Renal Nutrition and the Better Hospital Food Programme

C Duncan, A Harman

St Helier Hospital, Carshalton, Surrey

Introduction and Purpose: The NHS plan was published in 2000, identifying the need to improve the catering service in the UK. The Better Hospital Food Programme (BHF) was developed from this and introduced to our Trust in 2003. Diet is an integral part of a renal patient’s therapeutic treatment and it was identified that the renal unit would need to adapt the BHF recommendations.

Design and Findings: The renal dietitians were invited to work with the hospital catering management and Tillery Valley (T.V.), the cook-chill food supplier, to develop a suitable menu for the renal unit. After extensive consultation, we decided to use the guidelines produced by the Renal Nutrition Group (RNG) of the British Dietetic Association. They provided recommendations for the sodium, potassium and phosphate content of meals.

Using the nutritional composition of T.V’s products, we worked to identify suitable dishes. It soon became apparent that the RNG guidelines were going to be too strict for the sodium content of foods. This would result in the exclusion of many meals and puddings. After some considered discussion, we decided to adapt the sodium guidelines to make them more practical and usable.

Together with the catering department, we were then able to develop a menu. There was, however, limited choice for vegetarian dishes and desserts.

Catering management came to a solution by providing the dietitians with recipes from the BHF website. These were analysed by CompEat, a computerised nutritional analysis program, to obtain their full nutritional composition. A completed menu was finally formulated from a combination of the usual cook-chill system and in-house conventional catering. A tasting session was arranged for representatives of the renal unit to test the quality of in-house produced meals.

Conclusion: We now have a menu that meets both the BHF requirements and the RNG guidelines as far as practically possible. It appears that we are one of the first renal units to succeed in this.