Hospitals were told seven years ago not to give ready-made sandwiches to vulnerable patients because of food poisoning risks.
The warning about the listeria bug that has killed five patients over the past few weeks was issued by the British Sandwich Association and endorsed by the Food Standards Agency.
It specifically advised that ready-made sandwiches should only be given to the sick, including the elderly and those with a depressed immune system, on a doctor’s say-so.
Hospitals were told seven years ago not to give ready-made sandwiches to vulnerable patients because of food poisoning risks
However the FSA relaxed its advice in 2016 and decided patients could eat packaged sandwiches and other chilled foods without medical approval.
The U-turn will come under scrutiny as the Government investigates the listeria deaths.
The outbreak, which has left several others ill, has been blamed on sandwiches and salads.
Five hospital patients have now died after a listeria outbreak linked to pre-packed sandwiches by The Good Food Chain (pictured), which is considering suing the supplier who was the source of the infection
Health Secretary Matt Hancock faced an urgent question in the House of Commons yesterday.
He said the crisis had affected hospitals across the country and promised a full investigation with ‘severe consequences’ if wrongdoing emerged.
MPs demanded to know why sick and vulnerable patients were being fed a product known to be a food poisoning risk.
- They complained of cost-cutting with some hospitals spending as little as £2 or £3 a day on a patient’s meals. As the row over the outbreak intensified:
- Mr Hancock admitted cases had been reported in eight hospitals from Manchester to Worthing on the south coast;
- He urged anyone suffering symptoms of listeria, which include a high temperature and stomach problems, to contact NHS 111 or, in severe cases, dial 999;
- Public Health England continued to refuse to give details of the patients;
- The Food Standards Agency said it had revisited its guidance for suppliers and NHS trusts on serving sandwiches;
- The Chilled Food Association warned that safety standards at firms supplying sandwiches to hospitals remained lower than those sold to supermarkets;
- It emerged that a 2014 report by food consultancy STS had identified packaged sandwiches as the cause of ‘almost all’ of nine previous hospital listeria outbreaks.
The original warning about ready-made sandwiches and listeria was written in February 2012 by Jim Winship, director of the British Sandwich Association. He wrote: ‘In view of concerns raised about the risks to certain vulnerable patients from listeriosis, the BSA is recommending that sandwiches and salads should not be served to these high risk patients without the prior agreement of the clinicians responsible.’
An FSA official backed this advice, writing: ‘I would support the reissuing of this advice to your members.’
The FSA insisted it was right to change its advice three years ago. It said: ‘The FSA listeriosis guidance, published in 2016, is robust in setting out good practice controls that hospitals can put in place to manage listeria risks.
‘We have revisited this guidance in light of the outbreak and have confirmed that it remains current.’
Kaarin Goodburn, director of the Chilled Food Association, said patients were dying because NHS sandwich suppliers were not forced to stick to the strict environmental and hygiene requirements for those supplying major retailers.
Listeria monocytogenes (stock) as found in the pre-packaged food sold at hospitals. The warning about the listeria bug was issued by the British Sandwich Association and endorsed by the Food Standards Agency
According to Public Health England, the source of the current outbreak is products supplied by The Good Food Chain and the affected sandwiches and salads have since been withdrawn from hospitals.
The first three victims who died from food poisoning had been receiving treatment at Manchester University NHS Foundation Trust and Aintree University Hospital NHS Foundation Trust in Liverpool.
The other cases occurred at St Richards, Chichester, Worthing, Wexham, Royal Derby, William Harvey in Kent, and Leicester Royal Infirmary.
These deaths are tragic – but the rotten truth of hospital food is even worse, writes Radio 4’s Food Programme presenter SHEILA DILLON
The dollop of sludge on my plate defied belief. I prodded it with a fork, wondering how anything could look so unlike real food.
I was told it was potato, but it had the texture of plastic. I placed some on my tongue: it tasted like plastic, too. Whatever this was, it wasn’t nutritious. I was reminded of Smash, the heavily-processed dried potato flakes of yesteryear. Yet Smash was practically cordon bleu compared to this NHS version.
The dollop of sludge on my plate defied belief. I prodded it with a fork, wondering how anything could look so unlike real food (pictured, Sheila Dillon)
I phone a friend who lived nearby and begged her: ‘Please bring me some bread and cheese and a bit of fruit. I’m starving!’
I was diagnosed with multiple myeloma, a cancer of the bone marrow, in 2011. Since then I have had three stays in hospital, over several nights, after contracting infections during chemotherapy.
Treatment is not always pleasant, but I have never been so ill that I was unaware of everything around me and so I have seen at first hand how badly most hospitals handle meals.
I have been recalling that experience over the past weekend after reading that five people have now died after contracting a form of food poisoning known as listeriosis from eating NHS sandwiches contaminated with the bacteria, listeria. Hospital patients, including pregnant women, babies and the elderly, are uniquely vulnerable to complications of food poisoning caused by the bacterium. It killed 33 people in 2017.
Health Secretary Matt Hancock last weekend ordered a ‘root and branch’ review of NHS food as a result of the latest outbreak.
It cannot come a moment too soon. I believe these deaths are a grave underestimation of the dire effects of appalling levels of nutrition in our health service.
Some NHS patients are served meals that cost less than £1 a head, according to figures compiled last year by NHS Digital.
Health Secretary Matt Hancock last weekend ordered a ‘root and branch’ review of NHS food as a result of the latest outbreak
Other hospitals spend only slightly more than £2 a day on each patient – a few pence more than the cost of a day’s food for a prisoner in our jail system. This is a problem that has been with us for years and for years we’ve been told repeatedly that it is being fixed.
The celebrity chef and TV presenter Loyd Grossman attempted to tackle the issue when he led the government’s Better Hospital Food initiative between 2001 and 2006.
Eventually he was forced to admit defeat, saying: ‘Our efforts were hampered by a lack of political will.’
Before that it was Albert Roux, co-founder of the Michelin-starred restaurant Le Gavroche, brought in to improve hospital food standards in 1995. Two decades later, he was still bursting with frustration, calling for wholesale change to the hospital food system.
‘We must not think that high-quality hospital food is too difficult or expensive to achieve,’ he said. ‘But meetings, speeches and gimmicks do not work.’
He was right.
As recently as 2015, Prue Leith (pictured), now star of the Great British Bake Off, tried to tackle the pitiful state of NHS catering. She warned that ‘few hospital kitchens are actually cooking any food. All the staff do now is reheat frozen meals’
As recently as 2015, Prue Leith, now star of the Great British Bake Off, tried to tackle the pitiful state of NHS catering. She warned that ‘few hospital kitchens are actually cooking any food. All the staff do now is reheat frozen meals’.
So why, after the millions have been spent on these initiatives, have we seen so little progress? Indeed, it’s getting worse.
I believe it is partly it is because many of us expect hospital food to be dreadful: a throwback to the earliest days of the NHS after the war, when a spell on a ward didn’t seem so different from the rigours of national service. But today we understand much more about nutrition. The science linking our gut with our immune system is revolutionising our understanding of what underlies good health – though doctors still learn almost nothing about it at medical school.
After my own experiences on a chemotherapy ward, I decided to investigate how diet influences our vulnerability to illness and what we can do to minimise our risk.
Anyone with cancer, for example, should eat plenty of vegetables from the cabbage and onion families as well different kinds of mushroom. I learnt also that the spice turmeric can be very helpful for my own cancer.
Many patients are too ill, however, to control their diets to any serious degree. That is why hospitals should know better than to serve the cheapest low-quality food to save a few pennies. It’s short-sighted and counter-productive. Even if the meals are not actually toxic, poor nutrition will undermine expensive drug treatments and mean that recovery from illness takes longer.
Too often, as we now know, the food doled out on the wards, either reheated or taken from faulty chiller cabinets or transported hundreds of miles from a manufacturer, may be rife with