Campaign aims to increase hospital staff’s access to hot meals at night and at weekendsBMJ 2022; 376 doi: https://doi.org/10.1136/bmj.o167 (Published 20 January 2022) Cite this as: BMJ 2022;376:o167
Hospitals are facing pressure from a grassroots staff campaign to provide hot, nutritious meals to staff working night shifts and at weekends.
In many hospitals, catering for staff is based around regular office hours with canteens that open from Monday to Friday for breakfast and lunch. Some sites open for longer hours, but most staff who work weekends, overnight, and on public holidays are likely to struggle to buy food, particularly if they want a hot and healthy meal.
The #24hrhotfoodfortheNHS campaign (now rebranded #NoHungryNHSStaff) was launched two months ago by Neely Mozawala, a community specialist diabetes podiatrist based in Somerset, to draw attention to the poor state of food available for staff working unsocial hours in NHS hospitals in England and to push for change.
It is already having an impact. Pilot schemes to increase the availability of food at night have been announced at several hospitals, and John McDonnell, Labour MP for Hayes and Harlington, has sponsored an early day motion, which now has 15 signatures, calling on the government to provide the funding necessary to enable every hospital trust to provide a 24 hour hot food canteen service.1
Mozawala does not work nights herself but has many friends and colleagues who do. She launched the campaign after they told her how hungry they got when on a 12 hour night shift. She said, “Night shifts are difficult as it is, and then if you don’t have food because you forget your food, or someone takes your food out for the fridge, you’re quite stuck, so I decided to do a campaign about it.”
The aim of the campaign is to achieve access to hot, nutritious food in every trust 24 hours a day, ideally through extending canteen opening hours. This would be supported by increased provision of “smart” fridges, which give staff access to food that they can warm up, and extended opening hours from outlets such as M&S and WHSmith that sell meals.
“The main thing is [that] it is 24/7, it’s healthy and nutritious, and everyone has access to it,” said Mozawala. “The accessibility is what’s lacking, trusts are not prioritising it, and that’s what I want to get across.”
Lack of progress
In 2014 an independent report commissioned by the Department of Health led to legally binding standards on the nutritional quality of the food served to staff and patients in hospitals.2 The report acknowledged that, “Too often, choice (especially at night) is limited to unhealthy snacks,” but it stopped short of making 24 hour provision of healthy food mandatory.
The BMA’s Fatigue and Facilities charter from 2018,3 which trusts are encouraged to sign up to, says that catering facilities serving freshly prepared meals to staff should be open 365 days a year for breakfast, lunch, and dinner—where possible, to at least 11 pm and then for a further two hours from 11 pm to 7 am. Hot food should be available at other times through a supply of microwave meals or a similar arrangement, it recommends.
Mozawala said, “I’m tired of getting reviews and recommendations. Everyone thinks that they can just bypass recommendations: it’s not acceptable. Staff are suffering.” She called on NHS staff to write to their MPs to ask them to sign the early day motion and draw attention to the issue.
Sarah Hallett, co-chair of the BMA’s UK Junior Doctors Committee, said, “While clearly many agree that access to hot nutritious food while on shift in the NHS is important, actual progress on making this happen has been slow. The #24hrhotfoodfortheNHS campaign has shone a light on why this must change.
“Working in the NHS anyway, the hours are quite long and the conditions are quite stressful. The food provision in some places and some hospitals, I’d say, is non-existent, so if you don’t bring your own food to work there’s a good chance you could go hungry.
“Often NHS staff aren’t getting the kind of nutrition that they need when they are working those really punishing long shifts.”
Another supporter of the campaign is the celebrity chef and Great British Bake Off judge Prue Leith, who carried out a review of hospital food after a deadly outbreak of listeriosis in hospitals in 2019 was linked to pre-packaged sandwiches and salads.4 The review recommended upgrading hospital kitchens to provide a 24/7 service.5
“The sooner we get nurses and doctors and all the support staff fed at night when they need it, the better the service will be,” said Leith. “Let’s do something about this, because in many cases it is not that difficult to do.”
From 14 to 17 January, University Hospitals Dorset Foundation NHS Trust trialled serving pizza and burgers from vans at the Poole and Royal Bournemouth hospitals from 11 pm to 3 am, and on average 64 meals were purchased each night by the 400 staff working overnight. The trust believes that the uptake could double with a wider range of meals, including healthier options, so it will test this in another pilot in the coming weeks. Meanwhile, the M&S Café at St Thomas’ Hospital in London is trialling 24/7 opening, offering heat-to-eat products overnight such as ready meals and soup.
One of the few trusts to already provide a 24 hour canteen serving hot food to staff is Northumbria Healthcare NHS Foundation Trust at Northumbria Specialist Emergency Care Hospital, and the staff really value it. Vicky Gibson, a consultant geriatrician, wrote on Twitter, “It’s having the option in case you forget to bring food or are too tired to pack food, plus it makes the hospital feel a bit less lonely at night.”
Simon Jones, a consultant obstetric anaesthetist at the Northumbria trust, wrote on Twitter, “Bundling two children out the door in the morning means I never remember my own food. Also, I can’t underestimate the knowing nod to a fellow colleague, who you know has been there all day, going for the plate of chips at 0230.”
Jones wrote that he also worked better “when not hangry!” He added, “Great for my 24hr on-calls to get some food before that 0300 laparotomy.”
Tom Spencer, a Northumbria foundation year 2 doctor, wrote on Twitter, “An army marches on its stomach. If you don’t feed your staff, they won’t perform. Having 24/7 access to hot food enables you to focus on work and relax on breaks. Undoubtedly makes you a more effective clinician.”