The problem
Hospitals – like many other public sector and large institutions – are under pressure to improve catering sustainability. Transforming the food offer, including by reducing meat and increasing plants, has been recognised as a key part of the NHS approach to ‘Delivering a ‘Net Zero’ National Health Service’.
Increasing the sustainability of menus in this way involves a balancing act between a range of outcomes: nutrition, appeal and satisfaction, safety, cost, and operational practicality. The Birmingham Children’s Hospital (BCH) ccatering team has expertise in many, but not all, of these outcomes. Previous attempts to introduce more sustainable dishes have negatively impacted patient satisfaction, because the dishes were unfamiliar or unappealing.
While the hospital is keen to improve its inpatient meals, it is isolated from the increasing amount of work taking place around menu changes in other institutions such as schools, early years, and universities, and not able to benefit from the learning which could inform its catering activities.
The intervention
Changes to inpatient paediatric menus, to reduce meat and increase plant content, informed by expertise and evidence on: environmental sustainability, appeal, nutrition, safety, and operational feasibility.
The research
Research question
Can changes to inpatient paediatric menus improve the environmental sustainability of dishes, while maintaining or improving nutrition and appeal and costs?
Theory of change
Research approach
Outcomes examined will include environmental sustainability, nutritional quality, cost, and patient satisfaction,.
This will be a natural experimental study. We will conduct quantitative analysis of routinely collected hospital menu data on ingredients purchased and meal uptake, to determine the impacts of changes to reduce the meat and increase plants in hospital dishes.
We will conduct a Cost Benefit Analysis, to understand the costs of changing the proportion of meat in meals against its benefits related to environment, nutrition, and other outcomes where possible.
We will collect qualitative data on the catering process, actors, other contextual influences, and conduct a process evaluation to examine fidelity, acceptability and feasibility of the menu change intervention in the hospital context, and any unintended consequences.
Modelling approaches will be used to assess potential wider environmental, and potentially other impacts.
Outputs and impacts
We will produce
- papers reporting the results of menu changes (environmental, nutrition, cost, satisfaction impacts, process barriers and enablers)
- modelled impacts on the environment, costs, and potentially other outcomes
We will input to a paper on contributions to system change.
We will explore developing a multi-outcome menu development tool to design and analyse dishes against a range of outcomes.
We will disseminate the findings, through different methods like briefs, toolkits, podcasts and films, to different audiences, including other institutions and policymakers at local and national levels.
Research team
- Dr Kelly Parsons | MRC Epidemiology Unit, University of Cambridge
- Leticija Petrovic | The Food Foundation / Birmingham City Council
- Prof Andrew Balmford | Department of Zoology, University of Cambridge
- Dr Thomas Ball | Department of Zoology, University of Cambridge
- Dr Owen Nicholas | Statistical Science, University College London
- Prof Martin White | MRC Epidemiology Unit, University of Cambridge
- Dr Alexia Sawyer | MRC Epidemiology Unit, University of Cambridge
- Dr Catrin Jones | MRC Epidemiology Unit, University of Cambridge
- Prof Emma Frew, University of Birmingham
- Dr Lin Fu University of Birmingham
- Viktorija Kesaite, MRC Epidemiology Unit, University of Cambridge
- Prof Jean Adams, MRC Epidemiology Unit, University of Cambridge