Visiting the belly of the hospital – a shift with the catering team

Luke Blair
By Luke Blair     20/10/2022

The air is thick with the smell of spices. Pots are boiling, clouds of steam rising, sieves and spoons clattering. The chefs are busy preparing lunch.

It’s the hospital kitchen, in the belly of the building, one of the truly vital services here, a service everyone uses. You are what you eat, and nutrition is fundamentally important to recovery.

It follows that quality of diet is important too, though you would not always think it. Hospitals all over the world are constantly criticised for their food. Horror stories abound and the internet is filled with appalling pictures of terrible meals – tiny misshapen items, congealed substances, shrivelled, unidentifiable things patients are meant to eat.

Not here. Most emphatically not here. In fact, the Royal Brompton is so good at food that it not only wins awards, but staff from neighbouring hospitals come here to eat. Why? Why so successful? What’s the key ingredient?

Well, to start with, there is more than one ingredient – more than 1,000 in fact. That, the catering manager tells me, is the minimum number of food products in his store, dried, chilled or frozen. With these, his catering team each month serves over 18,000 meals, using 10,560 pints of milk, 3,600 eggs, 4,320 sandwiches, 720kg of fresh fruit, and 720 loaves of bread.

So one of the obvious ingredients of success is logistical efficiency. With a plethora of quality standards, not just for food freshness and safety but for nutritional value and dietary criteria, catering in hospitals is complicated. There are the different needs of patients who may not be able to eat or digest normal food. Then there are allergies (the entire hospital is nut free), different religious needs (kosher, halal, and so on) and vegetarian variations.

Dietitians are closely involved in determining what should be in each meal on each menu and what each patient should be eating, to best aid their recovery. There are also strict requirements on how much food is wasted meaning that the margins between supply and demand are ever more exacting to get right – even more exacting when so many of the ingredients are, unlike many other hospitals, not frozen or readymade but fresh and perishable.

And what is made fresh centrally here then has to be dispersed across a large, labyrinthine estate of corridors and wards with the temperature of the food being maintained throughout so each portion is just the same as when it left the kitchen.

Every patient has their own catering form, showing what they should eat due to their treatment regime. If they are lucky, this may coincide with what they actually like to eat. And this of course is the other key ingredient to the success of the operation – patient feedback. The catering department manager constantly walks the shop floor – not just the kitchen, canteen and café, but the wards too – and listens. “If they say the pasta is overcooked, we make it more al dente. And then of course people say it’s not easy to chew…”

So it is a constant process of adjustment, to get the food just right, backed by a complex matrix of quality standards and nutritional criteria, delivered by a committed, dedicated team who, in this kitchen at this lunchtime, appear to be happily going about their work with gusto, enthusiasm, and banter. It is Black History Month and some of the staff have dressed in their national costumes, making a vivid splash of colour amid the familiar NHS pastel shades.

I ask to go onto the wards as the department manager does her rounds. The patients are pretty happy. “Not bad at all” is the typical British answer to ‘how good is the food?’ One says she’d missed a bread roll, but the staff went and got one for her. And then we hit the jackpot – someone who has been here for four weeks. “The food is fantastic. I’ve been right round the menu and back again so I can tell you how good it is.”

If I didn’t know my colleagues better, I’d be suspicious of a stitch-up. But it isn’t. The simple fact is that there is a constant feedback loop from patient, to manager, to the team and back to the kitchen. Small changes are made to ingredients, preparation, and cooking, and menus and meals are tweaked accordingly. No wonder they do well.

But there is more to it even than that. With so many meals, so many patients, so many criteria, variations, and comments, there is one more ingredient involved here – real dedication and commitment which, as is so often the case, comes from a personal place.

“My mum was a ward sister,” says the department manager. “Growing up I used to sleep two or three times a week in the hospital and walk around with my mum, so this job reminds me of that. I’ve worked in catering companies and in hotels, but there’s nothing like working in a hospital. There is no comparison for the satisfaction of knowing you are making a difference.”

As with so many of the services in this hospital, the direct line between delivering high quality to patients and the care you feel for them is as important in catering as in any other role. It’s the dietitian who sums it up: “If there is no love put into the food people eat, that makes them heal, then they are not going to get better.”