The NHS catering system has faced significant challenges, but it has also presented opportunities for transformation, as highlighted by Julian Fris of Neller Davies in his recent presentation at Food Week. Drawing on decades of experience in food service and facilities management, particularly within the NHS, Fris outlined systemic issues and proposed innovative solutions to improve both patient nutrition and staff catering.
The perception of catering within the NHS has been a fundamental issue. Often regarded as a mere obligation or sunk cost, the focus has typically shifted towards cutting expenses at the expense of quality. Procurement processes have exacerbated the problem by over-commoditising solutions, leading to standardised approaches that failed to meet the nuanced needs of patients and staff. This race to the bottom has resulted in inefficiencies, poor food quality and substantial waste – up to 39% of food served in hospitals went uneaten as identified in the Hospital Food review conducted by Prue Leith and Phil Shelley from NHS England.
Staffing poses another significant challenge. Restrictive pay scales made it difficult to attract and retain skilled chefs, particularly when opportunities in commercial catering offer better remuneration and working conditions. Engagement among catering staff is alarmingly low, further hindering productivity and service delivery. Compounding this are infrastructural issues, with outdated facilities and limited investment restricting the ability to implement modern, efficient catering practices. Hospitals in England alone faced a £14 billion maintenance backlog in 2023, leaving little room for proactive improvements.
Policy inconsistencies and process inefficiencies further undermined the system. Unlike schools, which benefited from clearer national guidelines, NHS catering policies varied significantly across Trusts, leading to fragmented practices. Public procurement rules often prioritised cost savings over strategic outcomes, creating transactional relationships with suppliers that hindered innovation and adaptability. The lack of standardised policies also meant that many catering operations failed to achieve consistent quality, despite the availability of good-quality fresh ingredients.
Against this backdrop, Fris proposed a series of solutions to overhaul NHS catering. Central to his vision was a collaborative approach that involved all stakeholders – clinicians, dietitians, caterers and patients -working together to achieve shared goals. Drawing on models such as Vested outsourcing, he advocated for win-win partnerships that fostered innovation, improved service quality, and delivered mutual benefits for suppliers and the NHS.
One promising concept is the adoption of patient-centred room service models, as seen in the United States and the Netherlands. These systems allowed patients to order meals tailored to their dietary needs with food delivered promptly, reducing waste and enhancing satisfaction. Complementing this was the need to shift the focus from outputs, such as the number of meals served, to outcomes, such as improved patient recovery rates and staff engagement.
Improving the food culture within the NHS was another priority. Fris called for greater emphasis on education, accessibility and the celebration of culinary diversity. By introducing healthier options, reducing reliance on convenience foods and making high-quality meals more affordable, both patients and staff could benefit from enhanced dining experiences. Successful examples included Ashford & St. Peter’s Hospital, which implemented a business-and-industry-style catering model that increased revenues, reduced subsidies, and won multiple awards. Similarly, Western Sussex Hospitals introduced a centralised production kitchen that optimised processes, reduced waste and improved food quality.
A white paper, scheduled for release in early 2025, is expected to offer comprehensive insights into NHS catering, drawing on extensive research to propose actionable recommendations. By prioritising collaboration, innovation and outcome-focused strategies, Fris envisioned a future where NHS catering not only met but exceeded the needs of patients and staff transforming perceptions and delivering lasting value.
