4.5.1 Introduction
The production system is based around a large unplanned kitchen (see Figure 4.5) that follows the traditional hospital catering operation of bulk production cook and serve.
4.5.2 Conventional Catering: (trolley service).
This hospital catering operation is run by a team consisting of approximately 100 staff. The present trend within the NHS - that every patient service has to be cost effective - is adhered to within the budget, and efforts are made to generate other income from functions etc. But this is maintained with great difficulty, with the constraints of out dated catering equipment and a vast amount of kitchen space where staff have to walk long distances to prepare, produce and serve the food that has to be kept at a steady temperature during the hot holding session of ganymede service to reach the patient in an acceptable form at 68oC.
4.5.3 Kitchen Equipment and Layout
This particular hospital was built in 1936, a monument to pre-war architecture, and to the benefactor of the day.
The main production kitchen for the 28 wards is found in the basement, a vaulted room which stretches in all directions to encompass the special diet kitchen, storage room, and general stores and four walk-in cold rooms with metal tier shelving. These are used to separate items for example cooked and raw foods, dairy produce and vegetables. Stock control is monitored, but pilfering is difficult to control, due to the space and walking distance between each fridge. Open access is maintained.
The kitchen equipment is situated along each wall except for the steamers and boilers which are placed at right angles to each bank of equipment; the rest of the equipment appears to have been dropped into place within this arena. The equipment dates back to pre-1950's in some respects; the only concession to modem equipment is the two pressureless steamers with timers used to cook frozen vegetables in batch lots for service with excellent results, i.e. the colour and taste is retained during service time. The equipment consists of a bank of four Benham steamers (operated by a traditional steam boiler) used to cook gammons and steam puddings. On the opposite wall from the steamers is a bank of baking ovens (Thomas Collins), and although this equipment is no longer produced, a local company have taken on the task of repair when necessary. Items such as fish fingers, beefburgers, sausages are baked; it is difficult to cook so many under a grill or in a bratt pan for service time. One mixing machine (Peerless) stands against the wall, towering 2 m in height, but can only operate at one function, for example whisking, at a time, unlike modem machines where the operator can use three processes simultaneously (which would reduce waiting time for staff and speed up food preparation). Stotts Super Grills are in the centre of the kitchen and away from the boiling kettles. The bratt pan is placed against one wall with three deep fat fryers against another wall. All the equipment is clean and in working order.
The majority of the equipment here has no thermostats and temperature control is assessed by trial and error, until the chefs learn the quirks of the equipment and experience tells them how to set the dials to prevent burnt produce. There are no computerised equipment or probes set in ovens to assess "doneness". Experience based on trial and error prevails. Whilst this technique can work, it only adds stress to the pressure of work felt by the catering staff who wish to achieve a high standard of output for the patients and staff, but who have to deal with antiquated equipment (see Figure 4.5).
4.5.4 Production System.
Staff here are producing 15,000 meals per week (approximately 550 beds for patients, plus staff meals). In this large teaching hospital, there are many people to cater for, all with their own specific needs. The patients’ dietary requirements are varied and complex, with the addition of ethnic meals, all of which are produced for individuals at a prescribed time. A great deal of effort is needed to keep this production streamlined and to a high standard, especially with staff shortages and a tight budget of £12.50 per head per week. This is assessed on a sliding scale:
£11.25- geriatric patients £12.00- general
£12.50- teaching and specialist patients (for example renal dialysis patients, where the food has to be purchased sterilised to prevent risk of contamination.)
From this amount per week per patient, the catering manager has to produce three meals per day, plus morning, afternoon and evening beverages. When the Hospital catering went out to private tender, the private company withdrew after nine months, stating they could not operate the production system within such constraints.
4.5.5_ Food Service
The food is bulk cooked and plated by the catering staff with the aid of one ganymede conveyor system. The metal base that holds the plate is heated to 98oC and the plate is also heated; the food is (piping) hot, served from hot cupboards. Probes are used to monitor the food temperature. The heated base is designed to keep the food hot for 40 minutes from the time of plating to consumption. The caterer hopes that no mishaps will occur en route to the wards. Five hundred meals per hour are plated, which is hard work when this is calculated at ten plates per minute, (the average is usually four). Medical staff dictate that patients all need meals within an allotted time,
between 12 noon and 1 p.m., to fit in with medical rounds and visiting times. (This