Sadler et al., 2025

Background

Adopting plant‐forward diets is essential for achieving climate targets. As the second‐largest provider of public sector meals in the UK, the National Health Service (NHS) can significantly reduce its environmental impact by transitioning to plant‐forward menus, contributing to its goal of being a net‐zero healthcare service by 2045. This study evaluates the extent to which NHS hospitals currently align with sustainable practices by assessing the plant‐forward nature of in‐patient menus.

Methods

Green Plans from 40 hospital trusts were analysed to assess commitment to plant‐forward, lower‐emission menus. Freedom of Information requests were sent to 50 NHS trusts, and 36 menus from the spring/summer season of 2024 were analysed. A novel scoring system was developed to assess the hospital menus, with subscores reflecting the availability of plant‐based meals, ruminant‐meat meals, and menu strategies to encourage plant‐forward choices.

Results

Green Plans showed limited commitment to increasing plant‐based food options. Hospital menus scored poorly overall (average score of 20/100, range: 9–38). The lowest subscores were observed in the provision of fully plant‐based meals and nudging techniques. The provision of ruminant meat varied (subscore range: 0–100) and all hospitals included processed meat on their menu. Hospitals with outsourced catering scored higher than those with in‐house catering.

Conclusion

Despite national recommendations to shift towards plant‐forward diets, NHS hospitals currently show little commitment and provide limited offerings in this regard. The novel scoring system offers a practical framework for monitoring progress and guiding hospitals towards environmentally sustainable, plant‐forward menus.

Keywords: environmental sustainability, hospital menus, net‐zero healthcare, plant‐forward menus

Summary