Too many hospital trusts are failing to provide hot or healthy food for staff working outside canteen or café opening hours, with the lack of access to food taking a severe toll on staff wellbeing and patient care.

The survey from the British Medical Association (BMA) found that 73% of junior doctor representatives said that NHS hospital staff is ‘wholly inadequate’.

Only 10% of UK trusts or health boards offer freshly prepared meals and/or smaller hot snacks after 11pm, while just under a third offer pre-prepared meals suitable for heating. 

Dr Alessia Waller, a junior doctor in London, said: “In most trusts, canteens and on-site shops close around 6pm. After that, staff rely on vending machines that sell crisps, chocolate and fizzy drinks. Half the battle of a night shift is making sure you’re properly hydrated and have enough food to keep going. Eating badly happens because there’s nothing healthy available – and then I feel more tired from the sugar spike. You can’t provide patients with the care and attention you would wish to when you are surviving on junk food. 

“This situation is expensive for my wallet, bad for my health and it makes taking a break harder - there's not the same feeling of sitting down together with your team for a meal if you're all just snatching something from the machine.” 

Commitment to Fatigues and Facilities charter

The BMA is calling on trusts to remember their commitment to the Fatigues and Facilities charter, launched in England in 2018, which recommended that trusts should serve hot food for extended meal times for breakfast, lunch and dinner, where possible with a minimum late opening until 11pm and a further two-hour period between 11pm and 7am. Similar provisions exist in charters in Wales and in Northern Ireland.

Dr Sarah Hallett, co-chair of the BMA UK junior doctors committee, said: “This survey shows that food for NHS staff working evening and overnight shifts in busy hospitals is often wholly inadequate. This needs to change. The reality is that many trusts do not provide access to hot or healthy meals beyond 6pm, with staff turning to unhealthy snacks from vending machines to make it through the night. Doctors are exhausted and a poor diet only fuels fatigue. It goes without saying that we cannot provide high quality care to patients when we are burnt out and poorly fed.  

“Hospitals are open 24/7 and as junior doctors, our shifts also cover 24/7. We need trusts to recognise that their duty of care to staff extends to all hours of the day and night too. Trusts have a duty to their staff and to their patients to look after us and ensuring we can have a hot nutritious meal when we work through the night doesn’t seem too big an ask. 

"In particular, trusts in England committed to doing this back in 2018 when they signed up to the BMA’s Fatigue and Facilities charter and received funding to implement improvements. Yet here we are almost four years on and these results show that many trusts are not honouring that commitment and doctors are suffering as a result.” 

The charter outlines steps that can be taken to improve facilities and reduce fatigue so doctors can safely care for patients. All NHS trusts in England have signed up to the principles set out in the charter. Similar provisions exist in the charters in Wales and in Northern Ireland. With regard to catering the charter in England says:

A catering facility must be:

  • be open 365 days a year
  • provide adequate, varied, efficiently served and freshly prepared meals
  • offer healthy eating and vegetarian options, and options for a range of cultural and dietary requirements
  • serve hot food for extended meal times for breakfast, lunch and dinner, where possible with a minimum late opening until 11pm and a further two-hour period between 11pm and 7am.
  • Make hot food available if the canteen is closed, through a supply of microwave meals or a similar arrangement. Supplies should be sufficient for all staff on duty, readily accessible to doctors in training, and regularly restocked. Offer card payment or change machines where necessary.