Hospital catering services in Wales have improved and many patients are satisfied with the food they receive but more needs to be done to make sure patients get the nutritional care they need.
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Today's report found hospital catering services have improved. Many hospitals in Wales provide patients with an appropriate choice of good quality food and nurses are making efforts to clear up wards before food arrives.
Protected mealtimes times - when all non-urgent clinical activity stops on wards allowing patients to eat without interruptions and nurses are able to assist are becoming more common. Assembly Government policy initiatives have identified the standards of nutritional care that need to be applied and have encouraged ward sisters to take greater ownership of catering arrangements on their wards. The report highlights that where this strong leadership by nurses was in place, nutritional care of patients was invariably better.
However, there is still much room for improvement. Although most patients are screened for nutritional problems, important information about patients' nutritional status is often missing. Not all patients get the help they need at mealtimes, and the recording of food intake for at risk patients is not always carried out. The report found that care plans are not always in place for patients with nutritional problems and that these patients were not always referred to a dietician for a more specialist assessment.
The report found that financial information about catering services is typically poor and needs to improve. Where it exists, it shows that catering costs varies significantly in hospitals across Wales. The daily cost of feeding a patient ranges from £1.33 to £5.66 per day while non patient catering services - provided by hospitals for staff and visitors - are heavily subsidised, often unknowingly. More also needs to be done to reduce the amount of food wasted, which remains unacceptably high on many wards, and many hospitals could generate significant savings by reducing waste to more acceptable levels.
The report, Hospital Catering and Patient Nutrition, which follows up previous Audit Commission in Wales work in 2002, makes recommendations for improvement, including:
• The need for the Assembly Government to develop and issue standard all-Wales nursing documentation to promote consistent nutritional screening and care planning, and to help ensure important areas, such as oral health, are properly considered
• The need for NHS bodies to audit compliance with all aspects of the Assembly Government's Nutritional Care Pathway, and to establish clear plans of action to address any gaps that are identified
• The need to develop a clear costing model for patient and non patient catering services that supports meaningful comparisons of hospital catering costs across Wales
• Setting clear pricing policies for non-patient catering services; and
• Establishing local and national targets for food wastage.
Auditor General for Wales, Huw Vaughan Thomas, said today:
"Hospital food plays a vital role in patients' recovery and rehabilitation. Whilst my report points to encouraging improvements, it also shows that hospitals need to do more to ensure patients are getting the nutritional care they need. NHS organisations must recognise the importance of patient nutrition and ensure that there is effective leadership at ward level so that best practice is implemented."