Scroll Top
Health Care Without Harm (HCWH) Europe 1 Rue de la Pépinière, 1000 Brussels, Belgium

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

With 1,300 beds, the Hospital Center Simone Veil de Blois serves approximately 3,000 meals per day.

Their study on hospital food waste (2017 – 2018) showed that 18% more food is wasted during their dinner service compared to lunch. On average they found 180g of food waste per meal in geriatric areas) and 246g/meal in surgical areas.

Following this study, the hospital established an action plan to:

  1. Reorganise the food service and menus
  2. Adapt/Personalise food portions to patients’ needs and preferences.
  3. Conduct in-house training to raise awareness about food waste and improve communication between patients, kitchen, and staff.

In the first year (2019), food waste was reduced by 22%, representing annual savings of €186,000 and 232 tons of CO2. The Hospital also promotes food donation and bio-waste, and involves all employees in the communication and training strategy for raising awareness.

Representatives from the Hospital Center Simone Veil de Blois presented this work during the 2019 MECAHF workshop Food waste and nutrition in healthcare facilities: developing a circular economy; you can access their presentation here (in French).

With 14,000 employees and 2,700 beds, the University Hospital Center in Bordeaux accommodate patients from all over the Nouvelle Aquitaine region. The hospital serves approximately 12,000 meals a day (half of which are for patients), and they aim to improve the quality of service to patients, fight undernutrition, and reduce food waste.

In 2015, the hospital’s Food Nutrition Liaison Committee launched a study to evaluate the amount of food wasted and identify ways to improve practices across the entire “meal life cycle”. Supported by the hospital’s sustainable development department and the French Agency for the Environment and Energy Management (ADEME), this study formed the basis of an action plan focussing on seven key areas:

  1. Patient autonomy
  2. Patients’ needs
  3. Adapting order of meal trays
  4. Meal presentation and portions
  5. Food distribution to patients
  6. The patient ordering system
  7. Food waste collection and sorting.

The most significant result shows that training staff to use meal control software (DATAMEAL) has helped to reduce the number of “undistributed” meals (those ordered inappropriately) by 40%. The study also highlights the main causes of food waste from distributed trays (196g per 600g):

  • The nature and composition of certain menus
  • Some patients require support when eating.
  • To limit undernutrition and waste among dependent patients, caregiver support is essential.
  • The coordination of the project, which requires time and resources.

Actions to combat undernutrition and limit food waste of distributed trays only yielded a modest 3% reduction food waste (weight) from distributed trays.

Awareness-raising activities such as flyers and posters did not result in the desired change in practice/behaviour; this exercise will be repeated in the hope that it will yield further response.

The University Hospital Center in Bordeaux will continue actions to reduce food waste:

  • An annual campaign of food waste collection in health care services, especially those with a high proportion of dependent patients.
  • Preventing/reducing food waste will be included in all training sessions on how to order meals.
  • Training for caregivers (primarily nurses) on how they identify, prevent, and reduce food waste.
  • The respect of the portions, the attractive presentation of the dishes and the taste quality of the food preparations are integrated as basic values of the project.
  • An assessment of food waste management as part of a cost/benefit analysis

The University Hospital Center of Grenoble Alpes produces approximately 2 million meals a year, (9,000 daily), for both employees and patients. Mealtimes are an integral part of the patients and staff care and well-being. As part of a recent project, the hospital wants to improve the quality of hospital catering and become an eco-responsible model for hospital catering.

The project (2018-2020) is structured around three strategies:

  1. Nutrition – adapt food to meet patients’ needs e.g. presentation or taste
  2. Purchasing – prioritise local, seasonal, and organic food.
  3. Food waste – avoid overproduction in the kitchen and donate remaining food

This project is carried out by three teams with members from all sectors of the hospital; each team works on one strategy. The first actions are already seen to be successful, such as introducing low carbon, plant-based dishes with local ingredients – the full project results are expected next year.

Twice weekly, unused food is donated to a local food bank; project members would like to extend this donation to other local associations.

Camille Devroedt from the University Hospital Center of Grenoble Alpes presented her work during the 2019 MECAHF workshop Food waste and nutrition in healthcare facilities: developing a circular economy; you can access their presentation here (in French).

One of the largest kitchens in Iceland Landspítali, National University Hospital produces approximately 5000 meals a day for the hospital’s 5000 employees as well as guests and patients. In 2015, the kitchen and its nine canteens received the Nordic Swan Ecolabel, and the environmental measures taken in the kitchen resulted in significant and positive benefits. The number of guests has increased by 30%, and satisfaction is up by 50% compared to 2012.

Food waste is closely monitored, and in an effort to reduce waste as much as possible portions have been adapted, an ordering system for the canteens has been developed, and purchasing has been better organised including offering a daily vegetarian meal and offering more organic products.

Since January 2017, unsold food is donated to a local NGO that redistributes food to people in need. In 2019, one the hospital’s biggest canteens have also implemented new measures to minimise food waste such as allowing the employees to fill their own dishes as well as paying for the food by weight. All remaining food waste is composted, and hospital employees can receive free compost to use in their own gardens.

One of the largest health enterprises in Norway, Vestre Viken provides specialist health services to 490,000 people across 26 municipalities. With more than 9,400 employees, three centralised kitchens, and five canteen, the healthcare provider serves 5,000 meals a day.

With a mission to promote good health through environmentally-friendly operations, they aim to reduce their food waste by 3% compared to 2018. To achieve this target, they are measuring food waste across all departments three times a year. The enterprise also reports on dinner requests and compares them to the number of inpatients. This information on food waste is communicated internally and externally.

Vestre Viken’s vision is to transition to a more holistic approach with a focus on sustainable and healthy food.

In 2019, the General Hospital Novo Mesto in Slovenia started the project Let’s not waste food! which consists of randomly measuring food waste, investigating causes of undistributed, untouched, and uneaten meals. Patients are also interviewed as part of the project and an analysis of the data has been already conducted; the most important findings show that:

  • Each year, 111 tonnes of food waste is produced at the hospital (excluding liquids)
  • The cost of edible food wasted is estimated at €157,000 per year i.e. 46 cents per one meal.
  • Five per cent of meals delivered to patients remain untouched, equivalent to 13,500 meals per year
  • Only three fifths of meals served were at least half consumed.
  • Patients often refused to eat food due to poor taste
  • Two thirds of the food delivered to patients is prepared according to dietetic therapeutic principles.

Following these results, the hospital drafted the following recommendations to help them reduce food waste:

  • Procure quality, local, and seasonal foods to prepare delicious and pleasing meals.
  • Provide adequate information to patients.
  • Create a rapid and reliable flow of information between departments and the kitchen.
  • Simplify the meal ordering system so that it becomes friendlier for healthcare professionals
  • Implement National guidelines to provide therapeutic (specialised) diets
  • Recruit staff to manage patients’ dietary support and nutrition
  • Regularly monitor food waste

The hospital has also applied to the Slovenian Ministry of Health for a new health program that focus on nutrition therapeutic management, and consequently a better food waste disposal.

Representatives from the General Hospital Novo Mesto presented this work during the 2019 MECAHF workshop Food waste and nutrition in healthcare facilities: developing a circular economy; you can access their presentation here (in English).

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

As part of a Madrid Community project to sort and recycle waste, the food waste from the María Jesús Hereza Health Center is composted in the garden. The center also promotes serving traditionally made products (especially sponge cakes) instead of commercial/industrially-produced meals. They also serve healthy seasonal fruits e.g. melons, strawberries, or tangerines.

The health center prioritises prevention of food waste; they also conduct training and education activities for staff, patients, and families on the importance of recycling and a healthy diet to prevent environmental deterioration and improve our health.

The Guadarrama Hospital Center in Spain currently wastes approximately 7% of food; they aim to reduce this further. To combat food waste, the hospital has implemented ideas to improve purchasing processes:

  • Adjust kitchen rations according to patient orders to reduce waste creation – this requires fluid communication between kitchen staff and health professionals
  • Offer tasty, healthy, and environmentally-friendly menus that can be adapted to the taste and preferences of patients.
  • Facilitate efficient storage with rotation of products based on expiry dates and consumption.

Food waste at the hospital is discarded as organic waste; used cooking oils are collected in special containers that are donated to a local association that works to raise awareness and eliminate gender-based violence.

The hospital’s future vision is to reduce carbon emissions from purchases, increase resource efficiency (including energy), and reuse and recycle unused food.

Representatives from the Guadarrama Hospital Center presented this work during the 2019 MECAHF workshop Food waste and nutrition in healthcare facilities: developing a circular economy; you can access their presentation here (in Spanish).

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

A leading public academic centre for patient care in The Netherlands, Radboud University Medical Center (Radboudumc) employees 11,000 employees and has over 600 patient beds.

In 2012, Radboudumc’s innovative project Food for Care was developed by young cancer patients, oncology specialists, dieticians, and the hospital’s food nutrition department. Through this project, Radboudumc has improved nutritional intake, reduced malnutrition and optimised recovery by offering small and tasty dishes six or seven times per day.

With the Food for Care project, food waste has been reduced from 37% to 11%, and patient satisfaction is now over 85%. The method and models developed to decrease food waste are shared with other hospitals as part of the project coordinators signing a green deal in 2018 with the Dutch Ministry of Health to reduce food waste in national 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

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