PATIENTS GET THE PIP

Patients go bananas over lack of apples

An apple a day keeps the doctor away. Or so we are told. During Charlotte Lebon’s recent hospital stay, she saw plenty of doctors, but there were no apples in sight.

“Have you got an apple?” I asked, when the catering trolley came beside my hospital bed. ”No, only satsumas or bananas,” said the trolley man.

I asked the same thing every day for five days, and there was never an apple, at the time of a bumper Kent apple harvest.



The main meal menu was shown to me on a card every morning, and the choices were always the same – about three meaty choices, one fish, and two vegetarian (a salad and a cheesy dish).

In the evening, there was soup of the day, and packet sandwiches from sliced bread.  I was never told I could make special diet requests, which I subsequently read in some small print from the East Kent Hospital Trust. If you’ve been admitted as an emergency, you are too shocked and fearful to make assertive requests, and have no idea how the system works.

So it was a week or so after discharge, that I began to consider my experiences of hospital diet, now under a new vegan regime to suit my new health condition.

The main problem is that the diet is not for vegans.  They have got as far as providing for vegetarians (that cheesy pasta) but not for vegans or people coming from ethnic traditions, whose meals would ideally include more beans and pulses. If I had eaten that salad every day, I would have been deficient in proteins;  if I had been lactose-intolerant, there were no alternatives for the beverages; and had I been gluten-intolerant, there was no alternative to those sandwiches.

The controller of the contents of those bedside trolleys is 2gether Support Solutions, a wholly owned subsidiary of the East Kent Hospital Trust. Their website boasts:

“We deliver high quality, award-winning catering services to over one million patients a year. We provide tailored inpatient menus alongside hospital restaurants and cafes, working alongside clinical teams to ensure patients’ needs are met and promote healthy eating.”

No offer of that tailored inpatient menu for me, nor for the patient within earshot who was foolishly eating eggs every day, exacerbating her condition. I considered whether finance restricted the supplies. Surely not for those apples, which in that season were so abundant this year that the hospital could almost have got them for free from local farmers!

Menu

As for vegan options, it could not, of course, be expected to stock the ward trolley with all the choices of Waitrose (other supermarkets are available). But a reasonable expectation would be a non-dairy option with the beverages (oat or soy milk), and a vegan option in the main meal (either a pulse or tofu).

As an alternative to those buttered sandwiches, a wrapped roll with a hummus dip. And alongside the biscuits could be some carrot and celery sticks. I do not see how these new items could be challenged on grounds of cost, hygiene or room on the trolley. But I tried making these suggestions through the PALS patient comment system for three months, with no reply.

According to Waitrose Weekend, 7.1.21 p3, “Plant-based diets reduce a personal carbon footprint by 73%, and 62% of adults bought plant-based milk in 2020. There was a 26% increase in Waitrose sales of plant-based products in 2020.”

Apple in plastic bag.

Whoever makes the catering decisions at 2gether is stuck somewhere in the 1990s. Pity the vegan patients stuck in an East Kent hospital. Some of them might still be asking for apples..


For the record

Thank you for your response, indeed your feedback has highlighted a communication concern of which we have noted throughout our investigation. We have taken actions from your feedback which will be addressed within our housekeeping training sessions.

We take all feedback very seriously and do our best to continually improve the service we provide with it. Your points raised are very much appreciated.  


Thank you for your response to my complaint about menu choices in WHH.

I am somewhat reassured that you do now have more vegan choices and Kent Bylines will publicize this.

However, I think the problem now is to ensure staff are well-trained to communicate this to patients. On their first day in a ward, patients are often confused, and intimidated by the new environment, so those with something to communicate have to make a special effort.

It needs to be someone’s duty to specifically ASK a new patient about dietary preference, and then some sign should be put over that patient’s position so that the trolley staff know that they must offer further choices to that patient, including the full vegan menu if requested. It is all too easy for the trolley assistant just to say “tea or coffee” to each patient – and fail to point out that there are choices in the teas and choices in the milks.

I am intrigued by your assertion that apples pose a contamination risk. Could you please give me the reference to this research finding?


In relation to the apples, there is potential for chemical and biological contamination. Apples are skinless in terms of an edible outer layer, therefore increasing risk should it be mishandled or stored inappropriately (ie at bedsides). For example, if a domestic was to clean your table with the use of a chemicals this could potentially contaminate the apple placed on the table, in addition should a member of staff or another patient in close proximity have a virus of any kind unknowingly they could potentially contaminate it.

We do stock a variety of apples in addition with other fruits such as pears, kiwi’s, peaches etc and can provide them to our patients. This service is delivered through our diet chef, this reduces risk of contamination significantly as limited handling is present and appropriate storage is provided in terms of suitable packaging of the apple.  

Again, should you have any further question please do not hesitate to ask.


Thanks for your quick response. I am much reassured that my feedback is useful.

Apple in plastic bag.

Now about apples. The workaround this is for the trolley assistant to put the apple in an easy-seal bag and instruct the patient to take it out only when they are about to eat it. Also warn nurses to and cleaning staff to REMOVE any apples found out of the bag on the ward furniture near the patient’s bed. The same treatment could apply to peaches, nectarines, plums, cherries as they come into season.

We have considered a seal bag but as an organisation we are working on being environmentally friendly and by adding further non-recyclable/plastic materials to our service we felt we would be moving backwards. Having said that, our procurement team are working closely with local companies as part of our social values to get biodegradable packaging solutions of which the market has significantly improved in this area in the last year. With this in mind, we will definitely consider your feedback as a way forward once we have the packaging in place

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