A review into hospital food in England following a fatal Listeria outbreak this past year includes plans to improve food safety.

The work, ordered by Health and Social Care Secretary Matt Hancock in June 2019, was welcomed by the Food Standards Agency (FSA).

In 2019, nine people developed listeriosis and six died after eating sandwiches supplied to hospitals by the Good Food Chain. The meat was produced by North Country Cooked Meats and distributed by North Country Quality Foods.

The review panel was chaired by the former head of the Hospital Caterers Association and catering lead for Taunton and Somerset National Health Service (NHS) Foundation Trust, Philip Shelley, with Prue Leith as an independent adviser. Members included the FSA, Public Health England as well as catering and food industry associations.

Stronger on food safety
Proposals include having food safety specialists in each NHS trust, hospitals implementing food safety management systems, and compulsory reporting of concerns across the hospital food chain. NHS Trusts must also recognize they are food business operators responsible for ensuring what they provide is safe.

The aim is to ensure NHS catering suppliers, workers and contractors are meeting high standards to prevent foodborne infection. This includes training hospital workers, including non-catering staff such as nurses, on food hygiene matters relevant to their work.

Emily Miles, chief executive of the FSA, said: “We have seen the devastating consequences that foodborne disease outbreaks can have, and we welcome the recommendations to improve food safety in this report. It is vitally important that all NHS Trusts recognize their legal responsibilities to ensure the food they sell and serve is safe to eat.”

The FSA submitted evidence to the panel on the food safety element of the review.

This showed Listeria monocytogenes in sandwiches and salads was the most common factor in outbreaks of foodborne illness in hospitals. It also indicated that premises with high food hygiene rating scores are less likely to be associated with foodborne illness and highlighted potential risks associated with food produced on and off-site.

Evidence from 16 outbreaks in hospitals showed involved NHS Hospital Trusts have not always recognized their legal obligations as food businesses leading to food safety failures. The increased vulnerability of patients means shortcomings in hygiene practices, failure to consistently follow food safety advice, and over-reliance on accreditation schemes contributed to some outbreaks.

Making food onsite
The government announced it will establish a group of NHS caterers, dietitians, and nurses to take forward the recommendations and decide on the next steps. One recommendation is agreeing to national professional standards for NHS chefs with mandatory professional development, including compulsory food hygiene and allergen training.

Craig Smith, chair of the Hospital Caterers Association (HCA), said the group supports the plans.

“Yet we simply can’t move forward without capital investment in our hospital catering operations, and we urge the government to release details of funding plans to support these initiatives,” he said.

“We must not lose sight of the reason this review was called for in the first place. The HCA welcomes the call for appropriate training for everyone involved in the foodservice. Recognizing the importance of food, and its role in wellbeing, and how food safety needs to be considered at all times.

“Without adequate kitchens, it is impossible to prepare food safely. The case for investment in hospital kitchens has been made and this is a once in a generation opportunity to get kitchens back into hospitals at the design and build phase.”