Patient Choice Standard for adult patients

Designing a menu to promote variety and opportunity for choice.

The menu design allows a healthcare facility to design a menu that prioritises patient needs and preferences.

Menu planning, design and review

Include consumers in the menu design and planning process so that cultural preference and appropriate comfort foods of the population are reflected.

Your menu design should show consideration of:

  • patient profile and length of stay
  • religious, cultural, lifestyle and life stage food preferences and requirements
  • cultural diversity, in the selection of main meal items, condiments and meal accompaniments
  • variation in ingredients, preparation styles, flavours and textures
  • limited repetition
  • offering foods that have had minimal processing for each meal and snack, along with a fresh food choice at each mealtime.

Do not repeat items at consecutive meals or on consecutive days, except if the menu is a static style menu or if the items are popular and preferred.

Set up a menu review framework outlining how often the menu will be reviewed. Conduct a review activity at least every two years.

A menu review activity may be:

  • a full menu review, or
  • occasional component review or interchange of items, e.g. based on seasonal availability.

A menu review must show:

  • consideration of patient needs and preferences including patient feedback data. This includes religious, cultural, lifestyle and life stage food preferences and requirements.
  • engagement and input from key stakeholders of the healthcare facility such as food service representatives, clinical dietitian representatives, clinicians, patients and carers.

Complete an assessment of the compliance of the menu to the Nutrition Standards every two years to inform the menu review.

Length of stay considerations

Very long length of stay (four weeks or more)

  • A healthcare facility has mechanisms to identify patients with a very long length of stay.
  • The menu design includes strategies to offer additional variety for these patients. Additional variety should be offered for all meal components, not just main meals.
  • Patients staying for multiple months or years should be actively consulted and contribute to menu design.
  • Increase menu variety by providing meal events, such as barbecue, picnic, takeaway night or self-catering opportunities, e.g. when consumers are engaged in food preparation and cooking.
  • Use your local framework to plan meal events. Some meal events may be out of scope for compliance with the Nutrition Standards.

If the facility is selecting the menu for the event, the Nutrition Standards apply. If the patient is choosing the menu, compliance isn't necessary.

Short length of stay (three nights or less)

  • Facilities where the length of stay is three nights or less and patients are nutritionally well can consider implementing a short stay menu.

Mental health facility considerations

Menu review

  • Schedule a component review or product interchange of items, e.g. based on seasonal availability, at least twice a year.

Mid-meal opportunities

  • If a mid-meal service is not provided, patients can select mid-meal options. Plan mid-meal options based on patients' needs.
  • When mid-meals are offered, provide a range of items. This includes a fruit option and, as appropriate for the nutritional needs of the consumers, a high-energy and/or high-protein item and a lower-energy option.

Caffeine

  • Caffeine is a drug found in food rather than a nutrient. It can interact with some medications.
  • Healthcare facilities should make a clinical decision on the quantity of caffeinated beverages available to patients.

Minimum standard serve for adults

Beverages

Beverages

Juice

100mL

Minimum number of options

One option at each main meal.

Menu item actions

n/a

Beverages

Cold beverages

150mL

Milk and other options

Minimum number of options

Offer two milk options at each main meal and mid-meal.

Offer water at all main and mid-meals.

Other drinks optional.

Menu item actions

Offer full cream and reduced fat milk at each meal.

Soy milk or non-dairy milk containing at least 100mg calcium per 100mL to be available.

Flavoured milk, cordial and soft drinks optional.

Beverages

Hot beverages

150mL
15mL milk for hot beverage

Minimum number of options

Offer at four meal occasions per day.

Menu item actions

Offer more than one variety of hot beverage (e.g. tea, coffee, decaffeinated and hot chocolate beverages).

Beverages

Sugar and sugar substitute

Portion control pack

Minimum number of options

One of each option when hot beverage or cereal served.

Menu item actions

Offer as an option with cereals.

Offer as an option with hot beverages.

Breakfast

Breakfast

Cereal – hot

150-180g cooked weight

Minimum number of options

One option per breakfast meal.

Menu item actions

n/a

Breakfast

Cereal – cold

Portion control pack or 30g serve

Minimum number of options

Four options per breakfast meal.

Menu item actions

At least 50% of cereals provide over 3g fibre per serve.

Breakfast

Breakfast – protein

100-150g yoghurt or one egg
or 20g cheese or 110g baked beans

Continental or cooked service

Minimum number of options

One option per breakfast meal providing at least 5g protein.

Menu item actions

Can offer other low-protein options such as spaghetti, tomato and mushrooms as optional additions.

Bread and spreads

Bread and spreads

Bread

One slice or one roll (30g)

Minimum number of options

Two options at each main meal.

Menu item actions

Offer variety, including white and either wholemeal, wholegrain or multigrain.

Bread and spreads

Margarine and butter

At least 7g

Minimum number of options

One margarine option at each main meal.

One portion to be used for two slices of bread.

Menu item actions

May also offer butter.

Bread and spreads

Spreads

Portion control pack

Minimum number of options

Three options per breakfast meal (e.g. strawberry jam, marmalade, honey and vegemite).

Menu item actions

Make different spreads options available at other meals during the day.

Offering peanut butter and low-joule spreads is optional. Assess according to healthcare facility requirements.

Lunch and dinner

Lunch and dinner

Soup

180mL

Minimum number of options

Offer one Band 1 soup at one main meal per day.

Menu item actions

Additional soups offered can be of any band.

Small serve size is available, where possible.

Lunch and dinner

Hot choice (main)

As determined in bands

Minimum number of options

At least two options at two main meal occasions per day (four options per day).

One option per meal must be Band 1 or Band 2 meat, poultry or fish.

One option per meal any band meat, poultry, fish or Band 1 vegetarian.

Optional unbanded food choice.

Menu item actions

Offer variety in meat and protein options at consecutive meals.

One hot choice per day is a vegetarian option, unless a vegetarian main salad or sandwich is offered as an alternative.

Unbanded options can be included, but must be in addition to the minimum number of banded options.

Protein- and energy-fortified options are available.

Small, standard or large serve sizes for hot main options are available, unless constrained by the nature of the item (e.g. pre-packaged meal, single serve item).

Lunch and dinner

Potato, rice, pasta and others

75-120g

Including noodles, cous cous, and other grains. Excluding bread.

Minimum number of options

Two options at each meal offering main hot choices.

Menu item actions

Offer an alternative to potato at least once per day.

Offer rice or pasta when it would be a typical accompaniment with a meal.

Recipe-based dishes must comply with sodium and saturated fat limits stated in the Nutrient Goal Standard.

Higher-protein and energy-fortified options are available for those with small appetites.

An option of a small, standard or large serve size is available unless constrained by the nature of the item (e.g. pre-packaged meal, single serve item).

Lunch and dinner

Vegetables including side salads

70g per vegetable portion
90g side salad

Minimum number of options

Two options at each meal offering main hot choices.

One option per day may be a Band 3 side salad.

Soups containing a significant amount of vegetables per serve can contribute to vegetable options.

Menu item actions

Offer at least one red or orange vegetable per day.

Offer at least one green vegetable per day.

An option of a small, standard, or large serve size is available, unless constrained by the nature of the item (e.g. pre-packaged meal, single serve item).

Lunch and dinner

Sandwich

Two slices of bread

Minimum number of options

One option Band 1 at two main meals per day.

Menu item actions

Offer at least one option with wholemeal or multigrain bread per day.

Offer one vegetarian option per day, unless a vegetarian hot choice or main salad is offered.

Varied serve size options are available including half sandwich, full sandwich and one and a half sandwich.

Lunch and dinner

Salad as a main meal

At least four different vegetables with minimum total weight of 90g

Minimum number of options

One Band 1 or Band 2 option at one main meal per day.

Menu item actions

Portion control salad dressings are offered.

An option of a small, standard, or large serve size for main salads is available, where possible.

Lunch and dinner

Condiments

Portion control pack

Minimum number of options

May offer or be available on request.

Menu item actions

A range of condiment options to be available (e.g. tomato sauce and mayonnaise).

Salt sachets are available.

Desserts and fruit

Desserts and fruit

Desserts

n/a

Minimum number of options

Two options per day at main meals.

One option must be Band 1.

Menu item actions
n/a
Desserts and fruit

Fruit

150g fresh fruit (one medium piece, two small pieces or five prunes) or 120g serve canned fruit

Minimum number of options

One option at each main meal.

One option available at each mid-meal.

Menu item actions

A variety of different fruit is available.

Offer a variety of presentations of fruit including full pieces, canned options and cut-up options.

Snacks

Snacks

Nutrient-dense snacks

Standard serve size or portion control pack

Minimum number of options

Acute care facility

A high energy (at least 500kJ) and a high protein (at least 3g) snack are available per day. These can be combined.

One mid-meal per day must have two options available.

Menu item actions

Include both savoury and sweet options in range.

For products without portion control packs, use the standard serve sizes as specified in this Standard.

Snacks

Other snacks

Standard serve size or portion control pack

Minimum number of options

Two options at each mid-meal per day.

At least two different lower-energy, nutritious snack options available each day (less than 400kJ per serve).

Menu item actions

Include both savoury and sweet options in range.

For products without portion control packs, use the standard serve sizes as specified in this Standard.

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