What is CQUIN?

Thursday, September 6, 2018

The Commissioning for Quality and Innovation (CQUIN) is a framework within the NHS that supports improvements in the quality of services and the creation of new, improved patterns of care.


A hospital reception area showing a seating area for visitors

It covers a wide range of areas, intending to drive transformational change within the NHS. As part of the scheme, 13 indicators have been published which aim to:

  1. improve the quality of the NHS services and outcomes for patients,
  2. reduce health inequalities, 
  3. encourage collaboration across different providers 
  4. improve the working lives of the NHS staff. 

The first indicator is Improving Staff Health and Wellbeing. This is made up of three parts with equal weighting, although only one refers to food provision:

  • CQUIN 1b: Healthy food for NHS staff, visitors and patients

If trusts adhere to the CQUIN scheme, they receive additional funding. CQUIN 1b is worth just under 0.1% of the trusts overall budget, but this can still be a huge amount for simply providing healthier food options. 


Why is the Improving Staff Health and Wellbeing indicator in place? 

In 2015, it was reported that 700,000 NHS staff are estimated to be overweight or obese and that sick leave cost nearly £2.5bn. Improving staff health and wellbeing is thought to improve patient safety and experience, improve staff retention and experience, reduce costs, set an example for other employers and reinforce public health initiatives. 


What is CQUIN 1b – Healthy food for NHS staff, visitors and patients?

‘Healthy food for NHS Staff, visitors and patients’ covers all food and drink sold on NHS premises including shops, cafes, kiosks and vending machines; irrespective of the size of the retailer. 

It does not ban any specific products but uses two methods to change the food environment within hospitals:

  • it restricts promotions, placement and advertisement of less healthy foods
  • it restricts sales volumes of less healthy foods



HFSS (High Fat Salt & Sugar): Within CQUIN the term HFSS is used to refer to foods that have or would have a red traffic light front of pack, according to Government guidance . In some instances, dried fruit, nuts and similar products which are considered healthier snacks, can still be CQUIN compliant even if they have a red front of pack. For example our YES! Beetroot & Apple fruit bar. 

Sugary drinks: The CQUIN considers sugary drinks to be those with more than 5g of added sugar per 100ml, or more than 10g sugar/100ml for milk based drinks. 


Promotion, placement and advertising restrictions:

Sugary drinks or ‘HFSS’ foods cannot be: 

  • Price promoted, including within meal deals, multi-buy discounts or when a free item is provided with a purchase. 
  • Advertised
  • Sold from checkouts, points of purchase or immediately behind the checkout.

Additionally, Healthy options should be available at all times, including for staff working night shifts. 

Sales volumes guidelines: 

  • 80% of drinks provided must not be sugary drinks
  • 80% of confectionery sweets must not exceed 250kcal
  • 75% Pre-packed savoury meals (e.g. sandwiches and salads) must contain 400kcal or less per serving and must not have have more than 5g saturated fat per 100g.


How can Nestlé Professional help?

It’s important to remember that CQUIN 1b does not ban any foods, so all of our products can be sold in hospitals. However, HFSS foods do face advertising, placement and promotion restrictions. Our sugar free POLO® products, YES! Raspberry & Chia Seeds Bar and both the NESCAFÉ® Azera® Nitro Latte and Americano cans are not defined as HFSS products or sugary drinks, so are a great choice for meal deals or positioning at checkouts. Our new Nature’s Heart Blueberry and Goji Trail Mix, Tropical Mix and Strawberry and Pistachio Trail Mix are also CQUIN compliant. 

Additionally, most of our single serve confectionery is under 250kcal per pack so can be useful additions to ranges without negatively impacting the sales volumes.

For more information, read the official NHS England CQUIN 2017-19 Indicator 1 Implementation Support

If you'd like more information about products then feel free to contact us


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