Patients at Epsom and St Helier hospitals now only get one hot food option a day, with some being offered ready meals which they could be asked to pay for in the future, it has emerged.

Last summer, the hospitals’ "cycle" menu, which enabled patients to have a hot lunch and dinner, was replaced by an a la carte service, offering patients a hot lunch and a sandwich or salad at dinner times.

Whereas the cycle menu gave patients a limited range of options on a three-week rotation basis, the a la carte service means patients can choose to have the same meal every day if they want to.

As well as now only having one hot main meal a day, the trust has been trialling the use of ready meals in Epsom Hospital’s Elective Orthopaedic Centre (EOC) outside of set meal times.

And the hospital's chief executive said the trust is "working on whether we could ask" patients if they are willing to pay for these.

FROM SEPTEMBER 14, 2014: Epsom Hospital food in "middle range" compared to other hospitals, according to study

At a meeting of Epsom Council’s health liaison panel last month, Daniel Elkeles - who was appointed the trust's chief executive in October - said that while an a la carte menu offers greater choice, it is expensive and this was the reason behind the sandwich and salad option for dinner.

Addressing councillors, he said: "That costs quite a lot of money to do a la carte.

"So the way we have paid for that is that we now only do hot food at lunchtimes.

"In the evening it is now a salad or a sandwich."

Nearby Croydon Hospital offers patients hot meals at lunch or dinner, and at St George’s Hospital, in Tooting, lunch and dinner are both hot meals with a choice of sandwich and salad as well.

At the meeting, Mr Elkeles said the introduction of the ready meals option, particularly in the evenings, "is going down very well".

He said: "We are contemplating rolling it out right across the trust but there is a cost of doing that.

"One of the things I have been asking people, would people mind having to pay for that in addition to the normal NHS food?

"We are just working on whether we could ask that question."

Mr Elkeles added: "It’s not hospital policy [to charge]."

After the meeting, a spokesman for Epsom and St Helier hospital trust said, in a statement, that the change to an a la carte menu was the result of an "extensive period of engagement with our patients" and advice from dieticians.

Asked to provide details on the results of the consultation, the spokesman said they were unavailable to do so as it was carried out by a previous contractor but that "the vast majority of those surveyed told us that they would choose to have one main meal and one lighter meal and would prefer to have the main meal at lunchtime".

Last year, the trust spent £1.06m on patient food - £150,000 more than before the new menus were introduced.

Despite Mr Elkele’s assertion at Epsom Council about why the cold dinners were introduced, the hospital spokesman said: "We do not serve sandwiches and snacks in the evening to save money."

The spokesman said that patients in the EOC "who need a larger, hot meal can currently receive one" but that the new ready meals system being trialled "makes the process easier".

He said the ready meals trial will soon be rolled-out to Epsom Hospital's maternity department to acknowledge new mothers need flexibility around mealtimes.

But he added: "Whilst this system gives flexibility to offer meals at short notice outside of traditional service times, it does not suit all patients."

The trust said there are "no plans" to ask patients to pay for any of their meals - but it will be asking people how they think the ready meals should be funded.

"We would like to offer all our patients more choice for all meals but are conscious that we only have a limited budget," the spokesman said.

"And so Daniel would like to begin a process to find out how people think we could do this."

According to the spokesman, the trust’s dieticians "have not raised any concerns about the healthiness of meals" - despite normal ready meals being notorious for additives, preservatives and a lack of vitamins.

MP Chris Grayling said he was not aware that patients meals at the hospitals had changed, but that he does not have a problem with patients only being served one hot meal day - something which has been introduced in prisons since he took over as Justice Secretary.

He said that "the key question is whether patients have enough to eat" and believes it would be reasonable to charge patients for additional ready meals.

When asked whether it is right for hospitals to be actively promoting the use of ready meals, Mr Grayling added: "Any NHS trust would want to ensure they are providing decent, wholesome food.

"If you fancy an afternoon snack it’s not unreasonable to get them to pay for it. It would be unacceptable to be charging for the main NHS meals."

Epsom and St Helier Hospitals' food is supplied by Appetito, one of the biggest suppliers of hospital food in the UK.

Asked if all food served at the hospitals is made from fresh ingredients and cooked on-site, a spokesman said: "Ingredients are a mix of fresh and frozen."

Last August, the Department of Health announced that new mandatory food standards will be introduced in the NHS contract for the first time and hospitals will be rated for food quality.

The recommendations, formulated by the Hospital Food Standards Panel, which was set up in December 2013, are due to come into force next month.

The new standards emphasise hospital food that is nutritious, sourced in a sustainable way, good for individuals and clinically appropriate.

Announcing the recommendations, Health Secretary Jeremy Hunt said: "We want to know that all patients have nourishing and appetising food to help them get well faster and stay healthy, which is why we’re introducing tough new mandatory standards for the first time ever."

What do you think about the food at Epsom and St Helier hospitals?

Contact Hardeep Matharu by calling 020 8722 6346 or emailing hmatharu@london.newsquest.co.uk.