Written evidence submitted by NHS England (END030)

Context – improving the health of food and drink on NHS retail premises for staff, visitors and patients

The Five Year Forward View made commitments to improve the health of the NHS workforce and to ‘cut access to unhealthy products on NHS premises, implementing food standards, and providing healthy options for night staff.’

NHS England has put this into action through two projects: an incentive scheme to restrict unhealthy food and drink sales, and a sugary drinks reduction project.

The CQUIN incentive scheme (Indicator 1b: Healthy food for NHS staff, visitors and patients) offers NHS providers a payment depending on compliance against food and drink standards for retail premises. This includes restrictions on the promotion of all products which are high in fat, sugar and salt, a restriction on the sale of high calorie and high fat sandwiches and salads and ensuring provision of healthy food for staff 24/7. This scheme has been in operation since 2016.

Alongside this, NHS England has led a project specifically on sugary drinks – NHS Action on Sugar[1], which has removed nearly 11 million teaspoons of sugar from NHS canteens, shops and vending machines in nine months.  Just under nine out of ten trusts are now signed up to the scheme to reduce sales of high sugar drinks to 10% and we aim to achieve 100% sign-up by October.

Energy drinks are not a separate component within the CQUIN incentive scheme or Action on Sugar. However a number of energy drinks will be captured by these schemes because of their high sugar content (e.g. Red Bull, Monster). Further detail on the progress that has been made on sugary drinks is set out below.

NHS Action on Sugar Project

The NHS Action on Sugar project aims to reduce the sales of high sugar drinks, also known as Sugar Sweetened Beverages (SSBs) in hospitals.[2] In November 2016 a public consultation was launched to gather input on other policy options to reduce sales of SSBs.

In response to this consultation, NHS England initiated two concurrent courses of action: a voluntary sales reduction scheme, and a proposed contractual ban.

The voluntary sales reduction scheme was launched in July 2017. This asks NHS Trusts and retailers on NHS premises to commit to:

• Reduce the total volume of monthly sugar-sweetened drink sales per retailer, per NHS Trust, reaching a target of 10% or less of total volume of drinks sales by March 2018 and continuing thereafter and in future contracts.
• Provide NHS England with quarterly self-reported data on the proportion of sugary drinks sales.

Alongside this, a clause was included within the NHS Standard Contract to implement a ban on the sales of SSBs should the voluntary scheme prove ineffective in achieving sign-up by NHS Trusts and retailers, or in significantly reducing the volume of SSBs sold on NHS premises.

202 trusts and 14 national retailers[3] have so far signed their commitment to the voluntary scheme.  Quarterly data collected between July 2017 and March 2018 showed a reduction in the total sales from 15.6% in July 2017 to 8.7% in March 2018.  This is based on data covering over 1,000 outlets.[4] 

As a result of the successful engagement and results to date, the current sugar reduction scheme will remain in place for the rest of 2018/19, and NHS England will consult on making this part of the NHS Standard Contract from 1 April 2019. The reduction scheme will continue, with full participation from every Trust and retailer and achievement of below 10% linked to the payment of indicator 1b in the 2018/19 CQUIN.[5]

July 2018