HOSPITAL FOOD: Hospital mealtimes can be unhappy for patients.June Davis reports on how a trust has introduced nutrition assistants to help their recovery

Better hospital food for patients, improved nutrition and happier mealtimes have been the focus of several reports over the past decade.

1-4 assist patients who need help with their meals;

document patients' food and drink intake;

determine patients' food preferences;

complete menus and offer choices of menus and snacks as appropriate.

The posts have been financed from vacancy money from nursing budgets.We advertised the posts, which have salaries ranging from£10,300 to£11,500, and received high-calibre applications.

The nutrition assistants work across a range of wards, including oncology, renal, geratology and general medicine.Most have limited, if any, NHS experience and bring to their role a variety of new skills. Key skills to undertake this role include:

communication skills;

listening to patients' needs and anxieties;

empathy;

common sense.

Reasons why people applied for the posts included an interest in food and nutrition, wanting to help and talk to patients about food and drink in a relaxed way, and having the ability to help to make their stay in hospital more pleasant.

In their first month, nutrition assistants attend a food hygiene course and spend time with dieticians and the catering staff. The first nutrition assistant was appointed in December last year. Initially, there was some role conflict with other staff such as ward assistants, domestic staff and healthcare assistants.

But the role has been emphasised as complementing rather than conflicting with their duties.

A patient questionnaire was completed before nutrition assistants began their jobs and has been repeated now they are established. Patients perceive the main benefits to have been:

more help in completing menus;

more discussion of likes/dislikes;

all the hospital menus have been offered to patients rather than just one menu;

helping to highlight patients at risk of poor nutrition at an early stage;

ensuring the patients receive the required nutritional supplements and snacks;

ensuring likes and dislikes are discussed with the patients in detail to enable them to get the best from the menu;

dedicated people are available to monitor nutrition on a daily basis at ward level;

patients receive their preferences for food and drink, leading to less food wastage;

patients receive consistent help with feeding if they are unable to help themselves;

ward staff are clear about patients' nutritional needs.

Hospital catering itself has also seen gains, which include:

significant improvements in communication between catering staff, ward staff and the dietetic department, with catering now having a 'direct link to the patients';

highlighting of less popular menus assists with menu review.

We believe that building on this success and extending the numbers of nutrition assistants to cover all wards will further improve patients' welfare.

patients feel more able to discuss food and drink, now someone has the time to listen.

There have also been major benefits to dietetics.

These include:

releasing the dietician to review those specifically requiring dietetic input while liaising and allowing the nutrition assistant to intervene, particularly with those patients who have poor appetites.

Ward staff have also identified improvements to their own situation. For example:

menus are correctly completed, ensuring patients receive what they order;