Birmingham Heartlands and Solihull NHS Trust Meal provision

Martin Cantor at Birmingham Heartlands and Solihull NHS Trust hospital has to provide around 2.7 million meals annually for five hospitals in the Midlands and uses suppliers which operate NHS Purchasing and Supply Agency [PASA] approved.

"Approved" does not mean that the supplier has been inspected but simply complies with "framework agreements" drawn up by PASA which says the tendering process must comply with EU Procurement directives and contribute to the Government's aim for meat from more sustainable sources. PASA has to be careful to guide meat suppliers and hospital food buyers without getting entangled with the minefield of EU competition rules which demand that any preference for home killed supplies which could be considered a way forward in the "sustainability" trail is carefully balanced with a free market for EU partners.

Martin's main meat supplier is Midland Foods of Stourbridge which is running a trial to see if hand cut, diced beef can be supplied locally in attempt to cut food miles and improve quality albeit at a higher price. To Martin, whose meat purchasing is huge, "locally' means home killed beef rather than imported meat from Namibia which is a significant saving in miles.

Fortunately, price is not always the critical factor for Martin, as demonstrated by his substitution of topside with strip-loin. The uniformity of the loins make them less labour-intensive in the cook-chill system where chefs load 40-grid combi ovens for roasting followed by blast chilling before slicing in semi automatic machines. The better portion control with less wastage more than outweighs the higher cost of the loins.

Similarly, pork loins are preferred for their simplicity of cooking, chilling and slicing. Labour costs and butchery skill level are expensive inputs which is one reason why lamb the most complicated of the three meats is bought in ready cooked. The meals are prepared for reheating in regeneration trolleys supplied to the wards. These £4,000 trolleys are simple to operate by staff and have a side fridge for storage and convection oven for semi-automatic heating of prepared dishes.

Martin said: "Another reason for stretching budget to better quality meat is the number of preparation stages required before the meals reaches the patient. The higher the quality at the start the better the chance of good satisfying meals on the ward. After all the twice-a -day meal event is often the highlight for some patients."

He has to justify his selection sometimes when negotiating, meal prices with the four other hospitals he supplies. Equally he has to combat the never-ending enthusiasm of his own hospital's financial department for raising prices.

It costs around £5/head/day to feed his patients and that does not include breakfast which is provided internally in each hospital mainly continental style.

He can draw on advice from PASA set up on 1st April 2000 to be a centre of knowledge and operate national contracts for some supplies. PASA also contributes to the Public Sector Food Procurement Initiative {PSFPI} and says Alan Glover, lead category manager -Food and Nutrition, regularly provides updates against the 14 areas identified in the scheme.

PSFPI

PSFPI is operated by DEFRA and looks at practical ways the £1.8 billion food bill for the public sector can be tied into sustainable farming and offering healthier diet. The priorities are to raise production and processing standards, increase tenders from small and local producers , increase consumption of healthy and nutritious food, reduce impact of livestock production on the environment and help small and local suppliers meet the demands of contracts for supplying hospitals, schools and prisons. If successful the initiative should have a symbiotic effect of not only giving access to contracts by independent farmers, farming groups, processors and butchers but also reduce obesity and consequential problems which are reckoned by the National Audit Office to cost the NHS £500 million a year.

DEFRA cites Martin's operation as a good example of how to improve hospital nutrition after taking catering in-house and investing in a cook-chill unit.. Meals are more appetising and nourishing and over -cooked vegetables are a thing of the past. A Halal chef ensures every patient's needs are catered for," says the citation in the Government's document; "Sustainable Food Procurement in Action ".

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