Scottish Government Consultation on Proposed Options to Improve and Assure the Nutritional Standard of Food in NHSScotland Hospitals

Introduction

This document invites your views on proposed options to improve and assure the nutritional standard of food in NHSScotland hospitals, including the option to place nutritional standards for food in NHS hospitals on a statutory footing. By statutory footing, we mean establishing minimum, legal standards which NHS Boards in Scotland have to achieve in terms of the nutritional content of the food served to hospital patients.

In addition, we are also consulting on whether to introduce non-legally binding standards for NHS hospital catering, and whether those standards for catering relating to NHS hospital patients should be based on the food-based and menu planning criteria as set out in 'Food in Hospitals: National Catering and Nutrition Specification for Food and Fluid Provision in Hospitals in Scotland' (2016). At present NHS Boards are expected to follow this guidance though are not obliged to meet any mandatory criteria based on it. This document is published by Scottish Government and produced by Health Facilities Scotland, a division of NHS National Services Scotland.

The four options proposed in this consultation are to:

1. Define nutritional standards, based on criteria set out in the 'Food in Hospitals' guidance, and place those standards for food provided to patients in NHS hospitals on a statutory footing. Scotland would become the first nation in the UK to place these standards on a statutory basis. This option would provide legal, minimum standards which every NHS Board would have to achieve and maintain. Consideration would have to be given to how adherence to the legislation would be monitored and enforced, and whether an independent scrutiny regime would be required.

2. Develop standards based on 'Food in Hospitals' guidance and establish a new, independent scrutiny regime that specifically monitors the nutritional standard of food in NHS hospitals. This option would differ from option one as nutritional standards would not be placed on a statutory footing. Improvements could be yielded if standards of nutrition for food in NHS hospitals were targeted for specific monitoring. The legislative option would remain open if improvements were not made.

3. Strengthen existing Health Facilities Scotland and NHS Board audit and monitoring of the nutritional standards of food served to patients in NHS hospitals based on 'Food in Hospitals' and ensure existing arrangements to improve and assure these. Non-compliance would continue to be corrected through the current policy of co-operation, guidance and support.

4. Maintain the status quo, NHS Boards will continue to self-assess their adherence to the refreshed guidance set out in 'Food in Hospitals'. Health Facilities Scotland would continue to publish 6 monthly audit reports based on the self-assessments provided to them by the NHS Boards.

This consultation will also ask whether it is appropriate to develop catering standards to improve overall quality of food presented to patients for NHS Scotland. Health Facilities Scotland (HFS) currently produce catering guidance to provide Boards with practical advice on menu planning and the suitability of food choices for different dietary needs. However, no standards currently exist to govern characteristics of food served to patients in hospitals, such as how the food has been cooked, its temperature or when it is served. It is important to acknowledge that these characteristics or quality of food served may defy precise definition, and the consultation will ask whether it would be possible to produce relevant catering standards that would be workable in practice.

We would be grateful if you would use the attached consultation questionnaire provided to tell us your views on key issues and potential options, as this will aid our analysis of the responses received.

Audience

Anyone may respond to this consultation exercise. In particular, the Scottish Government would like to hear from all parties with an interest in the production, procurement, preparation and planning of food in hospitals and other health and social care and public sector settings. It is also imperative to hear from patients themselves, families and carers, the wider public and staff working in NHS Scotland. A provisional list of consultees is included at the end of consultation document.

Equality Impact Assessment

If legislation is introduced to regulate the nutritional standards of food in hospitals, it may have implications on protected equality characteristics. The Scottish Government has a statutory duty to consider these implications, in relation to their potential impact on the characteristics of:

• Age
• Disability
• Gender reassignment
• Pregnancy and maternity
• Race and ethnicity
• Religion or belief
• Gender
• Sexual orientation

This consultation poses questions in relation to this to help determine any potential impact.

Business and Regulatory Impact Assessment

If legislation is introduced to regulate the nutritional standards of food in hospitals, there may be cost implications for those with commercial interests in its procurement and preparation. This consultation poses questions in relation to this to help determine any potential impact.

Duration

This consultation starts on 22 March 2016.

This consultation closes on 13 June 2016.

This constitutes a period of 12 weeks, and fulfils the Scottish Government commitment to provide consultees with this minimum period to respond to any consultation exercise.

Responsibility for this consultation

The Chief Nursing Officer Directorate of the Scottish Government is responsible for this consultation. If you have any queries about the consultation, please contact the team on either fihc@gov.scot or 0131 244 5997.