Good practice examples

							Catering
Good practice example

Issue             Production control

Trust             University Hospital of Wales (Cardiff and Vale NHS
                  Trust)

Date              September 2001

Description       Provision costs are effectively controlled throughout the
                  process; from decanting of goods on arrival, weighing
                  ingredients to the specific standard recipe requirements and
                  the checking of actual production volumes against expected
                  levels to ensure appropriate use of provisions.

Contact details   Gary Rix
                  Head of Facilities
                  Management corridor
                  Cardiff and Vale NHS Trust
                  Llandough Hospital
                  Penlan Road
                  Llandough
                  South Glamorgan      CF64 2XX
                  Tel no: 029 2071 6747
ACUTE HOSPITAL PORTFOLIO


Good practice example
5 Production control – University Hospital of Wales (Cardiff and Vale
  NHS Trust)


What area needs improving?

The control of provisions throughout the production process is essential to managing
costs. Potential wastage during production can be as great as the food wasted on the
wards.

The University Hospital of Wales development of a new Central Production Unit
(CPU) gave the opportunity to consider and install effective controls over provisions
and the production process.

The University Hospital of Wales now operates a cook-freeze system where foils are
produced within the production unit on site. These foils are issued to wards and
stored in freezers. Ward based caterers then regenerate and serve the meals.

1. How can this be achieved?

When goods are received they are de-canted into appropriate quantities for delivering
on to the ward or for use in production. A Product Batch De-canting Record is
completed that provides the batch number, packs provided, the products rejected and
the reason why. The batch number enables all goods to be traced back to their
supplier. Goods are then booked into and out of stock via a card indexing system.

Standard recipes are laminated and are used by the chefs. All provisions are weighed
to the specific recipe requirements. For example if 2.4 kg of mixed vegetables is
required this will be weighed out from the 2.5 kg bag and the remaining 0.1 kg will be
stored in the freezer. To support this system there are:

   Various sizes of plastic containers for storing ready weighed provisions, from a
    few ounces of butter to a large container of salad
   Bins for storing dry goods such as flour, sugar etc.

Compliance with the standard recipes ensures that provisions are weighed carefully
and that wastage at this stage of production is kept to a minimum.

The CPU produces meals in the following foil sizes; 350 gm, 800 gm, 1400 gm, 1700
gm. Producing smaller pack sizes for vegetarian dishes and single portions for special
or pureed diets helps to reduce the amount of wastage on the ward.

The Trust has effective HACCAP controls in place and as part of the temperature
monitoring that takes place during cooking the number of packs required is detailed.
The number of packs actually produced is then reported as part of the monitoring of
temperatures and timing during portioning and freezing. Controlling and monitoring
production in this way ensures that meals are consistent in terms of quality and cost,
and production wastage is minimised.

AUDIT COMMISSION                                                                         2
ACUTE HOSPITAL PORTFOLIO



How much might it cost?

These system controls are integral to the operation o f the CPU and its compliance
with HACCAP. In essence they require supervisors to perform supervisory duties
rather than the hands on role that is performed at some trusts.

What are the most factors that must be in place for success?

Standard costed recipes – These are at the heart of procurement and production and
ensure consistency in terms of both the cost and quality of service provided.

Continuous control – the systems that are in place ensure that provisions cost is
controlled throughout the process, from arrival in the goods receipting bay to despatch
of the foils to the wards. At every stage in the process actual production volumes can
be checked against expected to ensure appropriate use of provisions.

How well did the trust perform on the diagnostic indicators?

The results of the diagnostic audit show University Hospital of Wales (Cardiff and
Vale NHS Trust) performance as:

       Total net cost per patient day below the median
       Patient provision costs per patient day at the lower quartile
       Wastage levels at the lower quartile
       Patient satisfaction at the upper quartile
       Monitoring checklist at the upper quartile
       Nutrition checklist above the median




AUDIT COMMISSION                                                                          3