Introduction
What is the food and drink strategy?
The ‘Food and Drink Strategy 2025’ outlines a comprehensive framework for improving nutrition and hydration across South Tees Hospitals NHS Foundation Trust for patients, staff and visitors.
It aligns with sustainability goals and national healthcare standards while focusing on operational excellence, staff well-being, and patient experience.
Who is the food and drink strategy for?
This strategy for 2025 to 2028, written and monitored by the trusts nutrition and hydration steering group and key stakeholders, applies to all in-patients, staff and visitors who use catering services provided by the trust.
This includes patient meals provided by the in-house catering service at the Friarage, and the outsourced catering service providers at The James Cook University Hospital, East Cleveland Primary Care Hospital, Redcar Primary care Hospital, and Friary Hospital.
Why do we have a food and drink strategy?
The food and drink strategy emphasises the critical importance of nutrition and hydration for patients, staff, and visitors, addressing health inequities and improving outcomes across South Tees Hospitals NHS Foundation Trust. Below summarises why this strategy is essential.
Addressing deprivation and health inequalities within our area
Some hospital sites are located in areas within the 20% most deprived in England, where health outcomes, including life expectancy, are significantly lower. Deprivation increases the prevalence of malnutrition, necessitating focused efforts to ensure adequate nutrition and hydration for vulnerable populations.
Enhancing patient outcomes
- Optimal nutrition and hydration reduces:
- Mortality and morbidity rates length of hospital stays post-surgical complications recovery times
- reduces overall healthcare costs by preventing complications and promoting faster recovery
Supporting staff wellbeing
Ensuring staff have access to nutritious food and hydration supports their health, reduces sickness absence, and enables them to perform effectively. A healthy workforce ensures better patient care and reduces the financial burden on the NHS.
Promoting a healthy lifestyle
As a healthcare provider, the trust is committed to fostering healthy lifestyles by promoting and providing access to good nutrition for patients, visitors, and staff. The strategy integrates sustainability with health objectives, ensuring a comprehensive approach to food and drink services.
Meeting community needs
The strategy is tailored to address the diverse nutritional needs of the South Tees community while embedding best practices, accessibility, and sustainability into its implementation.
How will we monitor and implement the strategy?
This strategy outlines the methods which will be used to gather feedback from patients, including vulnerable groups, to ensure their experiences with nutrition and hydration inform the future direction of our food and drink services. Our commitment is to provide high-quality, sustainable food and drink options tailored to the diverse needs of patients, staff, and visitors.
To achieve this, we will:
- Regularly monitor progress of the strategy action plan through the Nutrition Steering Group and its subgroups, including Nutrition and Hydration Councils.
- Use insights and data from these groups to identify areas for improvement in nutrition and hydration on each site, and recommend actionable changes.
- Collaborate effectively with stakeholders, councils, and working groups to ensure shared expertise and resources are utilised to deliver the best possible nutritional outcomes.
This approach ensures the strategy remains dynamic and responsive to evolving needs, fostering continuous improvement in food and drink provision across the Trust.
The nutrition and hydration standards for healthcare food and drink November 2022
There are eight nutrition and hydration standards that all NHS organisations are required to meet:
- Organisations must have a designated board director responsible for food (nutrition and safety) and report on compliance with the healthcare food and drink standards at board level as a standing agenda item.
- Organisations must have a food and drink strategy.
- Organisations must consider the level of input from a named food service dietitian to ensure choices are appropriate.
- Organisations must nominate a food safety specialist.
- Organisations must invest in a high calibre workforce, improved staffing and recognise the complex knowledge and skills required by chefs and food service teams in the provision of safe food and drink services.
- Organisations must be able to demonstrate that they have an established training matrix and a learning and development programme for all staff involved in healthcare food and drink services.
- Organisations must monitor, manage and actively reduce their food waste from production waste, plate waste and unserved meals.
- NHS organisations must be able to demonstrate that they have suitable 24/7 food service provision, which is appropriate for their demographic.
These standards are legally binding as part of the NHS Standard Contract and require all NHS trusts to develop and maintain a food and drink strategy.
References
Developing the strategy
Stakeholders
- Deputy chief nurse and chair of nutrition steering group
- Head of dietetics and adult SALT lead
- Sustainability lead
- Patient experience lead
- Estates and facilities contract manager
- Nutrition and hydration council leads
- All catering retail and vending providers for all sites
- Catering lead dietitian
- Dementia lead nurse
- Occupational health manager
- Patient safety lead
- Therapeutic care lead
Responsibility of stakeholders
- The organisation reviews and act upon patient, staff and visitor satisfaction with their food service.
- The national standards for healthcare food and drink are implemented across our organisation.
- The organisation has a food and drink strategy, evidencing a clear ambition to improve and how this will be achieved.
- There is evidence of regular board reporting and compliance status, for example minutes of nutrition steering group meetings discussing compliance checklists and documenting actions to be taken.
- Good quality evidence reflects current practice across our organisation for example patient lead assessment of the care environment (PLACE) results.
- Staff and visitor nutrition and hydration is prioritised within the trust wellbeing group and People Plan.
- Health promotion for staff and visitors is embedded in food and drink services across the trust supporting the Trusts People plan.
- A healthy, safe and sustainable food and drink culture is established in line with the trusts and the NHS green plan.
- Working together to reduce health inequalities related to food and drink.
Catering national standards and guidance
The trusts food and drink strategy is written in line with aiming to adhere to and achieve complaince with the following standards and guidance.
For patient catering
- 10 key characteristics of good nutritional care
- Nutrition and hydration digest
- Malnutrition Universal Screening Tool or equivalent
For retail catering
- GBS Nutrition Standards
- National Standards for Healthcare Food and Drink
For all catering​
- Government Buying Standards for Food and Catering Services, Defra
- National Standards for Healthcare Food and Drink
- One Blue Dot
- Maturity Matrix from the National Standards For all catering
Data collection sources
We are able to use the following data sources to support our compliance with the national standards and guidance.
- Patient-Led Assessment of the Care Environment (PLACE) scores
- Care Quality Commission inpatient survey
- Local surveys and Friends and Family Test
- Complaints, compliments
- Mortality and morbidity rates
- Patient demographics
- Hospital admission data
- Patient menus and nutritional, carbon emission information
- Finance and procurement data
- Care Quality Commission Inspection Rating reports
- Staff and visitor surveys
- Product range/turnover and information from sales and orders within catering
- HR data – sickness absence
- Estates Return information Collection (ERIC) data – including waste and energy
- NHS Supply Chain
Our priorities and objectives for patient, visitor and staff food and drink
We acknowledge that our diverse patient and staff groups have varying needs and requirements when it comes to nutrition and hydration.
What we eat, and drink has a significant impact on both our physical and mental health and wellbeing. Patients may have physical and mental health conditions which can affect their nutritional status.
Some patients admitted into hospital are already nutritionally vulnerable or become nutritionally vulnerable during their admission. The following objectives set out how we will ensure our diverse patient group have their nutritional and hydration needs met.
The food and drink strategy was written in line with the trusts patient experience and involvement strategy 2023-2026.
Improving patient experience relating to nutrition and hydration is a priority within our strategy and requires a multidisciplinary approach including collection, analysis and learning from patient and staff feedback.
We aim to include captured patient feedback to improve our provision of nutrition and hydration across the trust.
Patient food and drink pledge
We are committed to ensuring that every patient receives the nutrition and hydration they need, with the necessary support to meet these needs effectively.
To achieve this, we will:
- Screen and monitor patients: Ensure all patients are assessed for malnutrition risks, safe eating, drinking, and swallowing upon admission, as outlined in the Trust’s SOP22.
- Consistently provide high-quality food: Deliver healthy, sustainable, and high-quality meals across all healthcare catering services while adhering to financial targets.
- Cater to individual needs: Respect and accommodate religious, cultural, nutritional, allergen-related, and assisted feeding requirements. Nutritional safety will remain a priority, with all staff accountable for maintaining high standards, ensuring the correct diet is provided.
Supporting patient nutrition and hydration
- Develop robust care plans, monitor food and fluid intake, and make appropriate referrals to healthcare professionals for early intervention when needed.
- Promote positive mealtime experiences by protecting mealtimes and providing patients with the time, space, and assistance required to enjoy their meals, following the trust’s Protected Mealtime Policy.
- Identify and address individual needs in care plans, including the provision of suitable equipment, adaptations, and support to ensure safe eating and drinking practices.
Addressing specialist needs
Recognise that patients in specialised clinical areas, such as renal, surgical, oncology, neurology, stroke, and spinal, may have unique nutritional requirements. Collaborate across departments, including facilities, dietitians, speech and language therapy (SALT), and other stakeholders, to meet these needs and minimise menu fatigue.
Enhancing food services
- Develop trust-wide food safety guidance for managing food brought in or prepared outside the main catering services.
- Partner with food suppliers, contractors, and colleagues to ensure food quality from production to service, with accountability for every stage, including waste and monitoring.
Patient involvement and feedback
- Actively involve patients in decision-making, particularly regarding menu changes, by gathering insights through surveys, incident themes, and compliments, complaints. Feedback will inform the work of the Nutrition and Hydration Subgroup Councils, which will report to the Nutrition and Hydration Steering Group.
- Consult staff forums, patient groups, and external partners to address relevant topics in nutrition and hydration.
Supporting vulnerable patients
- Gather feedback from vulnerable patients through national audits and the therapeutic care team, while collaborating with the dementia and learning disabilities leads. Regular input and feedback will guide service improvements.
- Enhance menu accessibility for vulnerable patient groups by offering online, read-aloud, and pictorial formats.
Training, learning and development pledge
We are committed to equipping all staff involved in food and drink provision with the necessary skills and knowledge to deliver exceptional service. To achieve this, we will:
- Develop a structured learning framework: Collaborate with the Learning and Development team to create a comprehensive training program tailored to food and drink provision across the trust. This framework will be endorsed at the board level to ensure its implementation and impact.
- Provide specialised training: Ensure all staff handling food receive training in food safety, allergens, and special dietary requirements, including modified textures and cultural or religious needs.
- Set clear standards: Define and communicate clear competencies, responsibilities, and standards for food handling and service staff to uphold quality expectations.
- Celebrate excellence: Recognise and celebrate the contributions of chefs and food service teams who deliver nutritious, appealing, and well-presented meals.
- Foster nutritional awareness: Ensure all food service staff understand the critical role of nutrition and hydration in patient care and how the food they provide supports health and recovery.
- Support patient care: Train appropriate staff to identify patients at risk of malnutrition or those requiring assistance during mealtimes, enabling timely interventions and better outcomes.
By prioritising training and development, we aim to empower our teams to consistently deliver high standards of food and drink provision.
Staff and visitor food and drink pledge
Our staff are our greatest asset, and we take pride in the high standards of care they deliver. Promoting healthy eating is central to supporting the health and wellbeing of our workforce. The trust recognises its responsibility to provide an environment that encourages healthier choices and behaviours, ensuring these are accessible to all members of our inclusive and diverse workforce.
Delivering nutritious, safe, and effective food services requires a multidisciplinary approach. By working collaboratively across the organisation, we can meet the needs of staff and visitors while maintaining high standards of care.
The Food and Drink Strategy aligns with the trust’s People Plan, contributing to making the Trust a supportive and engaging place to work. This strategy acknowledges the value of supervision, appraisals, training, development, health and wellbeing initiatives and career progression opportunities. These elements are vital to retaining a motivated workforce capable of delivering the strategy’s objectives.
The trust will continue to work closely with food service providers to address workforce challenges, including recruitment and retention, which impact the safe and effective delivery of nutrition and hydration.
Where possible, we will support staff development through training opportunities and shadowing programs, ensuring teams are equipped to deliver exceptional service.
Ensuring access to nutritious food and drink for our staff
We are committed to supporting the health and wellbeing of our staff by providing access to nutritious food and drink options in line with the National Healthcare Food and Drink Standards and the trust’s People Plan.
To achieve this, we will:
- Collaborate with the health and wellbeing team: Work inclusively to ensure that staff health and wellbeing remain a priority, integrating feedback and aligning with national standards.
- Provide diverse food options: Offer healthy, balanced, and affordable hot and cold meal choices 24/7 where there is demand, ensuring they meet dietary needs and are convenient for staff schedules.
- Respond to staff needs: Use feedback from the Health Needs Assessment Survey to shape hydration and nutrition offerings, ensuring that staff voices are heard and their suggestions are acted upon.
- Support personal choices: Ensure that staff who bring their own food and drink to work have access to suitable facilities, enabling them to store, prepare, or enjoy meals comfortably.
- Promote healthy eating: Encourage staff to eat well and stay hydrated as part of the Trust’s People Plan, fostering a culture of health and wellbeing. Additional resources can be accessed via the trust’s healthy eating and hydration guidance.
- Support Breastfeeding Mothers: Provide facilities and flexible breaks to support women returning to work who wish to continue breastfeeding, in line with trust guidance HS07 – New and Expectant Mothers at Work Policy. We acknowledge the increased nutritional and hydration needs of breastfeeding and ensure no restrictions on required breaks.
By addressing the diverse needs of our workforce and promoting a supportive environment, we aim to empower our staff to maintain their health and wellbeing while at work.
Our sustainable food and drink pledge
The NHS has committed to reaching net zero carbon by 2040 for the emissions it controls directly (such as Scope 1) and by 2045 for the emissions it influences. The goods and services purchased by the NHS are part of the indirect category, known as Scope 3. As outlined in the figure below, food and catering are included in Scope 3 of the Greenhouse Gas Protocol (GHGP).
NHS carbon footprint
Scope 1 – direct
- Fossil fuels
- NHS facilities
- Anaesthetics
- NHS fleet and leased vehicles
Scope 2 – indirect
- Electricity
NHS carbon footprint plus
Scope 3 – indirect
- Medical devices
- Freight transport
- Business services
- Constructions
- Construction
- Medicines
- Food and catering
- Commissioned health services outside NHS
- Manufacturing
- ICT
- Staff commuiting
Travel outside GHGP scopes
- Patient, visitor travel
Food and drink and the trust’s Green Plan
The trust is committed to fostering a sustainable culture and prioritizing health and sustainability in its approach to food and drink. By aligning with the Trust Green Plan, we aim to promote healthier and more sustainable meal options that contribute to our organisation’s carbon reduction targets and broader sustainability goals.
To achieve this, we will:
- Provide sustainable nutrition: Ensure that all food supplied to staff and patients meets their nutritional and hydration needs while minimising carbon emissions through sustainable procurement practices.
- Adopt government standards: Procure catering products and services that comply with Government Buying Standards (GBS), ensuring alignment with higher sustainability benchmarks.
- Monitor progress: Regularly review our food provision against the Trust Green Plan, assessing progress annually to ensure continuous improvement.
Sustainable practices
- Reduce environmental impact: Incorporate practices that minimize water, electricity, and gas consumption by promoting behaviour change and adopting technological solutions where feasible.
- Reduce plastic use: Focus on waste reduction, including limiting the use of single-use plastics.
- Offer plant-based options: Expand the availability of plant-based, nutritionally balanced meals on our menus, where clinically appropriate.
Operational reviews
- Improve food ordering processes: Assess and optimize current food ordering systems for each site to enhance efficiency and sustainability.
- Reduce deliveries: Review delivery frequencies across sites to identify opportunities for consolidation and reduction.
- Evaluate meal service models: Examine the sustainability of existing meal service models to ensure they align with the Trust’s environmental objectives.
Waste monitoring
- Track and minimise waste: Monitor all forms of food waste, including plate waste, using tools such as ERIC Data and NHS supply chain information to identify trends and opportunities for reduction.
By embedding these initiatives into our operations, the trust aims to support the transition to a greener, healthier future while maintaining high standards of nutrition and hydration for staff and patients.
Our performance
Our food service dietitian will have an ongoing action plan to develop and review hospital site menus with the catering managers to ensure that they meet hospital food standards, BDA Nutrition and Hydration Digest standards, patient’s nutrition and hydration needs and special dietary requirements.
We will use a number of key performance indicators to measure our performance against the Healthcare food and drink standards and Food safety Legislation and report through to the Trustwide Nutrition and Hydration steering group for board level reporting.
It is recognised that verification of standards will be needed, and it is expected that the Trust will look to undertake an audit program to monitor the various aspects and standards adopted and provide evidence.
The food and drink strategy will be regularly monitored, kept up to date, reviewed and a live document. We will set a schedule to review this strategy quarterly within the nutrition and hydration steering group.
3 year implementation plan
Here is a comprehensive 3-year plan for implementing the Food and Drink Strategy 2025. It integrates all of the previous patient, staff and visitor and sustainable pledges into achievable goals.
Year 1 (2025): Improve compliance with standards, and initiate data collection.
Policy and standards alignment:
- Review current compliance with the eight Nutrition and Hydration standards.
- Update policies to reflect national and green plan priorities.
- Ensure training for relevent staff in food safety, special diets, and allergens.
Data collection and baseline measurement
- Conduct PLACE assessments, patient surveys, and waste audits.
- Monitor carbon emissions and energy use related to catering.
- Gather feedback on current food quality, portion sizes, and dietary options.
Initial improvements
- Introduce or expand recycling programs.
- Trial plant-based menu items and aim to reduce single-use plastics in catering.
- Address identified “quick wins” in patient and staff feedback.
Training and awareness
- Launch a trust wide training program for all food service staff.
- Educate staff on sustainable food practices and nutrition-related health promotion.
Year 2 (2026): Address identified gaps, reduce waste, and enhance menu offerings.
Waste reduction initiatives
- Implement targeted interventions based on waste audit findings (for example adjust portion sizes, improve ordering processes).
- Monitor and manage plate waste, unserved meals, and production waste.
Menu development and inclusivity
- Expand plant-based and culturally appropriate menu options.
- Collaborate with dietitians, catering staff, and patient groups to prevent menu fatigue.
- Pilot pictorial and read-aloud menus for vulnerable groups on all sites.
Sustainability enhancements
- Reduce delivery frequency through efficient ordering processes.
- Measure and lower energy and water use in catering operations.
- Assess and improve the carbon footprint of meals served.
Improving staff and visitor food services
- Ensure 24/7 access to healthy and affordable meal options.
- Upgrade break facilities to support health and hydration.
- Tailor food offerings based on staff Health Needs Assessment feedback.
Monitoring and evaluation
- Evaluate year-one changes using patient, staff, and visitor surveys.
- Report outcomes to the Nutrition and Hydration Steering Group and adjust strategies as needed.
Year 3 (2027): Ensure sustained impact and scalability of food and drink across all sites
Expand successful initiatives
- Roll out proven waste reduction programs across all trust sites.
- Scale plant-based and sustainable menu options.
Long-term sustainability goals
- Achieve measurable reductions in food waste, energy use, and carbon emissions.
- Align all catering practices with the Trust’s Green Plan and NHS Net Zero goals.
Cultural change and engagement
- Embed healthy eating and sustainability into the Trust’s culture.
- Recognise and reward staff contributions to food and drink improvements.
Performance tracking
- Set annual key performance indicators (KPIs) for food quality, waste reduction, and sustainability.
- Use PLACE assessments, ERIC data, and patient/staff feedback to report on progress.
Prepare for the next strategy cycle
- Conduct a comprehensive review of the 3-year strategy’s successes and challenges.
- Draft recommendations for the next food and drink strategy (2028 to2031).
This phased plan ensures steady progress, measurable outcomes, and alignment with both operational and sustainability goals.