Food, with care:

A 'whole hospital' approach

A snapshot of how we are developing our vision and strategy for food at Cambridge Children's Hospital

Emma Goodchild, Clinical lead nurse

Emma is one of three clinical lead nurses working on the Cambridge Children's Hospital project. Her background is as a mental health nurse.

Elena Neri, Senior Research Assistant

Elena is employed by the University of Hertfordshire to help us coproduce our food vision and strategy with children, young people and families.

Shakila Bukhari, Coproduction Champion

Shakila is mum to three daughters, one of whom has had lifelong struggles with food.

Sarah Asbury, Coproduction Champion

Sarah has cared for her daughters, one of whom has used acute mental health services and the other cancer services.

What should our dining spaces be like and where should they be located within the hospital?

How can we ensure there is appropriate equipment for parents to prepare food for children on a blended diet?

What is the cultural significance of food and how does this contribute to a child's sense of wellbeing in hospital?

How might we cook delicious food in hospital using the freshest ingredients from sustainable sources?

Emma

You were instrumental in setting up this workstream. What got you excited about it?

Food is a fundamental part of daily life. For some it’s an important family or social time, for others it may be a very challenging time. 

Being part of the food workstream is so exciting, as we have the opportunity to listen to and work with families to make food a part of patient care rather than this being viewed separately. As a nurse, I’m also passionate about staff health and wellbeing. It's really important to be able to access nutritional food and drink whilst working.

What are the challenges of developing a food strategy for a hospital that will integrate mental and physical healthcare?

One size does not fit all. The idea of healthy eating does not fit everyone’s needs. Children with certain physical or mental health conditions may have very specific dietary requirements, so we have to balance this.

Cambridge Children's Hospital wants to enable healthy eating habits and the ability to have a relationship with food. We don’t want it to be a place which completely disrupts existing routines around food. We need food to be available not just for the patients, but for the whole family. Where appropriate, the social side of food and eating can be instrumental in the recovery journey.

We have really focused on food spaces as part of the design. An inviting cafe should be available, but we need to balance this sensitively as there will be children and young people accessing the hospital that may not be able to eat or drink. We have explored dining spaces so, where possible, children can go to a dining room to eat as opposed to just being in their beds. This could allow for children to eat with their family or other children they have met during their time in hospital. Garden areas will have access to tables and chairs allowing for alfresco dining in the warmer months. 

 How visionary is the food workstream?

Our discussions test our boundaries and thought processes on a daily basis. As a project we are committed to a whole family approach with food playing an important role in this. We are keen to explore digital opportunities in supporting how food is prepared and delivered to the patient and family, along with ensuring nutritious food is available when children and family need it. 

ELENA

Why did you want to work on the food strategy?

When I saw the advertisement for this role, I immediately wanted to be part of the ‘Food with Care’ project. I think that Western society has a tendency to separate the mind from the body, and, when it comes to health, to medicalise food and talk about it only in terms of nutrients and calories. This is the first time that people from completely different backgrounds and expertise are coming together to create a food vision that really thinks of food from a holistic perspective, giving due importance to the social, cultural, environmental and educational dimensions of eating. What excites me the most is the opportunity for this project to reduce food-related social inequalities, and to make a difference not only within the hospital, but also outside of it, by helping the community and the environment.  

 What will you be doing over the next two years?

My research role involves drawing from national and international standards and finding the latest academic evidence to inform the strategy and, further down the line, engaging with children, young people and their families, as well as NHS staff, in order to really understand how food can fulfil people’s needs. To be healthy, children (and adults) need nutritious food, but also food that is enjoyable, comforting, allows them to be in company of their friends and families, and that is appropriate to their cultural background.  We are currently developing a food philosophy that will incorporate important aspects such as the social dimension of eating, and the language used around food and health, which I am very excited about!  
 

Why is it so important that the voices of children, young people and families shape this work?

Wouldn’t it be crazy to create a food strategy for a children’s hospital without engaging with children and young people themselves? Although almost one fifth of the people living on this planet are children, for such a long-time society hasn’t been taking them into consideration when making important decisions around the environment we live in. Children have very different ways of perceiving the world around us, and this reflects in the way they engage with food. The only way to create a child-centred, co-produced food strategy is to put the voices of children at the centre of the project. Furthermore, the creativity and imagination of young people can help to develop ideas that adults could never even think about! 

Shakila

Why did you join the food workstream?

I wanted to share my experience of my daughter’s journey from a 24-week old neo-Nate to young adult, who didn’t have the same exposure to food and liquids as her peers and the impact this has had and continues to have on her relationship with food and her social, mental and physical health.

When families are in hospital whether for it’s an hour or many months or years, food is usually the last thing on their minds. However, as I soon found, food becomes the source for mental and physical recovery, sensory normality for little ones and social inclusion. It’s so important we grab the opportunity to help shape healthy, respectful attitudes towards food from the earliest opportunity.

What are you most passionate about when it comes to thinking about food in hospital?

The holistic wholeness of food is crucial in supporting our children in their whole health. For me though, food represents a cultural invitation and join up of families and strangers alike and the foods that are prepared for each social gathering has its own purpose and special meaning. My experiences curtailed that social and cultural aspect because we simply couldn’t join in in and enjoy food in the way others could, with ease and comfort. I joined this project to make things better for the children and families coming up behind us.

What do you find interesting about this work?

I find it fascinating that food has impacted on so many lives in a way that I hadn’t appreciated before. I’m amazed by the dedication of my colleagues who are project staff, researchers and clinicians, as well as my fellow Coproduction Champions. The world seems to be waking up to the importance of food, from educational orchards in Dubai to local authority research on appetites of primary aged children. I’m so pleased things are moving in the right direction.

Sarah

What is your role on this workstream?

My role as a Coproduction Champions is to help inform and develop the 'food, with care' vision for Cambridge Children's Hospital. We advocate for the voices of children, young people, parents, carers and families. With a holistic approach to an integrated care model, I bring experience of caring for my daughters who have been in hospital for both mental health and physical health conditions.

I challenge and inform discussions surrounding the structure and mechanics of providing good nutritional opportunities in a sustainable and economical way to ensure the needs of staff and children and families are met.

In your experience, why is food in hospital so important to get right?

I know that food is paramount to the recovery of a young person, be it from a mental health or physical health perspective. It is also essential that staff are well hydrated and have time and space to eat, in order to care for our children and young people. Families supporting the person in hospital also need to have affordable, instantly available food to keep their own strength up. A malnourished mother is no help to a recovering child.

What you eat informs both the mind and body, simultaneously. Having access to tasty, nutritious food at the right time and in the right place can be the turning point for a young person. Commensality - sharing food together at a table - is a fundamental social activity which encourages and allows for the formation of relationships which are essential to the healthy development of a young person.

Why is this vision and strategy so important?

The logistics of feeding people well and, at the same time, sending a good nutritional message out to the wider region, when we face a national obesity epidemic, makes it all the more important that we get our food strategy right. Cambridge Children’s Hospital will be an anchor institution sending out a positive message on nutrition and wellbeing.

It’s fascinating to explore the diverse requirements for the hospital. We need to meet the needs of all patients, families and staff whilst aligning with the National Food strategy, considering socioeconomics, ethnicity, emotional, behavioural and social aspects of food, to mention but a few.

We spoke to members of Cambridge Children's Network about what food - and food in hospital - means to them.