NHS trusts spend about £500 million a year on food and catering. The government is committed to the economic, environmental, social and health benefits of sustainable food procurement, but this is difficult to translate into practice at a local level. In 2004 the Better Hospital Food Programme (BHFP) commissioned the King's Fund to identify opportunities for managing food procurement sustainably and promoting healthy eating in acute hospitals. Reporting on the project, this paper includes a framework to help organisations to assess their procurement and catering practices, and recommends policies, menu designs and contract specifications. [Summary]