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Cook the pumpkin for 15-20 mins in a steamer over boiling water, or cook in the microwave until tender. Set aside until cool enough to handle. Blitz in a food processor or using a hand blender until smooth. Heat the oil in a large frying pan and fry the sage for 30 seconds-1 min until crisp. Lift out of the oil using a slotted spoon and put on a plate lined with a sheet of kitchen paper to drain off the excess oil.
Fry the onion in the sage oil over a medium-low heat for 10-12 mins until softened but not golden. Stir in the garlic and chilli flakes, and cook for 1 min more. Set aside.
Cook the pasta following pack instructions, about 10-12 mins. Drain, reserving a mugful of the cooking water.
Meanwhile, put the onion mix back on the heat and stir in the tomato purée and vodka. Cook for a few minutes until the alcohol evaporates, then stir in the pumpkin purée and double cream and bring to a simmer. Remove from the heat and stir into the cooked pasta along with enough of the pasta water to form a thick sauce. Top with the sage.