Planet Vending Editor Ian Reynolds-Young talks to Vending Solutions’ MD Mike Gardner about the issues and opportunities surrounding CQUIN, the NHS’ financial incentive.
If, like me, you thought that CQUIN was something to sew on your Strictly frock, working with the NHS in the past year or so must have been, er… tricky. For others, looking for answers when it comes to questions of compliance has been as difficult as finding the scarlet pimpernel – they CQUIN here, they CQUIN there…
Enough with the groan-inducing gags already. In the real world, CQUIN is nothing to laugh about.
What is CQUIN?
Well, it’s what the NHS has introduced to encourage hospitals to improve aspects of their work; a financial incentive under a scheme known as ‘Commissioning for Quality and Innovation’, hence CQUIN. One of the aspects covered is the provision of healthy food for staff, visitors and patients.
The requirements for this apply to all sites providing food in hospitals, including cafés, shops, kiosks, patient meals and drinks, and more importantly to us – vending machines.
The CQUIN for 2016/17 banned the advertising and promotion of products high in salt, fat, and sugar from all points of sale in hospitals. It also required that healthy options be available at all times for those working nights. The CQUIN for 2017/18 built on this by requiring that:
- 70% of drinks lines must be sugar free (less than 5 grams of sugar per 100ml)
- 60% of confectionery does not exceed 250 calories
- 60% of snacks do not exceed a bag weight of 30gms
- At least 60% of sandwiches and other savoury products contain 400 kcal or less and less than 5g saturated fat per 100g
In the CQUIN for 2018/19 the above figures are increased to a maximum of 10% by volume sold of added sugar drinks, then 80%, 80%, and 75% respectively.
Just to be clear: the definition of ‘drinks’ includes water, fruit drinks, and milk drinks. They must not contain more than 5% added sugar, but the sugar naturally present in fruit drinks is not included. Milk drinks are allowed to contain up to 10% added sugar.
The changes have affected everybody in vending
…but few more so than Mike Gardner, MD of south-coast based Vending Solutions Ltd. ‘CQUIN has been on our radar for over two years now’, he said, ‘but I won’t say I’m an authority on it, because there are still amazingly different points of view, even when you’re talking to NHS people at the different locations, in terms of how they interpret what is and what isn’t CQUIN.’
In August / September last year, the CQUIN directive changed . The upshot was that by the end of March 2018, the volume of added sugar drinks sold through vending machines had to be a maximum of 10% by volume of product vended. You need only speak to a vending wholesaler to see that this has caused a huge shift in what’s been purchased for NHS use and that’s because the only way to hit that target has been to completely eliminate any added sugar drink.
‘Take your classic BevMax machine with 45 product choices, for example’, Mike said, ‘and bear in mind that CQUIN has always dictated that added sugar drinks can only be sold in a maximum 330ml, which means a can. So, with your 45 selection BevMax, you decide you’re going to be on the safe side and only have four facings of added sugar Coke or Pepsi full fat. But there’s no way a vending operator could ever control sales to be under the 10% by volume. That’s because those four slots would very soon be emptied; you’d constantly be refilling them. The vast majority of people would go for these choices automatically, which would blows your 10% by volume out of the water.
‘The only solution was to remove added sugar drinks completely’, Mike said, ‘and we did this in our first hospital client back in January.’
The demands of the strategy have placed an intolerable reporting burden on operators in order that they can be seen to be complying to the requirements. ‘We had to report the whole of the 2017 on a monthly and quarterly basis showing the actual situation at the beginning of the year and the progress towards the 10% maximum target’, Mike said. ‘The additional workload this created was horrendous. We had to go through every can and bottle sold and check whether it’s added sugar or not, and then separate out one from the other…
‘Can you imagine how many machines we have out in hospital sites?’
Vending Solutions approached its software provider, Vendman, to see if they could simplify the calculations of the latest changes on the cold drink parameter. ‘At that time,’ Mike said, ‘we said to Vendman ‘can you imagine how many machines we have out in hospital sites? Can we, through Vendman, do the calculation of the percentages, added sugar versus the rest?’’
The answer was ‘yes’. ‘Now thanks to Vendman, that has all been simplified and we’ve got it totally under control’’ Mike said. ‘Unless there’s an operator error, nothing goes into a machine that shouldn’t be in it and our people only have to run a report every month to get the information every FM or independent trust has to have.
By comparison, confectionery is rather easier to manage. ‘We’re informed have to offer the smallest retail portion size available, with a maximum of 250 calories and that’s easily measurable’, Mike said. ‘The trouble is that under the government’s ‘traffic light’ buying standards, nearly all the most common and popular products are strongly red!
‘But then, if you look at the directive for snack products there is apparently no logic in it. They’ve said ‘a maximum 30g bag’. Now that makes no sense, as it has no nutritional bearing on anything. I went to a meeting early last year at the AVA offices, with vending operators and some NHS representatives, and they categorically said ‘yes, that’s it, there’s a maximum 30g bag.’ So I said: ‘fine, does that mean I can put these in vending machines in hospitals?’, and I put on the table 25g bags of pork scratchings.
Everybody’s had to change what they’re putting in machines.
‘They had a hissy fit: ‘you can’t, you can’t!’ and I said, ‘I can; because you’ve just told me that there’s no parameter other than bag size.’ And they haven’t changed that. So, all your mini-cheddars? Gone. All your standard crisps went, because they’re 32.5 g. All your McCoys, and your Rough Cuts went, because they’re 50g bags. All your Doritos went, and they’re baked. Everybody’s had to change what they’re putting in machines.
‘Some of the manufacturers have opened their eyes and said ‘hold on, we’re losing thousands of cases of sales here to the vending industry because they’ve stopped buying’, Mike said. ‘The only company that’s really taken the bull by the horns and done a really fabulous job is Tyrrell’s: they’ve just launched a 25 g range with their first three products.’
Talking to Mike has been both eye-opening and ear-bashing. The cadence of his voice veered from mirth to incredulity as he held forth; it was as though he couldn’t decide whether to laugh or cry…
In the final analysis, far from being the end of the world the introduction of CQUIN can be seen as a positive vending industry story. Vendman has been able to simplify the process of collecting the data NHS clients need and wholesalers, such as Automatic Retailing, have worked closely with suppliers to ensure that operators have alternative products that won’t just fill the empty spirals, but prove popular with consumers. (As John Crichton writes, here*).
I suppose, like everything else, that the conclusions you’ll draw will depend upon whether your glass is half full, or half empty.
- Planet Vending wishes to thank NIVO, the source of much of the factual material in the opening part of this article.
- Vendman on working with Vending Solutions Ltd to facilitate compliance, HERE.
- Automatic Retailing’s John Crichton discusses the issue in his own inimitable way, HERE.
- Planet Vending News Archive, HERE