Proposals to Improve the Out of Home Environment in Scotland

Applying maximum limits and densities feels a bit to assertive considering the nature of e.g. "Chippies" . Reducing offers on food high in both calories and density can be supported by other actions and supported by some of the actions listed above. Options could be offered such as boiled potatoes or salads to a 'Fish Supper' instead of fries. It is very desirable to control the criteria that determine what is on offer from a public health and nutritional angel but all this must be considered within the business setting and consumer choice. A step change with strong associated support e.g. MenuCal and local support from Environmental Services can be part of a joined up approach. Smaller portions should be strongly promoted and supported. As an argument – smaller portions costs less. A start in order to engagement might be to via Menucal help businesses provide small, medium and large portions although great care should be not to apply fast food selling tactics regarding monetary sales value.

Smaller portions tailors to the diverse calorie need in the public population and strengthen a visual message about more normalised portion sizes towards nutritional needs. It would further support those trying to manage their weight.

It does help to be able to compare and contrast at point of purchase. calorie labeling further strengthen the food literacy level. However, numbers of calories means very little if not put in contrast to something else such as e.g. daily recommendations or similar products with less calories. However, there are products that maybe should be exempt such as fruit and vegetables and tools or resources should be developed or shared with small enterprises supporting smaller businesses where capacity and knowledge in regards of this can be limited.

ManyCal is an excellent tool supporting any catering business. Learning how to calculate calories will increase food literacy and maybe stimulate alternative options, cooking methods or portion sizes. menuCal could be part of any application to Environmental Services.

Ongoing technical training and support on the use of the programme would be essential. Local awards and encouraged promotion of businesses through council and local media.

There is tentative evidence of effectiveness that calorie labelling has a positive impact on calories consumed, although it is far from definitive. (https://www.cochrane.org/CD009315/PUBHLTH_nutritional-labelling-promote-healthier-consumption-and-purchasing-food-or-drinks)
Calorie labeling is a useful tool when making informed choices about healthy options.
Voluntary approaches are not generating enough to have an impact a mandatory approach would be more successful.
The format needs to be considered ensuring consistency across Scotland and not add confusing of mixed messages.

There might be single event including small enterprises where this would add /burden their ability co comply. In the case of such events e.g. hamburgers to the Easter Parade of bikers at NHSGGC's Children's Hospital where adherence to the HLA+ could be better suited. Alcohol must be included.

Standardised and simplified provision of information is the way forward. It diffuse any confusion of what is what, it mitigate inventive marketing tools to create illusion of a healthy option. care should be taken to those with literacy challenges and options should be made available to those who are blind.

The larger private sector chains are masters in utilising marketing tools and campaigns. More can be done to encourage that knowledge to be applied to support a cultural change regarding food and drinks. These larger businesses should be encouraged to learn from the implementation of the HRS where new business models were developed and implemented. There was great learning with these new models in that although the turnover initially dipped, consumer convenience is strong customers returned and profit is not far off from the "before" position.

The change will come from consumer preference and demand unless a change is more financially favorable for businesses and it is therefore important to continue strengthen the work in Education around choices and health as well as creating an informed consumer base. New enterprises could be asked to provide their MenuCal results as part of their application. Local figure heads could promote and be seen to want to enage working with this sector.

All suggestions would have a positive impact. However, it is pertinent to work with the industry to take “them with us”. It is easy to forget that their objectives to providing a service are very different to ours. All of the above would help but implementation of the actions suggested must be considered from the service providers perspective and not only from a health perspective. More can be done working with the industry to create new alternative with an acceptable palate for the consumer. More can be done to promote the composition of dishes e.g. heavy main course, opt for a lighter dessert option etc. Children’s menus and children’s food is not necessary, it is better to encourage the normalisation of family food and options

Recognition schemes are very good but more can be done to make them or new ones a bit more “hip” or contemporary. Lists, national awards why not a BAFTA for sustainable health improved provision, highly visible in national press and media. Local councils can follow up at local level. Evidence of impact and customer satisfaction are two components that can be included.

The Healthcare Retail Standard and the HLA+ combined has changed the landscape of what’s available in NHS settings and this should be duplicated at Council and Local Leisure services. The national approach to all NHS settings assertively encouraged supplier to review what’s on the market, work with sub supplier, change formulation and package size. A new business model has been created in the private business providing in public setting. Public settings should be a reliable role model and actions should be joined up between e.g. council and NHS.

The proposal should not impact negatively on any of the above issues. However, special consideration needs to be taken to tailor more bespoke messages and accessibility of information. Healthy eating is for everybody.

This consultation is welcomed and signal a real commitment to join up the national priorities.