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Case studies

Below you will find a variety of European case studies of healthcare providers tackling food waste in their hospitals, often as part of a wider sustainable food strategy. Many of these case studies are featured in HCWH Europe’s publications where you can read more about the work to reduce food waste in the European healthcare sector.

Hvidovre Hospital, Denmark, provides an excellent example of the prevention and reduction of food waste. With more than 5.8 million patient meals, and 5.1 million staff meals per year, patients can choose from an à la carte menu, with different menu options for patients in the paediatric department. Using this ordering system, patients receive small portions (but have the possibility to order a double portion if they want more) and thanks to this system, food waste has been reduced. The system requires dialogue between the kitchen and the departments within the hospital, as well as with the patients, and this dialogue contributes greatly to both patient and employee satisfaction.

In addition to delivering high-quality, seasonal, and local produce, the hospital has introduced a strict inventory management system, particularly for dairy products, constantly monitoring any remaining produce in the fridge. The hospital also pays particular attention to the aesthetics of their dishes, making the food served more attractive. In terms of re-use, uneaten sandwiches from the staff canteen are served in the cafeteria.

Read more: Food waste in European healthcare settings

Serving over 1.7 million meals per year to patients and staff, the annual plate waste at Le Mans Hospital Centre is 200 tonnes from 80 wards.

The hospital has carried out a study to quantify the food wasted after breakfast, lunch, snacks, and dinner. It has been recorded that, due to changes to patient diets for medical reasons, food waste rates can vary from breakfast to dinner. This study, based on weekly cycles, differentiates between food products (meat, vegetables, cheese, bread, fruit, etc.) and other disposable waste (plastic, paper, or glass) throughout the week.

Read more: Food waste in European healthcare settings

A general hospital in Mid-West France the Niort Hospital Centre employs 3,000 people and offers a complete range of medical, psychiatric, and surgical services in the Deux-Sévres region to 75,000 patients annually.

The hospital serves over 900,000 meals per year, which are prepared and cooked in an on-site kitchen. The hospital includes their food and catering services in their sustainable development approach, which is based on a 21-point agenda that includes goals to include sustainable development criteria in procurement, to reduce food waste, and to improve food quality and general well-being of patients and employees.

Read more: Fresh, healthy, and sustainable food: Best practice in European healthcare

Located in the south of France, the Perpignan Hospital Centre is a medium-size hospital serving 740,000 meals per year, including employees’ meals. These meals are all produced in the Hospital’s central food production unit, which allows the development of varied and appetising dishes, which contributes to the improved nutrition of patients and a reduction in food waste.

Read more: Fresh, healthy, and sustainable food: Best practice in European healthcare

Serving over 1 million meals annually, (approximately 3,100 per day), the Sant’Orsola-Malpighi Polyclinic in Bologna has been operating a central kitchen since 2010 enabling control over the meals served to patients.

In collaboration with the University of Gastronomic Sciences in Pollenzo (commonly called The Slow Food University), the hospital holds courses for kitchen staff and workshops on sustainable food for all staff.

Read more: Fresh, healthy, and sustainable food: Best practice in European healthcare

In the Netherlands, more than 25% of food in hospitals and healthcare institutions is thrown away, representing a loss of €50,000 – €150,000 per hospital annually (depending on the type and size), according to the research carried out by the Wageningen University & Research.

Reducing food waste starts with awareness: processing, analysing, and presenting food waste data both internally and externally is important in order to promote change, and leads to significant improvements in the reduction of food waste in healthcare facilities.

Read more: Food waste in European healthcare settings

Providing a range of healthcare services for over 1 million people, the Germans Trias i Pujol University Hospital in Badalona serves approximately 130,000 patient meals annually from its on-site central kitchen – 547,500 meals are served in cafeterias to both staff and visitors.

The hospital’s “3Rs Strategy” has been in place since 2010: Reduce or optimise production at source, Reuse, and Recycle. Initially the hospital generated over 1.5 tonnes of organic waste per year, but since this project started food waste has been reduced by approximately 1 tonne.

Read more: Reducing hospital malnutrition with a circular economy approach

With 650 beds and 3,000 employees caring 35,000 patients annually the Hospital of Santa Creu i Sant Pau in Barcelona has its own kitchen preparing 2,500 meals a day for patients, staff, and visitors. The hospital’s healthy and sustainable food policy aims to offer high quality produce within budget that can be adapted amd served to a variety of patients.

To reduce waste, kitchen staff reguarly ask suppliers to take back and reuse packaging once food has been delivered. In the kitchen, other strategies to reduce waste have been devised, such as replacing disposable containers with re-usable metallic ones, eliminating paper from hospital dining room trays, or replacing individual water bottles with water from mineral water sources.

The hospital conducts annual satisfaction surveys for long-stay patients (mainly cancer patients), with this feedback the department has adapted its menus to increase patient satisfaction thus reducing food waste in the wards.

Read more: Fresh, healthy, and sustainable food: Best practice in European healthcare

With approximately 1,000 beds, and 5,100 employees, the Regional University Hospital of Malaga welcomes over 34,500 patients annually. Approximately 335,000 meals are prepared annually in the hospital’s on-site kitchen where they prioritise local produce in their procurement criteria to promote local economy.

As well as the standard menu, the hospital offers patients a choice from menus designed for patients with allergies, food intolerances, diabetes, oncological problems, or other special needs. Improved communication and coordination between the ward, kitchen staff, and patients, as well as staff training has helped improve food procurement, and reduce food waste and malnutrition.

Read more: Reducing hospital malnutrition with a circular economy approach

With one central kitchen and four satellite kitchens, the Santiago de Compostela University Hospital served 2.6 million meals to patients in 2015 only wasting 2.5% food – which is sent to a grinder/compactor.

The hospitals planned developments include improved communication with patients via TV or mobile phones and adjusting portion sizes. The hospital complex is also exploring a partnership with dairy companies, so they can serve appropriate portions to each patient according to their needs. In this way, a partnership would consequently generate less food and plastic waste (one of the hospital’s targets for the next two years is to reach zero plastic waste).

Read more: Food waste in European healthcare settings

Serving over 440,000 meals per year to both patients and staff, the La Paz University Hospital in Madrid generates 40-59 tonnes of food waste per year. This food waste is either sent to landfill sites or treated for composting – thanks to their collaboration with the municipality, which also ensures that other types of waste such as paper, carton, plastics, and oil (converted to biodiesel), are recycled.

The hospital has a computerised ordering system that allows control over allergens and the amount of food that needs to be prepared. Meal sizes can also be adjusted to minimise food waste.

Read more: Food waste in European healthcare settings

The Vall d’Hebron University Hospital in Barcelona has over 1,200 beds and approximately 9,000 employees. It offers many services such as mother and childcare, traumatology, and rehabilitation. With a central on-site kitchen the hospital produces approximately 4,800 meals daily including breakfast, lunch, snacks, and dinner. Vall d’Hebron offers approximately 450 menus across the year, including vegetarian menus and individual dietary choices for both staff and patients. This large choice, combined with efforts to improve communication and coordination between kitchen staff and patients, has lead to a reduction in food waste.

The Hospital’s Dietetics Department adjusts patients’ diets to accommodate for allergies, patient preferences, and to prevent malnutrition. The department also carries out satisfaction surveys and monitors patients’ intake in different wards. Close attention is paid to menu presentation (especially for oncological, nephrological, and paediatric patients), and dishes’ design (especially for geriatric patients). They have also developed a management system for each ward to monitor stock levels, allowing for better management of expiry dates – often a main cause of food waste

Read more: Reducing hospital malnutrition with a circular economy approach

With 4,000 employees, the Freeman Hospital in Newcastle provides approximately 270,000 meals per year and on average wastes 6% of the food it serves. This low wastage (compared to other hospital facilities) can be attributed to the bio-digesters and their controlled the ordering system. Importantly, the hospital offers two different portion sizes – a smaller portion for elderly patients and a regular portion for other patients; these smaller portions still provide patients with the necessary energy and nutrients.

Read more: Food waste in European healthcare settings

The fourth largest hospital in the United Kingdom, NUH has a sustainable food programme accredited by the Food for Life programme of the Soil Association with the hospital acquiring the Gold Standard in 2014. The hospital purchases fresh and locally sourced food, which is cooked in an on-site kitchen. The local producers also have to be accredited by the Food for Life Programme: the producers are kept in regular contact with the programme through yearly monitoring visits, with perfect traceability ensured. The main focus of the hospital’s sustainable food programme is to provide fresh and locally produced food. For example, 95% of meat served comes from a local processor sourcing from farmers in the East Midlands. This switch to local suppliers has saved food miles and has also contributed to the socio-economic growth of the region. The hospital does offer organic meals, but the organic supply chain is too small to provide all the hospital’s meals on a regular basis.

Whilst NUH has also developed a food waste policy, the main challenge is having an accurate record of number of patients present at each mealtime. It is therefore crucial to receive patients’ orders as closely as possible to mealtimes. With a tablet available in each patient’s room, patients are allowed to order meals directly from the bedside just two hours before mealtime, thus improving the accuracy of number of meals required.

Read more: Fresh, healthy, and sustainable food: Best practice in European healthcare

Situated in the North of England, the Rotherham NHS Foundation Trust delivers a wide range of healthcare services to approximately 66,000 inpatients and 295,000 outpatients per year.

The private company ISS Healthcare is contracted to provide meals to inpatients at Rotherham Hospital as well operate the hospital’s popular Rooftop Restaurant,. Over 500,000 meals are cooked on-site and served annually. As part of its sustainable and healthy food programme, ISS offers seasonal and fresh ingredients, addresses animal welfare issues, and employs innovative methods to reduce food wastage.

They offer a seasonal one-week menu cycle with daily chef specials – an innovative, integrated solution for the provision of enjoyable, attractive, and high quality patient meals that support patient recovery.

Read more: HCWH Europe (2016) Fresh, healthy, and sustainable food: Best practice in European healthcare