Quantifying food-waste in patient feeding in an acute setting and identifying opportunities for reduction

Project completed as part of the Cwm Taf Morgannwg University Health Board (CTM UHB) and Centre for Sustainable Healthcare Intensive Sustainable Innovation Group Scholar Programme. 

Background:
Food and catering accounts for approximately 6% of the NHS’s total carbon emissions – 1,543 ktCOe annually. It is particularly pertinent to note that the NHS is wasting 18% of purchased food, or one in every six meals. Food-waste in the NHS is directly linked to climate change – food as a whole is responsible for a quarter of the United Kingdoms (UK) carbon footprint. Food is also a vital part of a patient’s recovery and health: if this food is not being consumed and is subsequently wasted, this can potentially also lead to extended recovery times in hospital.

Specific Aims:
The six-month project aim was to engage with Catering and Nursing colleagues to quantify the food-waste in patient feeding. The pilot was conducted at Princess of Wales Hospital (POWH) where the site has non-ward hostess (n=16) and ward hostess (n=4). The data collection methodology was to establish the number of wasted meals, cost and environmental impact to the Health Board between ward hostess and non-ward hostess. The medium-term goal is to develop a SusQI project to educate staff the need to prevent this waste from occurring – thus reducing all associated costs with producing and manufacturing food that is not consumed by patients, and re-measure.

Method / Approach:
A patient catering value process map was produced to give an overview of the social, economic and environmental impact of food production (see main report).  This highlighted the complexity of the project, it was decided to refocus the project on measuring patient food-waste only at one acute site. The next step was the compilation of a methodology for ward audits conducted by Facilities Technical Compliance. Cook et.al (2021) developed a scientific hospital food-waste audit consensus tool from the most common food-waste audit methods and this assisted in identifying the types of food-waste to focus on.

Results:
Environmental benefit:

In summary, the GHG emissions associated with food production and food waste disposal emissions have been estimated at a total of 151,832.15kgCO2e (151.83 tones CO2e) in 7 months.

Financial benefit:
The financial impact of this wasted food is estimated to be in the region of £100,000 over a 7-month period. This is based on the purchase price of the food at approximately £3.25 a meal and 31071 wasted meals in a 7-month period. It should be noted that the financial impact just not take into account waste packaging or the actual disposal costs charged by the company collecting the waste-food for anaerobic digestion.

Patient outcomes:
• Ward hostess versus non-ward hostess – the data collected clearly identifies a lower return of meals to the Catering department via the ward hostess service model. This is desirable for the patient as they get a choice of food from a dietetically assessed menu with Catering staff dedicated to taking orders and serving the meal. They are ordering what they want to eat from a patient feeding menu.
• Protected meal-times – the protected meal-time outcome is essential to patient recovery and contributes to the overall care plan.
• Recovery and nutrition as medicine – this is an essential part of patient care plan and links to recommendations by the BAPEN 2012 report.

Population outcomes:
The population outcomes of food-waste in a non-ward hostess Catering model in an acute site are far reaching, and stretch further than financial, social and environmental. The BAPEN (2012) highlighted the clinical outcomes of patient choice, food intake and malnutrition as intrinsically linked to food-waste. These drivers ultimately lead to longer patient recovery times, increased stays in hospital and a larger population of ‘nutritionally at-risk patients’. The CTM UHB has a corporate strategy of improving patient nutrition and this is particularly imperative when 85% of the staff population live in the three regions of Rhondda, Merthyr and Bridgend – hence our staff population are our future patient population.

See full report for further information, results, impacts, learning points and next steps.