Some of London's top NHS hospitals are serving the worst food, according to the first set of food inspections to chart the progress of the Better Hospital Food programme launched in 2001.
But the good news, announced last week by health minister Lord Philip Hunt, is that the £40m programme created to improve hospital meals over four years is boosting overall standards across the country.
Amber hospitals - those with acceptable catering standards but still scope for improvement - have risen to 555 (81% of the total) from 506 (72%). And the top tier of green-rated hospitals has increased to 118 (17%) from 107 (15%).
The number of red-graded hospitals, where food quality was poor, has dropped to 15 (2%) from 89 (13%).
Of these, eight are based in the capital and include such luminaries as the Royal Free, the Hammersmith, King's College, St George's and the Middlesex. However, other London hotels such as St Bartholomew's and St Thomas' won top ratings.
"We are working closely with each red food hospital," added Lord Hunt. "They all have action plans in place with a clear timetable for fixing the issues uncovered. Ongoing support is being provided and we do not expect any red hospitals to remain by the end of the year."
Meals were rated on presentation, quality, menu choice, portion size, temperature, meal timings, service, and beverages. Hospitals winning green status have adopted at least five of six Better Hospital Food targets (see panel).
Key problems highlighted in a patient survey last year included meals served at the wrong temperature (50%), a limited choice (40%) and, in 27% of cases, not receiving the meal ordered.
"We believe 75% of hospitals are doing something to meet the Better Hospital Food programme," said a spokeswoman for the Hospital Caterers Association, adding that more were coming on board as funding gradually became available.
She suspected the poor showing of some London hospitals stemmed from the fact that many were larger, older buildings that lent themselves less easily to food service, and that higher costs made it harder to recruit and retain staff.
The HCA added that it was imperative for caterers to remain in control of food service from start to finish, and that many problems arose from putting the trolley service in the hands of inexperienced staff.
By Angela Frewin
Better hospital food targets
* A two-course main meal available every evening.
* NHS snack boxes available on request.
* Ward kitchen service fully available 24 hours a day.
* Three or more chef-inspired dishes to be included in the daily menu.
* Menus designed to the NHS format available by each patient bedside.
* Two new snacks introduced each day.