Healthy Eating Revolution for Scotland’s Hospitals

14 November 2017

Our Guest Blogger, Andrew Roberts is the Business Enterprise Manager for the Royal Voluntary Service and leads the charity’s Healthier Choices programme. He worked closely with Scottish Government and NHS Scotland on the development and introduction of healthy eating criteria for retail outlets in healthcare settings. He is also part of the HRS Implementation Group and chairs the Healthy Living Award Stakeholder group.

How the Healthcare Retail Standard helped the Royal Voluntary Service transform its retail outlets into hubs for healthy eating

The Healthcare Retail Standard (HRS) was introduced with the aim of transforming the retail food environment in healthcare settings in Scotland. The HRS aims to change the provision and promotion of foods to deliver healthier food choices to customers. A number of partnerships were formed to take this forward and now 100% of premises in Scotland comply. In this blog we hear from The Royal Voluntary Service (RVS), the biggest hospital retailer in Great Britain about how they took on the challenge.

Diet is vital to good health. That’s why it’s somewhat ironic that hospitals aren’t always the healthiest places to buy food and drink. We know through research that NHS hospital staff find it difficult to make the healthy choices they want:

  • 41% of Scottish hospital doctors and nurses told us they eat one or no pieces of fruit and veg during a typical working day
  • 14% said they have a poor diet
  • 74% wanted to see healthier options introduced into their hospital workplace
  • 63% believed this would have a positive effect on their overall diet.

Improving NHS Workforce Health

Workforce health is a major priority for NHS Scotland so it’s important that food and drink options are healthy and nutritious. As the biggest hospital refreshments retailer in England, Scotland and Wales (our volunteer-led retail operation spans 400 shops, cafes and on-ward trolley services, including 76 sites in Scotland, which fund the charity’s wider work enriching the lives of over 100,000 older people every year) and with a long relationship with the NHS, we knew this was a problem that we could help tackle.

In 2016, after much planning, we took a major strategic decision to transform our entire hospital retail estate into hubs for healthy eating. We would do this by improving and increasing the range of healthier choices available to NHS staff, visitors and patients in the hospitals we operate in.

The starting point for our Healthier Choices programme was Scotland. Here, the government and NHS have introduced a stringent new healthy eating framework for healthcare buildings. NHS Health Scotland’s Healthyliving Award Plus is the baseline standard for all our cafés, and the Scottish Grocers Federation Healthcare Retail Standard (HRS) for our shops and trolley services. The tough standard restricts the food and drink items that hospital retailers can offer, based on health criteria, and we have adopted it as the benchmark for our entire retail operation.

Throughout 2016, we worked closely with supply partners, store designers and renowned nutritionist, Dr. Mabel Blades, to prepare for the new standard. Measures taken included:

  • Delisting non-compliant items and dramatically reducing space for less healthy options
  • Reformulating products to reduce salt, sugar and saturated fat levels
  • Increasing the selection and range of healthier items like fresh fruit, salads, soups, sushi, smoothies, sugar-free syrups, healthier snacks and meal deals, plus dietary-specific ranges
  • Refreshing the look and feel of our shops and cafes to encourage customers to make healthier choices
  • Improving signage and labeling to enable customers to make healthier choices and to find items that meet dietary requirements
  • Training our staff and volunteers on the new menus, items and ranges.

By March 2017, with the support and commitment of our hospital retail staff and wonderful volunteers, our Scottish retail operation was fully HRS and HLA plus compliant - well ahead of the government’s deadline and long before other retailers had even begun the process.

Achieving the HRS has been no quick and easy task, but the proof, as they say, is in the pudding (fresh fruit or low-fat yoghurt of course!). The transformation is having a profound effect on consumer behaviour and we are seeing a marked increase in sales of healthier items. During the first 3 months of rolling out our new product ranges, we have made healthier choices available to over 500,000 hospital staff, visitors and patients in Scotland, rising to 3.4 million in the next year.

By working with suppliers on product reformulation and range change:

  • Calorie intake from sandwiches alone will reduce by two million in the year ahead
  • Fat consumption from crisps will reduce by three million grams and salt consumption by 15,000 teaspoons
  • Sugar intake from soft drinks will be reduced by the equivalent of 50,000 sugar cubes a year
  • A focus on fruit will result in 30,000 additional portions of ‘1-of-your-5-a-day’ being consumed in Scotland over a year.

The impact of these changes speaks for itself. We’re delighted to be helping millions of customers make healthier food and drink choices and have been ranked top of the Healthy Hospital Food League Table by Sustain’s Campaign for Better Hospital Food. We look forward to seeing other hospital retailers follow our lead. 

Organisation website: