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Darren Millar AM Chair Public Accounts Committee National Assembly Wales Cardiff Bay Cardiff CF99 1NA
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Our ref: JW/
1 November 2013
Dear Mr Millar
Hospital Catering and Patient Nutrition
Further to your letter of the 11 October 2013 requesting additional information on Hospital Catering and Patient Nutrition, I am writing to provide Committee members with specific responses to the issues they have raised, as follows:
Why has the Betsi Cadwaladr system for accessing the nutrition e-learning package, without the need for an email account, not been adopted by other Health Boards?
I wrote to Nurse Directors at the beginning of June to remind them of my expectation that the Nutrition Care Pathway and the Food Record Charts are used as mainstream practice, with the e-learning package as its training resource. I informed them about the Betsi Cadwaladr University Local Health Board system for accessing the All Wales Food Record Chart e-learning tool and encouraged them to get their lead on e-learning to do likewise. It is my understanding that the lead in Betsi Cadwaladr Health Board has had contact with some other Health Boards to describe her approach.
Participation in on-line training packages in the NHS.
I recognise that the low level of compliance with completion of the e-learning nutrition package remains an issue and this continues to be a priority. NHS Wales Informatics Service (NWIS) and the Health Boards are considering further options for improving the completion rates. NWIS has been commissioned to produce a status report from each Health Board, which will give us the opportunity to consider if an all-Wales solution would be appropriate.
Officials are also exploring alternative mechanisms with the company that developed the e-learning package. I will provide you with a further update in the New Year.
Destination of Food Waste including details of the waste contracts between health boards and local authorities.
A number of Health Boards are making arrangements with local authorities for the separate collection of food waste. For example, Cardiff and Vale University Health Board work in partnership with the City of Cardiff and Vale of Glamorgan County Councils for the separate collection and disposal of food waste. All community hospitals within Hywel Dda Local Health Board also have food waste collections by their respective local authorities. The NHS would like to work more closely with local authorities to improve food waste collections and closer collaboration should be encouraged. However, some local authorities are reluctant to collect food waste from large hospital sites.
More environmentally friendly forms of hospital food waste disposal are being considered. This could include the use of new technologies which will have to be evaluated to ensure they comply with statutory requirements. To date there has been no cost benefit analysis undertaken to assess the benefits of introducing more environmentally friendly forms of hospital waste disposal. This would be undertaken in respect of any new proposal.
From a nursing perspective the reasons for plate waste should be recorded on a patient’s notes or food chart as their nutritional status is extremely important in their care and treatment. This information on their food and fluid intake would influence the plan of nursing care for the patient. There are no plans to collate consumption/waste on a meal by meal basis at ward level.
The Welsh Government is working with NHS Shared Services Partnership – Facilities Services (NWSSP-FS) through the EFPMS (Estates and Facilities Performance Management System) process to introduce new methods of measuring food waste to include plate waste other than just the untouched meals. The proposal would be to carry out a pilot study in one of the large acute hospitals and, if successful, to discuss the outcome with all other Health Boards/Trusts and to roll it out across NHS Wales.
Colleagues in NWSSP-FS have met WRAP Cymru to discuss food waste. As this is a local issue, where the individual Health Boards and Trust manage their own activities, it was felt the best way for WRAP to potentially help was to provide them with the contact details of the facilities/catering managers at each NHS organisation. WRAP Cymru have also been invited to give a presentation to the Welsh Health Environment Forum (WHEF) Waste Managers meeting in the New Year.
Food Hygiene Rating Stickers
When the statutory Food Hygiene Rating Wales scheme commences on 28 November, Health Boards will need to agree with their local authority food hygiene inspector where best to display their hygiene stickers at their hospitals.
Welsh Government officials are meeting Health Board Catering Managers to discuss the location for display of food hygiene rating stickers in hospitals and also food hygiene issues in hospitals more generally. We hope to be in a position to update you on developments in the New Year.
Yours sincerely
Professor Jean White
Chief Nursing Officer
Nurse Director NHS Wales