Back in 2015, the Conservative Party set out an ambition to deliver a seven-day hospital – providing access to many of the equivalent quality primary & secondary care services during the weekend, as patients have access to during the week¹.
Covid, and the consequent increase in the elective backlog, has driven the need to create additional capacity within the system, resulting in a range of new initiatives such as the Community Diagnostic Hubs, ‘Virtual Wards’, the Adult Social Care Discharge Fund, Private Sector support and additional localised bed capacity creation.
There has also been a renewed call for broader access to services 24/7 – which has been cited as one potential solution to increase capacity. In November 2022, Health Secretary Steve Barclay suggested that having fewer decision makers available at the weekend was delaying discharges – creating blockages in care pathways².
Challenges in achieving 24/7 treatment and care
Freeing up clinical care pathways and delivering an expanded range of clinical services 24/7 requires the NHS to overcome several significant challenges:
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Workforce shortages – potentially taking people away from weekday service delivery
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Additional cost – overall hospital costs could increase by 1.5-2 per cent³
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Fitness of the estate – increased pressure on an already challenged hospital infrastructure
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Integrated working – a 24/7 hospital could also require 24/7 community & step-down input
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Support & facilities services – many of which run 24/7 but in skeleton form out of hours.
For many support & facilities services, the NHS uses outsourced arrangements, to increase capacity and capabilities in their workforce. Whether delivered ‘in-house’ or by external partners, many services already operate seven days a week, such as security, portering, cleaning and patient dining. However, with limited resources, many are focused on peak times during the day, meaning a skeleton operation is delivered during the night and at weekends.
24/7 access to food & drink
An example of skeleton service delivery is the hydration and nutrition support offered outside of standard working hours. Patient dining services are only provided at core times and access to food and drink off the ward 24/7 can vary significantly. It’s such an important factor in a patient’s wellbeing and satisfaction that the CQC added, for the first time, a question about the availability of food outside set mealtimes to its 2021 Adult Inpatient Survey.
The survey found that nearly a third (27.5%) were unable to get any food and 30.4% could only ‘sometimes’ access food outside set mealtimes.⁴
However, it’s not only patients who require these essential support services. The National Standards for Healthcare Food & Drink, published in November 2022, highlighted that over half of food provided in NHS hospitals is served to staff and visitors, and their needs can differ significantly.
Meeting the National Standards for Healthcare food and drink
The standards outline the need for organisations to consider how to best support shift workers’ nutritional requirements, as this group suffer higher rates of chronic illnesses, such as diabetes.
Although overnight restaurant services for staff are ideal, the best solutions should consider demand, convenience and value. Staff may not always have the time to go to the restaurant or café, even with employers supporting meal breaks, and so providers and their partners should look for innovative ways to provide healthy, balanced, hot and cold options 24/7⁵.
Read more: The new National Healthcare Food & Drink Standards - Interview with Phil Shelley
Sodexo’s 24/7 Deli Solution
Ahead of the publication of the standards, Sodexo recognised the need for increasing access to retail and restaurant food and drink, initiating several new, innovative solutions – such as the Costa to You service.
A Sodexo survey carried out at Manchester University NHS Foundation Trust found that 37% of staff didn’t use the retail services because of time and 25% due to the opening hours of these services
One solution designed to speed up and improve access to food and drink is the new 24/7 automated deli. Partnering with unattended retail experts, SV365 Technologies, Sodexo is the first provider in the UK to offer this solution and the first of its kind in hospitals too. With a vast array of food and drink available on demand, Sodexo can provide fresh, nutritious hot and cold food options throughout the day and night.
Dishes include allergen-free, healthy choices, Halal, plant-based (vegetarian and vegan) as well as cultural-choice options and can be tailored to the needs of that hospital site. This new innovative solution will help boost staff morale, improve their wellbeing, and impact the overall patient experience delivered. And early indications are that staff really value the new solution – scoring 9.8/10 in likelihood to recommend⁶.
Tracey Bullock, Chief Executive of University Hospitals of North Midlands NHS Trust recently said ‘we can deliver healthy meals, to meals that are more filling and substantial through the night shift. So, I think staff are really pleased with it.’
The 24/7 automated deli not only enhances choice but the availability of fresh, nutritious options also significantly raises the standards for what’s available outside of core hours – with clinical teams and hospital visitors rating quality of food delivered as 4.93/5⁶.
The introduction of this solution was recently praised by Phil Shelley, Chair of the Food Review, who stated ‘It’s superb to see such ambition and determination to “make that change” – thank you for the partnership working.’