Rest Unassured? Medirest

With budgets up and down the country being tightened and squeezed it was inevitable that the NHS would have to take on some of the burden. Unfortunately the NHS can’t simply pick the basics custard creams at the superstore instead of the more expensive ‘Taste the Difference’  Heart Surgery. It can however apply this concept to the food it buys in. But in a space where you are supposed to be given the best shot at recovery from serious illness is removing quality from meals that have a bad reputation already the right place to make the cuts?

In 2011/12 the average money spent on patients meals per day rose by 2% to £8.58 but over the last 4 years since 2008/09 has risen by 27% when the average was just £6.71 for all the food and drink an in patient receives during a single day.

This blog has been focused on Southampton General’s catering so far. This trust (Southampton University Hospital) increased its average spending on patient meals per fay from £7.69 in 08/09 to £11.11 11/12, both above the average for that year [foot] Full data sheets available from the Department of Health website [/foot] . However these figures are somewhat deceiving as they push all the different diets into one big mesh. Southampton has a nationally renowned Nutrition team and has for many years been able to give Nutritional support to complex cases that other hospitals are simply not able to offer. However the dieticians at the hospital are quite happy to tell patients how unhappy they are with the catering situation there.

Medirest, which provide all the catering on site – including the retail franchises (Including Burger King, Costa Coffee and To Jours) – have served their Steamplicity menu to patients on a standard diet since December 2011. The menu is designed to offer choice, it has 28 different options available every day. They are picked by the patient every morning for that days Lunch and Dinner. However what most don’t realise is all Steamplicity meals are prepared off site and brought up to the ward to be cooked by a series of Microwaves in the ward ‘Kitchen’ [foot]Kitchen By name only, Microwaves, Hot water tap and a Dishwasher are all that fill the room[/foot]. One of the key benefits that this menu offers Hospitals is to ‘Save you Money’. This has clearly been an appetising prospect with 50 trusts now signed up to the service.

A large part of the money saved is the decrease in wastage a Steamplicity menu offers. Southampton General has increased its ‘untouched’ meal wastage from 7.8% to 2.4% in the years between 2008 to 2012. However its very difficult to completely account for this and having stayed in a Steamplicity hospital and seen hundreds of meals served, if they could account for the “barely” or part touched meals the percentage would be massively higher. The Steamplicity menu promises so much, but the beautifully presented PR pictures on the menu and website are not close to what is actually served to patients – no wonder after they are prepared elsewhere, transported in lorries and taken up to the wards on bumpy carts. Here is the Poached Salmon I was served, with freshly cooked carbs for my IFD [foot] Intestinal Failure Diet, See other posts for explanation on why I need this particular diet [/foot]

2013-01-20 13.12.26 Screen shot 2013-04-13 at 7.57.47 PM

Displayed with an excerpt from the pictorial menu so you can see the difference in promise and delivery. And if you want to see how, indeed, if it differs at Barnet hospital check out Penelope’s Pantry: Operation Hospital Food

Southampton was recently named as one of the 17 hospitals in the country that is dangerously understaffed. Having been in and out for the best part of three years, its fair to say this is true with a noticeable change in staff number in just the time I’ve been an inpatient. This makes it very difficult for both the staff and patients to question their food quality, it’s hardly high on the agenda when you have to wait so long for actual medical attention. Some people might argue that this is even more reason to squeeze the food budget, in order for it to deliver money for staff. Indeed this is exactly what Medirest’s Steamplicity promises. They say “significant annualized labour savings have been achieved, ranging up to £345,000 pa” at Trusts that use Steamplicity, but that money hasn’t been fed back into staff numbers, and as the blog as shown so far it hasn’t improved the specialized diets or delivered what it promises on the ‘A La Carte’ hospital food menu.

I Got Bored Quick

Even if it was the menu from my Favorite restaurant having to pick from the same 10 meals for two meals a day is going to get quite boring quite quick. Especially delivered to you in this state:

Lets start with the Curry. Everyone out there knows that acidic tomato based meals (Think baked beans for the extreme of this) cause more gasses and bloating than others. So for someone with a tummy whose intestine has failed enough to put them on the Intestinal Failure diet, could do with avoiding any extra pain and uncomfort than what they suffer with anyway. So to order a Cream based Curry and be confronted with tomatoes causes more than a bit of heart burn. With the rest of the menu being things like Bolognaise & Shepard’s Pie, having a creamy curry should be some rest bite to the nasty acid. Alas.

The Sausage & Mash? Not very exciting. True. But as my Dietician said how do you make this look exciting and appetising? Its not easy. False.

Tesco Suasage and Mash(Credit to Tesco Real Foods)

This meal is exactly the same, Two Sausages and Mash. But the quality and appetizing appeal of it is massively different. Admittedly I hadn’t added my mug of gravy to the meal before I took the picture – but I’m sure you can agree why I didn’t jump straight it. The irony of the sausages I was provided was the poor quality of them too; My dietician was more than specific and explicit if you must eat processed meats like Sausages, make sure they are good quality, high in percentage of meat. The rusk and cereal in cheap sausages may cause you bloating. I can assure you – those sausages weren’t even of Little Chef breakfast style quality.

Which brings me to my final meal, a plate of cold soggy (In a overtly plain white sauce) carbs. Pasta is usually a big safe meal for me, carbohydrates are easy for any tummy to break down. However this is only true when they are freshly cooked. When the starch in Carbohydrates is cooked, it changes making it easy to digest, but it then changes again when it cools and becomes difficult for any tummy to digest. This is the predominant reason for me being on the IFD menu, because I really struggle with re-heated and cold carbs. The normal menu Medirest provides people at Southampton has around 40 meal options, but all are created off site, frozen and nuked on the ward for consumption. All of my carbs in particular needed to be freshly cooked and delivered to me hot in order for me to be able to eat and not have to deal with painful trapped wind for the following hours. I’ve now been in four days, and I’m yet to be served a meal that is freshly hot or hasn’t been re-heated.

The Dietician will be back tomorrow and I’ve kicked off to the ward staff who have arranged for someone from the kitchen to come see me too. Lets see if they can do anything to get me something hot?

And for those of you wondering why not just order a Sandwich? Check back at breakfast…

The History

Southampton Hospital

In and out of Hospital for nearly 3 years and had some pretty serious surgery over the time. Born with a 1 in a million anomaly that allowed my bowel to twist leading to much of it being taken away and a few days being lost to operations and general anesthetics.

With 7 major operations, somewhere under 30 minor ops, and enough radiation from scans to cook a ready meal (or two) under my belt before the age of 21, its been a bit rough. The worst bit? Not eating for a year and a half! I relied on intravenous[foot]Intravenous therapy or IV therapy is the infusion of liquid substances directly into a vein. The word intravenous simply means “within a vein“. – Wikipedia[/foot] parenteral nutrition [foot] Parenteral nutrition (PN) is feeding a person intravenously, bypassing the usual process of eating and digestion. The person receives nutritional formulae that contain nutrients such as glucose, amino acids, lipids and added vitamins and dietary minerals. It is called total parenteral nutrition (TPN) or total nutrient admixture (TNA) when no significant nutrition is obtained by other routes – Wikipedia [/foot] for the best part of a year and a half and was not able to absorb food or drink. During that time the only way to get in touch with food, was to cook: I did this for my family every meal time, that I had the energy to do so, so that when I could eat again I could eat well.

Southampton HospitalAs I’m sure you’re already aware, Hospital food is more Michelin wheels than stars in style, and that’s Michelin wheels that have a massive puncture. Now its not all bad – the first meal I had, Chicken with white rice and white sauce tasted just fine. But, anything is going to taste good after nothing for a year and a half. The problems I’ll refer to in this blog centre largely around my most recent hospital stay at Southampton General University Hospital – A hospital I was sent to (away from my home town) for its specialist Nutrition team and capabilities. And let us be clear, the Doctors and my team looking after me have been Fab! Its the food I have the BEEF with – If you’ll pardon the pun.

My most recent stay I was on the Intestinal Failure Diet, created especially for people like me, whose intestines have failed. And for the record, not just a little bit, you could say #EpicFails to coin a twitter term. Hopefully this blog will encourage the ongoing, but largely under the radar, discourse on how poor hospital food is to come into the LIME light. If you have experiences similar or at the completely the other end of the spectrum, why not share them? – Submit pictures and articles of your experiences anytime below. We’re not just looking for food at Southampton either, anywhere in the NHS is appropriate – Southampton is not the only place with problems with their meals.
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