The NHS 4 Nations Challenge returns to International Salon Culinaire on Monday 20 March to challenge NHS chefs to demonstrate their skills, catering knowledge and menu engineering know-how in a live competition. 

In this exciting new addition to the 2023 lineup of live and static challenges taking place as part of Salon Culinaire, teams from England, Scotland and Ireland will be competing to construct a meal suited to an average NHS patient, with an emphasis on Government Buying Standards for Food and Catering Services (GBSF), The Department of Health’s Obesity Strategy and nutritional balance in accordance with the British Dietetic Association (BDA) guidance. 

The challenge, sponsored by Unox, is organised by the NHS and the Hospital Caterers Association and spearheaded by Philip Shelley, Chair of the NHS Food Review and Senior Operation & Policy Manager at NHS Improvement (pictured right).

HRC caught up with Philip to learn more about the evolution of catering in NHS hospitals over the past few years, and how the NHS 4 Nations Challenge will give a platform to chefs rarely recognised for their talent, skill and creativity. 

What's the origin of the NHS 4 Nations Challenge? 

The NHS Food Review came about unfortunately as a result of listeria food poisoning, which became an opportunity to refresh how NHS healthcare catering was managed and promoted. One of the eight recommendations given was around catering staff support and promoting the skills of chefs in healthcare. 

Within the public sector, it can often be seen as one of the lower rungs of the ladder. And, having 30 years experience of the NHS, I've witnessed some very, very good chefs over the years that can certainly stand on their own in the hospitality sector but they're not always given the same platform as everybody else, or they may be a little bit shy in stepping forward to promote their skills. They're often back-of-house chefs rather than front-of-house. So the intention of the NHS 4 Nations Challenge was to give them the opportunity to step forward, and the NHS Food Review recommendations gave them that chance.  

We now have eight mandatory standards within the new food standards and part of that is enhancing skills, giving people the opportunity they should get. We're looking at a wide range of people across catering and healthcare, not just chefs, but we're promoting chefs right now to do a little bit of showing off! 

It's been quite a change in attitude. Nick [Vadis, Compass Group Culinary Director and NHS Chef Ambassador] has driven that very much through the NHS Chef's Academy's that have been running over the last 18 months.

They also say to the chefs: 'You're learning new skills through the academy, you have a chance to enter a competition later in the year to show off what you're learning.'

NHS chefs often face a lot of restrictions in the meals they can prepare, with health and price considerations. 

Let's be honest, there are cost restrictions in every chef environment. There's a balance between quality, presentation, skill, cost, but also for NHS chefs it's about the nutritional value. In other sectors it's often more around the quality of the produce, where it's come from, and so on.  

Where food comes from is a really big talking point right now and I think it will continue to be over the next couple of years. We work very closely with DEFRA on where the public sector purchases its meat and how much we link with local farmers and with local producers. 

I can't say the government are fully on board with that - it's a political game for the government to play - but I think everybody genuinely wants to promote what is good in our local and our national environment to ensure that every farmer and producer gets an opportunity to not just provide food to the hospitality sector, but also to public sector, which of course, is a massive market. 

Can UK producers meet the demands of these massive public sector contracts?   

We have to realise there will always be some parts of the market that they will never be able to produce. There are some foods that are only in season for quite a short term, but I think it needs to be reversed a little bit. We need the public sector, particularly the NHS, to write more flexible menus.  

If we're putting strawberries on a menu in December, where are they coming from? 

It's being a little bit more ad lib around fruits and vegetables, and adapting to the seasons rather than sticking something on the menu all year round. It's getting chefs and managers to write menus with a bit more flexibility to hopefully address some of the things that local producers can't provide. 

How much of a challenge is it to integrate seasonality into hospital menus?   

The problem is you can walk into a hospital and they've had the same menu for five years. It takes a long time to produce a menu with dietetic support and that can be a barrier. We're working closely with dieticians, as well as caterers, to say we need menus that can be adapted a lot quicker, with an emphasis away from what's easier to produce raw and toward what should be being produced.  

It is a change, and it won't happen overnight. We know that. But within NHS England we have 20 exemplar catering hospitals across the country. They are our pilots, they are innovators. They're the ones driving change. They're in every single region of the country and we use them to help shape the other hospitals in their regions to say ‘we're doing it, why aren't you doing it?’  

You need those models, not just in this, but on other things around food waste and using digital to capture patient information around allergies. There's lots of things going on and we need to take hospitals on board with us. 

How time consuming is the process of creating hospital menus?

It's very time consuming, but could be shorter. One of the recommendations is to ensure that a catering department has access to a catering dietitian.

In other words, they're not writing to the head of dietetics and saying, 'we're looking at changing our menus in the next few months, can you let us know when someone's available?' and getting an email back saying, 'no one's going to be available for the next six months.' 

That's the issue we've had over many years. Now, we're saying that dietetic teams need to make somebody available so they can make changes a lot quicker, and they can work closely with the teams to recognise the challenges that are out there. 

Do you think while you've worked in and with the NHS you've seen positive change in hospital catering? 

It's been enormous. It's funny, sometimes the biggest changes that you see are when the NHS is under the most pressure. I think it's the way the NHS works. Just when you think they can't take any more, they go up another level.  

At the moment, as we talk about mental health and staff health and wellbeing, food & drink has never been as important.

During the pandemic we closed all of retail down, so none of our staff had anywhere to go to eat. We bolted the doors, because it was easier to bolt the doors. But actually, we stopped thinking about how we feed our staff. How do we provide things. Now we're looking at not just provision during the day, but actually around the 24/7 period. 

Whether you're working at 2pm or 2am you should have suitable food available around the clock. And now there are trusts that are doing some amazing work around that. I think the mindset has changed.   

Is there a specific end point for hospital catering, or more of a moving goalpost? 

We're never ever going to be in a place of perfection. It is always constant review and constant improvement. And having mandatory food standards is very much the line in the sand. That is the starting point.

Everybody at least has a baseline, but we will always have those that are leading, those that are following and those that are not moving very quickly. It's getting everybody up to what we would call a common sensible baseline. But then at the same time trying to promote a little bit more speed and quality in what we're doing. 

The NHS 4 Nations Challenge is one of more than 100 static and live competitions taking place as part of International Salon Culinaire on 20-22 March at ExCeL London. Find out more at internationalsalonculinaire.co.uk.