Addressing food waste management challenges in NHS hospital kitchens.

Abstract

Food waste within National Health Service (NHS) hospital kitchens constitutes a persistent and structurally embedded sustainability challenge with significant environmental, financial, and organisational consequences. As one of the largest institutional food providers in the United Kingdom, the NHS prepares approximately 141 million patient meals annually. Despite this scale and the centrality of food to patient care, food waste remains a material concern across healthcare settings. Current sector estimates indicate that reducing avoidable food waste by 50% could deliver savings of approximately £43 million annually, alongside improvements in patient experience, operational efficiency and environmental performance (NHS England, 2026). Beyond financial considerations, food waste represents a critical sustainability issue, embodying wasted agricultural inputs, energy, labour, and water, while contributing to greenhouse gas emissions through production and disposal. This study critically examines sustainability and food waste management practices in NHS hospital kitchens in England. Using a purposive sample (n=37) with a structured questionnaire administered to healthcare chefs, catering managers, and sustainability and facilities professionals, the study conceptualises food waste not as a discrete operational inefficiency but as a socio-technical and behavioural phenomenon embedded within complex healthcare systems. The analysis is informed by the Theory of Planned Behaviour (TPB - Ajzen, 1991) applied in the context Healthcare Catering Food Waste Reduction (HCFW); the proposed theoretical framework extends the original TPB model by integrating organisational support, policy mandates, digital infrastructure, and feedback mechanisms. The findings reveal a consistent disconnect between awareness and action. While respondents demonstrated high levels of awareness of sustainability policies and NHS Net Zero ambitions, this awareness did not consistently translate into effective food waste reduction practices. Food waste continues to be driven by structural and operational constraints, including overproduction, dietary complexity, patient non-consumption, workforce instability, and fragmented approaches to measurement and reporting. Behavioural intentions to reduce waste are frequently undermined by limited perceived behavioural control, uneven access to training, and weak organisational feedback loops. Rather than framing food waste as a technical or managerial problem alone, this report argues that waste in NHS hospital kitchens is best understood as an outcome of organisational culture, governance arrangements, and everyday decision-making under conditions of clinical uncertainty and institutional constraint. Meaningful and sustained reductions in food waste require the alignment of behavioural change initiatives with systemic reform, supported by long term investment in skills development, robust data infrastructures, and visible leadership commitment. The report concludes by outlining implications for policymakers seeking to enable more sustainable healthcare food systems.