hospital Catering Association, as they look at ways to boost the number of hospitals with their own kitchens and cut the reliance on frozen food. Also tasked with the reinvigoration of hospital grub is Henry Dimbleby, co-founder of Leon, an upmarket fast-food chain.
But their appointments seem odd given their lack of experience with patients. As Catherine Collins, a dietician with more than 30 years’ experience working in British hospitals, explains: ‘Hospital patients have very specific needs which can be entirely different from the general population.
‘To feed sick people, we need qualified experts with experience and understanding of the complexities of thousands of different medical conditions.’ I couldn’t agree more. But is Prue that person?
140 million meals a year… but many of them go untouched
The NHS serves 140 million meals a year but research suggests 80,000 of these go untouched every day – and one in three patients is at risk of malnutrition. In a recent article, Prue was scathing about the quality of hospital food. ‘Disgusting-looking, flavourless and a national disgrace,’ she said. But according to a report by the British Dietetic Association, an unappetising meal is only part of the problem. Lack of staff assistance, poor appetite due to medication, changing preferences and hefty portion sizes are often more important.
There is no denying that in some hospitals Prue is right about the standards. There is also a concern about the supply chain of bought-in ingredients, after six patients died having contracted bacterial infection listeria from sandwiches purchased in hospital shops.
The NHS serves 140 million meals a year but some 80,000 of them go untouched by patients
But will home-cooked, appetising meals made with fresh ingredients get patients eating more, and recovering faster, as Prue claimed? According to dietician Cherry Hagger, who has worked on NHS wards over the past six years, the answer may not be so simple. She says: ‘For some patients eating can be painful, or they don’t have much of an appetite. Some lack dexterity, so negotiating cutlery is tricky. The crucial thing is having staff to help them eat.’
And in the vast majority of hospitals, with staff already stretched, this isn’t possible. The Government introduced the ‘Red Tray System’ 20 years ago – an initiative to make sure patients in need of assistance are assigned a specialist staff member at their bedside every mealtime.
‘But hospitals now rely on volunteers because there aren’t enough nurses,’ says Hagger.
And what about letting patients choose what they fancy, then having it cooked fresh, as Prue suggests?
Collins says: ‘Many change their mind when it comes to lunchtime because they’ve started on a different medication, or come back from a procedure and they have lost their appetite. That’s when a lot of food is thrown away.’
For this reason, pre-packaged meals such as sandwiches are seen as essential.
Collins says: ‘We need to have meals ready to go whenever a patient wants them. Sick patients often don’t like the smell of hot or fresh food. They need something cold with a boost of calories.’
Eating greens thanks to a colourful plate
‘A cloche, watery, grey mass,’ is how Prue described the meal given to her 90-year-old mother during a stay in a North London hospital. Other patients, she said, had been given food that was ‘dangerous for their health’.
This may be the experience for some and it is unacceptable. But is it the case for most? I’ve recently come across examples of outstanding food in British hospitals.
Nottingham’s Queen’s Medical Centre has reduced food waste. Cancer wards at London’s Great Ormond Street Hospital and Cambridge University Hospitals trust have developed recipes for cancer patients with dulled taste buds.
Barts in London offers tasting sessions for patients, and I’m told the Robert Jones and Agnes Hunt Orthopedic Hospital in Shropshire does the fluffiest jacket potatoes.
Each NHS trust decides how much it spends on food – this varies from £3 to £12 per person
Collins says: ‘Caterers, with the help of dieticians, are doing amazing things with limited resources. In order for patients to eat something, they have to enjoy it.’
In fact, in a study of two South London hospitals, only a fifth of patients said the food served wasn’t to their taste. So how do these hospitals achieve this?
‘Some of it is to do with space,’ says Andy Jones, a hospital caterer who has headed NHS food services for almost 40 years. ‘Creating kitchens means using up valuable clinic space.’
The bottom line? Money. Each NHS trust decides how much it spends on food – this varies from £3 to £12 per person. ‘Even adding a yogurt at 4p can add an extra £200,000 to the annual bill,’ says Collins. But there are some simple fixes that can make the world of difference. Jones says: ‘Presentation is key. Often caterers don’t think about how they dish up food, leaving it in a mess by the time it reaches the patient.’
Studies show that serving food on colourful plates can increase intake by 25 per cent.
It is still unclear how much cash the Government has set aside for this makeover. But it’s going to cost. As for Prue, I’m sure her advice is well-meaning. But I wish she’d stick to what she does best: being a judge on Bake Off.
A nutritionist contacted me last week, traumatised by threatening messages she has received from ‘vegan activists’.
Her crime? She wrote an article in the British Medical Journal on the importance of choline, a mineral found primarily in beef and eggs. Choline deficiency in pregnant women has been linked to brain damage in unborn babies. Within days, a video was uploaded on YouTube to shame her, and she’d received a swarm of angry emails.
I’ve faced similar vitriol for writing about the number of eating disorder patients I’ve met who turn to exclusion diets, such as veganism.
Of course, it is a good thing that social media allows us to debate the science. But if you have to resort to trolling, you’ve lost the argument.