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How to ‘Farm to Fork’ for Healthcare Caterers

Article by Susan T. Jackson

Photo created by Freepik

Our food systems provide us sustenance, but at a cost. On average, Germany produces 75 kilograms of food waste per person each year. Agriculture accounted for about 9% of Germany’s greenhouse gas (GHG) emissions in 2020 and Germany has harmfully high levels of agriculture-related nitrate concentrations in its groundwater. Unless and until we tackle these problems, our food systems will continue to have negative impacts on people and the planet, including contributing to biodiversity loss and poor nutrition. Part of the EU Green Deal to reach climate neutrality by 2050, the Farm to Fork Strategy is a key component of the EU approach to sustainably transforming food systems in Europe and beyond.

Sustainability gaps in the healthcare food system

The goal of the European Farm to Fork (F2F) Strategy is to make food systems fair and healthy by increasing the availability and affordability of healthy and sustainable food options, reducing the environmental footprint of food systems, and making it easier to adopt a healthy diet. These goals entail a wide set of stakeholders and activities in food-related processes and account for the societal, economic and natural environments in which they are embedded.

Institutional kitchens and caterers and other entities that engage in large-scale food procurement, preparation and delivery can be catalysts for transforming food systems and by supporting local communities in a variety of ways. For example, in 2019, hospitals in Germany spent €2.5 billion on food and related services, yet overall Germany’s agricultural sector can only meet one-third of local demand for vegetables and one-fifth for fruit. Local sourcing can boost those figures. Further, with an estimated more than 950,000 (one out of five) deaths attributable to unhealthy diets, caterers can help patients and healthcare staff with healthier and more sustainable food choices at the same time healthcare providers can offer community education regarding these initiatives. Together, the F2F Strategy supports local economies by looking closer to home for sustainable sources.

From farming to catering

In Eurobarometer 2020, about 90% of respondents agreed that public institutions should offer sustainable food, with food producers and manufacturers as key to this shift. However, small farmers and institutional caterers face intersecting challenges in making this transition happen.

The German agriculture and food sector generates an estimated €499 billion in production value annually and employs over 12% of workers in Germany. However, less than a tenth of the farms in Germany tend more than half of the agricultural land here. In the EU more broadly, small and very small farms make up 70% of farms, but only account for 5% of the crops and livestock, which is likely an underestimation in official statistics. Small farmers often lack market access which can make it difficult to sustain livelihoods in the agricultural sector. At the same time, farmers are tasked with environmental and biodiversity stewardship that can be a daunting task for small farms in particular.

Caterers for healthcare facilities balance between being able to scale their food service to a large group of patients and staff and identifying food supply chains that value taking care of people and the planet. At the same time, globally between 30% and 50% of patients in healthcare facilities are estimated to be malnourished, meaning they do not have access to the healthy choices they need in order to heal.


Farm to Fork strategies can address these intersecting challenges and bring more security to small farmers while providing more nourishing food to healthcare caterers. Regardless of the size of the catering organization, the transformation journey to sustainable food systems is within reach.

Leading sustainably by making and following through on commitments. Any actor ‘between farm and fork’ can sign on to the EU Code of Conduct on Responsible Food Business and Marketing Practices. This voluntary commitment for creating a sustainable food system opens up access to a network of sustainability advisors, a platform for information sharing, and case studies on sustainability technologies. Aiming to gather opinions and evidence from the public and all relevant stakeholders, the Open Public Consultation (OPC) for the Sustainable Food System Framework initiative is running until 21 July 2022. The OPC is collecting input from all stakeholders regarding key issues for implementing the farm-to-fork initiative.

Innovating ways to bring communities, farmers, healthcare caterers, and procurement officers together. The possibilities for creating new paths for sustainable food systems are limitless. Market access for farmers is already being promoted in new initiatives such as local auctions and B2B tastings that introduce local and regional offerings – opportunities that can help caterers find more sustainable food sources. In addition, policy reforms such as date marking rule revisions can prevent food loss.

Strategizing farm-to-fork in business models. From production to consumption, the EU’s F2F Strategy provides measures and targets along the food value chain. Procurement officers can reach across typical department boundaries to foster joint approaches to developing and implementing food-related policies. Integrating a circular approach into business models across the food system can help promote biodiversity while at the same time supporting people and businesses.

Transforming the food system in just and sustainable ways. The F2F Strategy opens up transformational opportunities for businesses and communities. Some local transformations for supporting hospital caterers are on their way, for example, in the Biometropole Nürnberg. Moving from food as a commodity towards food as a common good means shortening supply chains and transforming the business of food systems so that the people who grow our food can meet the people who prepare it.


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