Q&A

Yes, that’s right. Although not explicitly stated it’s implied on their websites. The HS website https://www.healthystart.nhs.uk/retailers/states that retailers “can accept NHS Healthy Start card payments if your retail store accepts Mastercard® and sells eligible healthy food and milk items”.

It also outlines…https://www.healthystart.nhs.uk/what-youll-get-and-how-to-shop/ 

You can use your card in most places that sell milk, infant formula, fruit and vegetables. This includes:

• supermarkets

• convenience stores

• grocery stores

• drug stores and pharmacies

• markets

• dairy products stores

• news dealers and newsstands

• freezer and locker meat provisioners (such as butcher shops)

• petrol stations

They must display a Mastercard® symbol. The symbol is normally shown on the shop door or at the till. Ask an employee inside the shop if they take Mastercard if you’re unsure.

If you try to spend the money anywhere else, the card will be declined. For example, you cannot use your card at a fast-food restaurant.

A pharmacy wouldn’t sell fresh milk – so to me that confirms that retailers can accept healthy start even if they do not accept all items

Answered by Rachel Childs, First Steps Nutrition Trust.

An approach to place-based food systems may be one consideration, food needs to go where people are not the other way around, engaging a range of stakeholders in addressing food systems challenges, including community engagement and meaningful consultation. Creating food citizens may be another consideration, pioneering social and cultural change by galvanising people and communities into action. 

A useful resource may be the Feedback website; Feedback is a UK- and Netherlands-based environmental campaign group working for food that is good for the planet and its people; challenging power, catalysing action and empowering people to achieve positive change. Feedback is currently trialling new ways to involve people in their food system through projects in Buckinghamshire, UK. 

Answered by Food Active

In recent weeks there has been various reports suggesting that the new government are interested in reviving the National Food Strategy, which is promising given that the recommendations in the strategy were left largely untouched by the previous government. We hope to hear official word from government soon on whether they are going to dust off this important strategy!

A cross-departmental approach is absolutely pivotal to ensuring any strategy is effective. At present, we know that departments are working in silos and a report by the National Audit Office in 2020 found that there is limited awareness and co-ordination across departments of wider activities that may impact on childhood obesity rates. Read the report here: https://www.nao.org.uk/wp-content/uploads/2020/09/childhood-obesity-summary.pdf 

We were pleased to see the recent House of Lords Food, Diet and Obesity Committee ‘Recipe for Health’ report recommend an effective cross-departmental governance structure on food policy, which would go some way in ensuring any revised National Food Strategy is truly owned by departments beyond the Department for Health and Social Care. Everyone has a role to play Read the report here: https://publications.parliament.uk/pa/ld5901/ldselect/ldmfdo/19/19.pdf 

Answered by Food Active

We are yet to see the new Labour government make significant announcements or detailed policy proposals specifically addressing the lack of support for those struggling with eating disorders. 

Labour has pledged to expand mental health services, including a focus on improving access for young people, and has emphasised the importance of reducing waiting times for treatment. Despite these promising commitments, there has yet to be a comprehensive policy specifically addressing support for eating disorders. 

Given the distinct challenges and specialised care required for eating disorders, advocacy groups like BEAT (an eating disorder charity) are urging the government to explicitly consider eating disorders within the Mental Health Act. 

We would also like to see more done by the government to support individuals living with eating disorders, ensuring that their unique needs are recognised and addressed within the broader mental health strategy.

Calorie labelling

The issues of calorie labelling on menus, which was mandated by the government in April 2022 as part of a broader strategy to tackle obesity, has raised concerns for those living with eating disorders. While the regulations include a provision allowing consumers to request menus without calorie information, advocacy groups, such as BEAT, have argued that this does not go far enough in preventing harm to people living with eating disorders. 

There has yet to be a large-scale review of the impact of this policy. However, we would like to see the government routinely evaluate this policy to ensure it does not inadvertently harm vulnerable individuals and that it strikes the right balance between promoting healthier eating and protecting those affected by eating disorders.

Answered by Food Active

We absolutely agree, and this would support the new government’s missions to kickstart economic growth and build an NHS fit for future. The recent budget from the Chancellor, Rachel Reeves, reiterated the need to reduce the deficit and  the upstream policies discussed at the conference could be a great tool to work towards this. 

Answered by Food Active

This is a really important and timely question; the recent House of Lords Food, Diet and Obesity Committee ‘Recipe for Health’ report made reference to conflicts of interest that can occur during the food policy process. The report included the following recommendation:

“The Government should exclude food businesses that derive more than a proportion of sales (to be defined by the Food Standards Agency) from less healthy products from any discussions on the formation of policy on food, diet and obesity prevention. This should also apply to the industry associations that represent these businesses.”

The government is expected to publish a response to this important report on 6th January; and we look forward to seeing whether they address conflicts of interest in their response. The full report can be viewed here: https://publications.parliament.uk/pa/ld5901/ldselect/ldmfdo/19/19.pdf

Answered by Food Active

The framing of conversations is really important in terms of changing the narrative, consistent messaging, culture change and individual behaviour change.  We are starting to see a shift in the types of approaches used to frame conversations to focus on broader health gains, rather than a single focus on weight. Frameworks UK have undertaken research and produced a toolkit supporting communications to reframe how we talk about children’s health and food.

Answered by Food Active

There are some SMEs and social enterprises but the majority of the market is made up of private contract caterers.  Chefs in Schools offer support to schools wishing to go in house.

Answered by Stephanie Slater, School Food Matters

We want more children and young people eating school meals so increase in take-up is good news.  Economies of scale afforded by high take up helps drive quality.

Answered by Stephanie Slater, School Food Matters

A tight contract specification is key.  We appreciate that training is needed to upskill school business managers and LA authority procurement leads to write smart specifications.

Responsibility for complying with the school food standards lies with school governors/trustees. We believe that every governing body should have a lead governor on school food as it’s a statutory requirement and therefore governors/trustees are accountable. The National Governance Association has just launched governor training, funded by DfE so worth taking a look.

Answered by Stephanie Slater, School Food Matters

I agree.  It’s a sticking point with many schools, particularly if they’re mid-contract.  Contract breaks offer an opportunity to challenge the caterer and make sure they’re meeting the contract specs.  In LB Southwark the council has recognised the need for training for school business managers and has funded e-learning.

Answered by Stephanie Slater, School Food Matters

We need both! We would never advocate for food teachers over quality school food. Cooking and nutrition is part of the national curriculum (since 2014) and we agree that there are not enough trained food teachers to make this part of the curriculum effective.  That’s way we’ve set up the Food Education Network (FEN) to champion food education in England. Join us AND submit to the Curriculum review – deadline is Friday 22ng November and you’ll find a template submission on the FEN website.

Answered by Stephanie Slater, School Food Matters

Yes – the previous Conservative government announced (Autumn Budget 2021) a £500 million investment into breastfeeding support services, including local authority run family hubs, NHS parenting programmes and antenatal classes.

The current Labour government have not detailed plans to increase funding for breastfeeding support, which is needed, given current UK breastfeeding rates remain low at 52.2% (2023-24) (slight increase from 49.2% in 2022-23). First Steps Nutrition Trust are calling for proper regulation of formula milk marketing, which mislead parents into buying unhealthy/unnecessary products, and undermines breastfeeding, and a comprehensive maternal and infant nutrition strategy, to include breastfeeding support. 

Answered by Food Active. 

Below is a list of some recent reports and research which may be of interest. 

• Food Active’s ‘Fuelling the Future’ report explores young people’s perceptions of school food and summarises views from 40 young people across Blackburn with Darwen, Blackpool, Trafford and Wirral on the food and drink available at breaktime, the dining environment and experience, existing school food policies and the food and drink available to them beyond the school gates.

• FUEL study (2024) – sought to find out how well the gov’s School Food Standards are adhered to in secondary schools. Summary of findings here: Healthy food options don’t equate to healthy eating in secondary schools, study finds - University of Birmingham

• Food Foundation’s ‘Feeding our Future’ report (2021) looks at the UK’s school food system, picking out examples of good practice from across the four nations, identifying opportunities for positive change, and making recommendations for policy and decision makers. 

• Bite Back’s ‘Spill the Beans’ report (published in 2021) explored secondary school pupils(aged 13-16) views on school food and developed a series of recommendations for action

Answered by Food Active. 

We completely agree that the food provided in breakfast clubs should be healthy and it’s encouraging to see the launch of these initiatives. However, at this stage, the specific plans for how these meals will be measured against nutrition standards and what the exact criteria will be, are still to be confirmed.

We hope that the food provided in these breakfast clubs will align with the School Food Standards, which should currently apply to all food served in schools, including both breakfast and lunch meals. 

While the introduction of breakfast clubs is a positive and much-needed step forward, we recognise that there is always more to be done to ensure all aspects of school food meet the highest nutrition standards. We look forward to seeing more details as they become available.

You can read more about the breakfast clubs early adopter scheme here: https://www.gov.uk/guidance/breakfast-clubs-early-adopters-scheme#overview  

For further updates, subscribe to the School Food Matters bulletin: https://www.test.schoolfoodmatters.org/get-involved/subscribe

Answered by Food Active. 

Yes, researchers have started to look at affordability in other ways (e.g. per serving size) and this can show different results. It will be interesting to see the results of these studies once they are in the public domain.

Answered by Professor Charlotte Hardman. 

Online deliveries can, in some cases, alleviate issues of poor food access. But there are some caveats – it depends on availability of delivery slots and whether these are offered in local areas (can be particularly true in more rural areas). There are also issues with affordability as most retailers charge a delivery fee and have a minimum spend which can be prohibitive for lower income households.

Answered by Professor Charlotte Hardman. 

You may be interested in a recent report from Nesta, which explored how supermarkets can increase healthy food purchasing. The key recommendation was introducing mandatory healthy food targets for large retailers as modelling data suggests this could reduce obesity in Britain by approximately 23% and help four million people achieve a healthier weight. The policy is designed to incentivise the UK's largest 11 grocery retailers to offer healthier food options, discouraging business models that rely on pushing people to fatty foods and sugary snacks. The report goes beyond solely the issue of affordability and recognises the wide range of other levers that can be used to support healthier food purchasing such as product reformulation and new product development, placement and advertising. Read the report here: https://www.nesta.org.uk/press-release/healthy-food-targets-for-uks-biggest-retailers-help-four-million-move-to-a-healthier-weight/ 

Answered by Food Active.

We’re currently undertaking some consultation with schools with several options on how we proceed with building auto-enrolment into the FSM service. Once this consultation has taken place and we have reviewed the responses, this will be included in the recommendations of the next report going to the Executive. 

Answered by Anne Rose.

The questions are used more to raise awareness of the scheme. This varies depending on the organisation, for some it is as simple as ‘have you heard about the healthy start scheme?’ – detail and / or a leaflet is then given, for other organisations they have added additional questions such as ‘would you like support to complete the application’

Answered by Liz Fisher.

Working with markets, looking a different way to engage with larger retailers, the business support service internally are just a few ideas on who to engage with to increase retailer participation.

Answered by Liz Fisher.

It has increased slightly across the city but still remains low, looking at how we increase this will be one of our next actions as a group.

Answered by Liz Fisher.

We don’t have an idea of the success rate at present, some trends include those with no recourse to public funds and those in shared households, e.g. we had a mother and daughter who both had young children, and one was rejected as there was already a claim for that house, however, this was resolved.

Answered by Liz Fisher.

It took long term planning to develop the current model, with successive fresh food tender terms including contractual levers to effect sustainable change. For example, the requirement to meet Food for Life accreditation was included as a future objective which the Supplier was expected to support during the contract period. When the tender was re-let the requirement became a contractual obligation (via terms and conditions and food specifications), resultantly allowing time for industry to gear up for requirements. In all, it took 3 x 2+2 successive tender terms to get to the current model. The only setback worthy of note would be certain product specifications becoming too restrictive to garner any real competition – this has since been overcome via the use of nutritional +/- tolerances.

Answered by Hayley Stafford

Not in our experience. The only feasible way to influence non-authority publicly funded organisations would be for government to implement mandatory standards and compliance reporting, similar to those advocated as part of the National Food Strategy.

Answered by Hayley Stafford