Can the NHS afford to ignore food and nutrition any longer?

Can the NHS afford to ignore food and nutrition any longer? This is the question that we started to address at the recent NutriTalks – conversations for change, hosted by MyNutriWeb and kindly sponsored by AYMES at The Royal Society in London on 21st of October. The event marked the beginning of a roadmap toward more cohesive, collaborative action on food and nutrition within the NHS that leaves no one behind and is fitting with the NHS 10-year health plan.  As part of this ongoing initiative, we are engaging with organisations, leaders and citizens across the system to co-develop a 10-point action plan that will be shared with NHS leaders and government. If you would like to get involved or share ideas to drive meaningful, collective change, we would love to hear from you at hello@mynutriweb.com 

By Marta Buczkowska, Registered Dietitian, MyNutriWeb and Mel Nolan, Registered Dietitian 

NutriTalks expert panelists 

At the event, we were privileged to welcome an inspiring audience consisting of healthcare professionals – including dietitians, nutritionists, nurses and doctors, catering, procurement and sustainability managers, catering supply companies, NGO and policy leaders, chefs, researchers, students and journalists. 

They joined an expert panel of leading voices in health, policy and NHS procurement: 

• Professor Kevin Morgan – Professor of Governance and Development at Cardiff University
• Philip Shelley – Senior Operational & Policy Manager at NHS England
• Anna Taylor – Executive Director at The Food Foundation
• Lucy Jones – Chief Clinical Officer at Oviva
• Dr Duane Mellor – Senior Specialist Dietitian and Honorary Associate Professor at University of Canberra 
• Dr Shireen Kassam – Consultant Haematologist and Director of Plant-Based Health Professionals UK

The discussion was chaired by Mary Hickson – a Professor of Dietetics at University of Plymouth and joined by Stella West-Harling – a social entrepreneur and food systems pioneer. Together, we explored policy, procurement, and practice gaps holding back nutritional care, as well as the clinical, economic, and ethical costs of under-prioritising nutrition. We looked closer at the role of leadership, discussed responsibility, and accountability in nutrition provision and heard inspiring stories on how change is already happening on the ground.

Why does nutritional care matter?

Research is clear: good food and nutrition prevent illness, supports recovery, and improves outcomes. And yet, despite brilliant individuals and organisations working tirelessly across the country, nutritional care remains uneven, reactive, and fragmented. The statistics are scary. As highlighted in the AYMES’ annual report Nutrition in Focus: A UK Overview – in the UK around 3 million people in the UK are malnourished, including 30% of hospital and care home patients.¹ The cost to the UK is estimated at over £23.5 billion every year.² The survey by Age Concern highlights that 6 out of 10 hospitalised older people are at risk of becoming malnourished, which has ripple effects on the hospital economy – longer hospital stay, threefold increase in the risk of developing complications during surgery and higher mortality rates in comparison to well-fed patients 1. At the same time, the number of people with diet-related conditions, such as obesity, cardiovascular disease or type 2 diabetes continues to rise.³ These numbers alone showcase why meaningful action to improve nutritional care across our healthcare system is urgently needed. 

Good food is the foundation of good health

We opened the evening by asking why good food and nutrition matter – not just for the healthcare system or the economy, but for each of us personally. We listened to a conversation between Mary Hickson and Stella West-Harling – a social entrepreneur and food systems pioneer, who shared her patient experience with food and nutrition in the healthcare system. Stella spoke about the fact that hospitals lack consistency. For example, on cancer wards, where funding is higher, food is nutritious and a priority, while on other wards it is often overlooked. Stella highlighted that hospitals have a vital role to play in helping people help themselves. Yet, patients often receive only vague advice such as “eat a balanced diet” or “eat regularly,” missing a crucial opportunity to make food an active part of the healing process. Her story powerfully illustrated how something as fundamental as food can shape a patient’s comfort and journey to recovery – and why rethinking hospital food is not only a matter of health, but also human dignity.

As summarised by Professor Mary Hickson: “Good nutrition is the foundation of good health. The food we eat helps us to heal, recover, and thrive. But beyond its physical benefits, food is about so much more – it’s about culture, comfort, and connection. It can bring us together and help us feel at home – even in the most stressful times.”

The main barriers to good food provision and nutrition in the NHS

Understanding the reasons behind the current state of hospital food and nutrition is essential to develop effective strategies aimed at putting nutritional care where it belongs – at the centre of healthcare. That’s why we opened up the panel discussion by exploring the key barriers to good food and nutrition in the NHS. These are summarised below:

1. Unclear accountability and responsibility. Without clearly defined roles and ownership, progress stalls and policies risk falling through the cracks.
2. Lack of monitoring, evaluation and accreditation tools. Even though the UK has introduced meaningful policy measures, without proper monitoring and evaluation, their effectiveness cannot be accurately assessed or improved over time.
3. Food procurement is currently not at the heart of the system. At the moment, most food procurement falls under estate and facility procurement teams, yet food is not a basic commodity – it is fundamentally different – it is a core component of patient care and public health.
4. Not enough investment to provide consistent and effective support to all patients.
5. Hospital food faces an identity crisis. We need to identify what food is used for and what the focus should be. NHS food, and food in general, should be a care pathway not food on a plate or a service, food should be seen as a therapy tool.
6. Clinicians often do not realise the importance of good food and nutrition in patients’ journey – including prevention, recovery and post-discharge period. 

Audience insights 

During the event, the audience was encouraged to contribute to the discussion through answering questions and participating in polls and mind maps. Overall, 74% described the current quality of food and nutrition in the NHS as ‘poor’ or ‘mixed’, while 75% believed nutrition is currently given ‘very low’ or ‘low’ priority within our healthcare system. Audience members identified multiple barriers to better food and nutrition, while some of the reoccurring themes included:

• Lack of funding 
• Beliefs 
• Insufficient education and training 
• Limited recourses 

Notably, the challenges highlighted by both the expert panel and the audience closely aligned – underscoring that the systemic issues identified by panellists are clearly reflected in the lived experience of many healthcare professionals working on the ground. 

While these barriers highlight the challenges currently holding the system back, they also point to where the greatest opportunities for change lie. One of the most powerful of these opportunities is rethinking the role of hospital food itself – not only as part of patient care, but also as a driver of a more sustainable and resilient food system.

Transition towards more sustainable hospital food

Echoing the insights shared at the launch of the 2025 EAT-Lancet Commission Report, the panel discussion highlighted how transforming nutritional care in hospitals can inspire a wider shift toward plant-rich diets that benefit both human and planetary health. Dr Shireen Kassam pointed out that food systems are a significant driver of climate change, contributing to 30% of global greenhouse gas emissions, significant land and water use, as well as biodiversity loss. At the same time, our food supply chains are highly susceptible to the consequences of the climate crisis – including adverse weather conditions, such as droughts or floods, leading to increased food prices or even poorer nutritional quality of food.^4,5 What is more, climate change also has negative consequences on our health – worsening respiratory issues, triggering cardiac events or heat strokes⁶, and leading to more hospital admissions, which in turn add pressure to an already stretched NHS.

As explained by Philip Shelley, more and more trusts are starting to provide more plant-rich meals or minimising food waste – with some regions moving faster than others, but we need more education and strong leadership to empower food provisioners, dietitians, catering managers, chefs and others to promote meals aligned with the Planetary Health Diet to patients, hospital staff and visitors. Anna Taylor highlighted that beyond providing health and environmental benefits, moving towards more sustainable food provision could also support local economies. By prioritising local food provision, hospitals (alongside school, prisons and other public facilities) could contribute to shaping the economy of scale, ultimately benefiting British farmers, local communities and our environment. 

Stories of change from leaders on the grounds

Understanding the theory is essential – but real transformation happens on the ground. As we created NutriTalks to be a space to exchange ideas and spark inspiration, we invited true leaders driving change where it matters most to talk about their experience and share their expertise with our audience. 

One of them was Raouf Mansour, Head of Catering and Housekeeping at Ashford and St Peter’s NHS Trust, and a healthcare catering consultant working with trusts across the UK. Raouf has transformed the approach to nutrition at Ashford and St Peter’s Hospital, and generously shared key lessons from his journey. We learnt that for meaningful change to occur, it is essential to challenge existing perceptions, starting from changing the language we use: instead of ‘staff canteen’, we should use the word ‘restaurant’, and instead of ‘suppliers’, let’s call the people we work with ‘partners’. Such shifts encourage collaboration, respect, and a shared sense of purpose that drives long-term success. Investing in staff training is also critical, as it equips teams with the skills and knowledge needed to embrace new practices. When Raouf first took over, the staff restaurant only attracted around 20-30% of the population. After the significant changes he has introduced at the trust, it now attracts nearly 80% of the staff and the income has more than doubled. Moreover, the subsidies the canteen received gradually went down from £800 000 to £53 000. These results clearly demonstrate the substantial financial benefits achieved when the quality and taste of food are prioritised.

As highlighted by Raouf, for change to be possible, the proposals should be supported by strong business cases, clearly linking initiatives to patient outcomes, customer satisfaction, key performance indicators, relevant frameworks, and return on investment. 

We also had a chance to hear from Robert Strachan – a Catering Manager at the Hampshire Hospitals NHS Foundation Trust, representing the Hospitals Caterers Association. Robert highlighted that creating change in hospital food services requires moving beyond traditional “meat and two veg” menus to offer modern, nutritious, and visually appealing meals. He also pointed out that we should not forget about hospital retail, which currently contributes to poor health of hospital staff. Offering nutrition courses to hospital workers can improve their own well-being and enable them to pass healthy habits on to patients, creating a positive ripple effect throughout the hospital. Robert highlighted that engaging leadership, including the chief executive and chief nurse, is essential to drive this transformation.

Why strong leadership matters?

One recurring theme discussed by the panellists and audience members is the need for brave, inspiring leadership and intersectoral collaboration. We need courageous leaders across chief executive officers (CEOs), catering managers, chefs, dietitians and other healthcare professionals to drive meaningful change. As highlighted by the panel – education is one of the most powerful catalysts for change. To truly transform how leadership values and integrates nutrition within our healthcare system, we must ensure that all managers and healthcare professionals – including doctors – are educated about the essential role of nutrition in prevention, treatment, and recovery. One of the ways this could be achieved is through embedding robust nutrition education within the university curricula and as part of professional training.  

However, as pointed out by the expert panel, strong leadership is not enough, as change cannot happen in silos. As one of the experts leading the hospital food transformation, Idrees Anwaar – a Food Service Lead Dietitian in the NHS Supply Chain, discussed why fostering close collaboration between catering teams, clinical dietitians, catering managers, and trust leaders is essential. By working together and understanding each other’s challenges, we can build the mutual support needed to achieve lasting change. 

We need intersectorial collaboration 

Our event was kindly supported by multiple organisations already leading the transformation and raising the bar for nutritional care in the NHS – including Greener By Default, Plant-Based Health Professionals UK, MyNutriWeb, AYMES, ProVeg, Real Zero, UK Health Alliance on Climate Change, Malnutrition Action Group and the British Dietetic Association Food Service Specialist Group (BDA FSSG), who have highlighted their determination to (1) promote developing menus that meet patients needs (2) educate and empower dietitians (3) embrace research and (5) promote sustainability and intersectoral collaboration. Momentum is clearly building.

However, there are many areas for improvement that need addressing. As pointed out at the event by Giovanna Dicandia – a Nurse Practitioner, the system is currently overlooking nurses as one of the key drivers of change. Giovanna highlighted that nurses are the most trusted professionals in the NHS and are ready and willing to support nutritional changes, but often feel isolated and disconnected, facing disparities in resources and guidance. Many nurses recognise that poor diet is a primary contributor to patients’ hospital admissions, and they are themselves bearing the burden of treating the consequences of unhealthy eating. Nurses are calling for support from senior leadership, emphasising the need for joint messaging and clear guidance from the top to drive meaningful change. 

Designing the NHS food strategy from scratch

As the evening drew to a close, we turned to both the audience and our expert panel with one final question: If you were designing the NHS nutrition strategy from scratch, where money is no object, what would the main priority be?

The audience highlighted several priority actions to drive meaningful change:

1. Strengthen education and training to ensure all healthcare professionals and leaders have the knowledge and confidence to bring nutritional care from the margins to the mainstream of healthcare.
2. Build strong partnerships and foster lasting collaborations across teams and sectors to ensure effective and sustainable implementation.
3. Integrate more plant-rich meals into nutritional care to promote healthier, more sustainable food options.

Interestingly, the majority of attendees identified dietitians, together with senior leadership and government bodies, as the key drivers of this change – underscoring the importance of shared responsibility and coordinated action across all levels of the healthcare system.

While the expert panel underscored the importance of: 

1. Empowering brave and inspiring leadership. We need to believe in each other; we need to learn from others and cooperate to achieve meaningful change. As highlighted by Philip Shelley: we do not need managers, we need leaders.
2. Fostering lasting partnerships. There are many ‘bubbles of good practice’ across the country, but they are currently not joined up. As highlighted by Dr Duane Mellor – we need strong partnerships and teams working together to spark lasting change. While the NHS is traditional, it is also diverse, and partnerships are helping to introduce more innovative solutions and broaden people’s perspectives.
3. Developing strong frameworks and policies that foster, rather than frustrate, change. While strong leadership is vital, lasting progress depends on systems that sustain good practice long after individual leaders move on.
4. Raising the profile of food. Food must be given greater esteem within the NHS, reflecting its importance for health outcomes and staff wellbeing. We need to recognise nutrition as a central care pathway and, in Duane Mellor’s words: foundation block of healthcare – not merely a service provision.
5. Developing strong monitoring, accreditation and evaluation tools. Strict standardised monitoring and evaluation tools alongside a national accreditation system are needed to ensure accountability, generate leadership, drive inspiration and disseminate good practice.
6. Holding leaders accountable. All healthcare professionals, trust and Integrated Care Boards (ICBs) leaders should be responsible for good food provision, but it is the CEO who should be held accountable if the standards are not being met.
7. Championing prevention. Nutrition has the power to prevent disease and promote healing, not just to treat a single symptom or condition as pharmaceuticals do, but to support overall health across many areas. As Kevin Morgan highlights – the ‘Good Food Movement’ needs to have a stronger voice on prevention, influencing government policy to support healthier populations.
8. Climate change mitigation and adaptation. Food systems significantly contribute to greenhouse gas emissions, land and water use or biodiversity loss – all of which have a significant impact on our health and wellbeing. Hospitals should lead by example through promoting plant-rich, minimally processed nourishing, diverse whole foods diets that promote both human and planetary health.
9. Strengthening digital tools. We should enhance access to information and practical assistance through digital platforms to support both staff and patients in implementing nutritional improvements. As Lucy Jones explains, they could help with monitoring, screening, evaluation and even with understanding patients’ preferences.
10. Providing healthcare professionals with the education, resources, and support they need to improve both patient and staff nutrition, positioning them as confident key drivers of lasting change in the NHS.

Last but not least, we need to do our best to amplify the stories of good practice. While it’s vital to identify areas for improvement, if the hospital food narrative focuses solely on shortcomings, it risks leaving people feeling hopeless and disengaged. As Anna Taylor reminded us, celebrating what’s working is just as important – it inspires others and fuels the momentum for change. 

We need your input to drive meaningful change

The main goal of the event was to begin curating a 10-point action plan consisting of specific steps we could all take to accelerate food and nutrition care in the NHS and see it become a jewel in the crown of healthcare. This NutriTalks was just the beginning – we will continue our mission to help move good food and nutrition from the margins to the mainstream of our healthcare system through a series of further discussions, round tables, focus groups and engagement with senior NHS leaders and government. And we would ask for your ongoing support. If you would like to become a part of this movement, want to share insights or inspiring stories of change, make sure to contact us at hello@mynutriweb.com 

Thank you to all the partners who made the event possible, including the Guild of Health Writers, ProVeg International, Plant-Based Health Professionals UK, Real Zero, Nutrilicious, AYMES*, Greener By Default, MyNutriWeb, SENSE, UK Health Alliance on Climate Change, Malnutrition Action Group – A Standing Committee of BAPEN and the BDA Food Services Specialist Group.

*AYMES kindly funded this important meeting with a non-restricted educational grant.

AYMES is proud to support this NutriTalks and related initiatives advancing the quality of nutrition care across healthcare. As a company dedicated to improving patient outcomes through evidence-based nutritional solutions, AYMES recognises the vital role that good nutrition plays in recovery, wellbeing and long-term health in addition to planetary health. By partnering with professionals and organisations who are actively driving change, AYMES is committed to raising standards and ensuring that nutrition is prioritised as an essential part of patient care.

NutriTalks are free to attend and are made possible via unrestricted CPD educational grants received at MyNutriWeb – the Nutrition Education Hub. Grants do not imply any endorsement of organisations or brands by MyNutriWeb, its organisers, its moderators or any participating healthcare professional, or their association. Grants are invested into the creation and promotion of CPD professional development opportunities via MyNutriWeb.

Useful resources to get familiar with: 

1. AYMES Academy: https://aymes.com/pages/aymes-academy 
2. Malnutrition Action Group (MAG): https://www.bapen.org.uk/groups/bapen-committees-and-groups/malnutrition-action-group/ 
3. Plant-Based Health Professionals’ resources: https://plantbasedhealthprofessionals.com/ 
4. Real Zero’s work: https://www.realzero.earth/ 
5. UK Health Alliance on Climate Change website: https://ukhealthalliance.org/ 
6. Greener By Default: https://www.greenerbydefault.com/ 
7. BDA Food Services Specialist Group’s resources: https://www.bda.uk.com/specialist-groups-and-branches/food-services-specialist-group.html 
8. SENSE: sense-nutrition.org.uk 
9. Proveg International: https://proveg.org/about-us/ 
10. Guild of Health Writers: https://healthwriters.com/ 

MyNutriWeb – the CPD Nutrition Education Hub for health professionals: www.mynutriweb.com

References

1. AYMES. Nutrition in Focus: A UK Overview 2024. https://cdn.shopify.com/s/files/1/0164/2598/files/Aymes_Nutrition_in_Focus_Report_Download_Layout_High_Res_site.pdf?v=1723116876
2. BAPEN. The cost of malnutrition in England and potential cost savings from nutritional interventions (full report). 2015:96. https://www.bapen.org.uk/pdfs/economic-report-full.pdf
3. Taheri Soodejani M. Non-communicable diseases in the world over the past century: a secondary data analysis. Front Public Health. 2024;12:1436236. doi:10.3389/fpubh.2024.1436236
4. Erdogan S, Kartal MT, Pata UK. Does Climate Change Cause an Upsurge in Food Prices? Foods. Jan 2 2024;13(1)doi:10.3390/foods13010154
5. Owino V, Kumwenda C, Ekesa B, et al. The impact of climate change on food systems, diet quality, nutrition, and health outcomes: A narrative review. Frontiers in Climate. 08/01 2022;4:941842. doi:10.3389/fclim.2022.941842
6. Rocque RJ, Beaudoin C, Ndjaboue R, et al. Health effects of climate change: an overview of systematic reviews. BMJ Open. Jun 9 2021;11(6):e046333. doi:10.1136/bmjopen-2020-046333