James Martin's mission to improve hospital catering right accross the country. As he begins work with the team at Birmingham's Royal Orthopaedic, has he underestimated the scale of the task ahead? The kitchen staff face losing their jobs thanks to a growing overspend and shocking levels of waste, so as James starts trying to turn things around, he goes back to basics to understand why it is that no-one has any idea how many people they're cooking for. As tempers rise, there's a row with chef Gaz over custard and James meets patients to see what they think of the quality of the food. He also revisits Scarborough General Hospital to see if the team there have kept up with the improvements he introduced.