NHS Tayside outline to MSP action to be taken to improve the standard of its hospital food.

10 May 2010

Marlyn Glen has been informed by NHS Tayside of the action it is taking to ensure that the quality of food in its hospitals complies more fully with national nutritional standards.

She had written to NHS Tayside on the results of the recent survey of the standard of food in hospital – the National Catering and Nutritional Services Specification report published by Health Facilities Scotland.

 The survey indicated that NHS Tayside had the lowest score out of all of Scotland’s health boards with a compliance rate of 72.6 per cent over a range of criteria that were investigated.

 The overall Scottish compliance figure was 87 per cent.

Ms. Glen said, " I asked the health board why its results compared unfavourably with other health board areas in Scotland.

 " I asked as well how it intends to raise standards , in particular in the categories "Nutritional needs of the population" and " Therapeutic diet provision" where the performance was rated as below 50 per cent.
"Good, balanced, nutritious food is an important part of patient care in hospital." 

In a letter to Ms. Glen , the health board detailed both the reasons for the below 50 per cent scores in each category and NHS Tayside’s intended action to improve the standard of compliance with NHS Scotland Catering specifications for its hospital food. (the text of the letter is below)

In response to the letter of NHS Tayside’s reply, Ms. Glen said,

" I welcome this assurance from NHS Tayside that it is taking action on the findings of the report

" Diet has a significant impact on the recovery of patients, particularly amongst the elderly, and so it is essential to improve nutritional standards in hospitals to meet national criteria."


The text of the NHS Tayside’s response is given below :

Nutritional needs of the population

"NHS Tayside is at 45.5 per cent for this element of the self assessment of the package for two reasons.


"Due to the limitations of the current nutritional analysis package used in NHS Tayside the menus are unable to be analysed with accuracy to ensure that they meet the nutrient standards within the specification.

"Since 2003, approximately 800 NHS Tayside recipes have been nutritionally analysed but the current software package does not enable the analysis of cooked dishes from raw ingredients i.e. the package does not allow for adjustments to due to "cooking losses.", and therefore this will affect the calculated nutritional value of the cooked dish for both macro and micronutrients.

"The NHS Scotland specifications were published in 2008 and this provided very specific and extensive standards in relation to the nutritional analysis of recipes and menus that are beyond what our nutritional analysis software can now fulfil.

"Action to be taken : NHS Tayside is an "early adopter" of the forthcoming national Nutritional Database which is due for roll out in June 2010 with full implementation to other territorial boards by September 2010.

"This database will enable comprehensive analysis of recipes and menus."


"NHS Tayside is involved in rolling out the national Clinical Quality Indicators (CQIs) programme across hospital wards and includes a nutritional CQI.

"CQIs support senior charge nurses in delivering improvements in the quality of processes and outcomes of care in their areas by providing real-time reports and data to support where they are doing well and highlight areas that require further work.

"At this time not all wards in NHS Tayside have rolled out the CQIs.

"Action to be taken : The deadline for full implementation of the CQI programme nationally is December 2010 and NHS Tayside is already working towards this target.

Therapeutic Diet Provision

"NHS Tayside is at 42.7 per cent for this element of the self assessment for the following reason :

"Again, due to the limitations of the current nutritional analysis package, the menus are unable to be analysed with accuracy to ensure that they meet the nutrient standards within the specification which includes therapeutic diets.

" Action to be taken : The national Nutritional Database , due in June 2010, will assist NHS Tayside in having approved recipes for therapeutic diets and in ensuring that the menus meet the nutritional requirements of patients.

"Since the last self-assessment locality menu planning groups across NHS Tayside have developed protocols for the provision of therapeutic diets and provide further training to staff.

"The NHS Scotland National Catering and Nutritional Services Specification : Half Yearly compliance report provides self assessment data on compliance with the requirements set out in the NHS Scotland Food in Hospitals National Catering and Nutrition specification for food and fluid in hospitals in Scotland in 2008.

"Compliance is measured by self-assessment using a standardised monitoring template and it is important to note that the process has not yet been subject to external verification/audit.

" However since the introduction of the Health Facilities Scotland Self Monitoring Tool in late 2008, NHS Tayside has established robust systems to undertake the required self assessment.

"As part of this process, one senior registered dietician in NHS Tayside acts as a moderator and reviews the submission before it is submitted to Health Facilities Scotland ,and anything that is not evidenced is downgraded.

" As such NHS Tayside has a very rigorous system of review before it is submitted to Health Facilities Scotland and therefore although the organisation may be considered as being too hard on itself, it can nevertheless guarantee that the information that is submitted is accurate, factual and evidenced.

" As a result of this process NHS Tayside also has a well established and dynamic system to ensure a continuous improvement approach in its provision of nutritional care and catering services to inpatients across 20 hospitals."



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