Local food procurement by hospitals: a scoping review

Local food procurement by hospitals is gaining traction as governments and advocacy groups seek to influence food systems and strengthen local communities, but there is little empirical evidence as to its practical application or efficacy. The aims of this review were to describe the extent, range and nature of local food procurement models in healthcare foodservices, and to understand the barriers and enablers to implementation, including from the perspective of stakeholders across the supply chain. A scoping review was conducted following the protocol published in the Open Science Framework Registration (DOI: 10.17605/OSF.IO/T3AX2). Five electronic databases were searched for the following concepts: 'hospital foodservice', 'local food procurement practices', 'the extent, range and nature' and/or 'the barriers and enablers of procurement'. Eligible peer-reviewed original research published in English from the year 2000 was included following a two-step selection process. The final library included nine studies. Most studies (7 of 9) were from the United States. Three studies used survey methods and reported high rates (58%-91%) of US hospital participation in local food procurement. Studies offered minimal description of local procurement models, but two models, conventional ('on-contract') or off-contract, were typically used. Barriers to local food procurement included restricted access to suitable local food supply, limited kitchen resources and inadequate technology to trace local food purchase thereby limiting evaluation capabilities. Enablers included organisational support, passionate champions and opportunistic, incremental change. There is a paucity of peer-reviewed studies describing local food procurement by hospitals. Details of local food procurement models were generally lacking: categorisable as either purchases made 'on-contract' via conventional means or 'off-contract'. If hospital foodservices are to increase their local food procurement, they require access to a suitable, reliable and traceable supply, that acknowledges their complexity and budgetary constraints.