Official Statistics

United Kingdom Food Security Report 2021: Theme 5: Food Safety and Consumer Confidence

Updated 5 October 2023

This chapter of the UK Food Security Report looks at food security in terms of the extent to which consumers are confident in the overall safety and authenticity of the food they eat and the supply chain that delivers it. Public trust in UK food, both in the UK and overseas relies heavily upon confidence in food safety, food standards and confidence in a high-quality food regulatory regime. Without public trust in food safety and standards the UK food supply chain could be undermined. Safe food produced to high standards is integral to food security: it protects public health, reduces the economic and social burden of foodborne disease and food hypersensitivity, and contributes to economic growth and international trade. This theme provides data on the key factors that underpin confidence in the UK food system and risks to this, such as food business compliance with food safety regulation, food safety incidents and recalls, levels of foodborne disease, and activity to disrupt food crime.

Key messages

• The majority of consumers in the UK trust the food they buy and eat to be safe and accurately labelled, when prompted consumers express concern around animal welfare, environmental issues, nutrition, and food production methods.

• Food business compliance with food safety regulation has remained high with slight increases in all four countries of the UK in the past six years, although there is some year-to-year variation.

• Laboratory confirmed reports of pathogens causing foodborne gastrointestinal disease in the UK and the proportional trends in foodborne disease outbreak surveillance data generally remained relatively stable over the period 2015 – 2019.

• Although food safety incident reports have increased since 2010, this is attributable to better detection and higher levels of reporting rather than an increase in risk.

Both safety and consumer confidence in the food system are key to national food security. If there are products which people are not confident in eating, or if doing so actively risks undermining health, this could effectively reduce supply.

The UK nations have a strong regulatory base to ensure the confidence and safety of the UK food supply is maintained. Within this regulatory context it is the responsibility of food businesses to ensure that all food placed on the market is safe, that its quality is what consumers would expect, and that it is not labelled in a false or misleading way. Consumers are responsible for the safe preparation and storage of food in the home and for checking labels to make sure that food is suitable for them to eat.

In the context of assessing UK food security, the effectiveness of the UK’s regulatory system for food safety is paramount. Metrics to monitor confidence in the system, indicators to track compliance, challenges which could undermine confidence and realised risks (incidents) help to illustrate this.

Consumer confidence in the food system and its regulation

Confidence in food systems is key to food security. It ensures that physical supplies of food are fully utilised and reduces the risks of consumer demand shocks which may result from product substitution through loss in confidence in some elements of the system. Food regulation is a cornerstone of the maintenance of high standards and confidence in authenticity and safety.

The food system is complex, and its regulation involves multiple bodies. Risks to consumers are varied, including foodborne disease, food allergic reactions or intolerances, risks associated with food crime such as the misrepresentation or adulteration of food and risks arising from mislabelling. Food regulation, and its enforcement, are designed to prevent or reduce these risks. Critical interventions include legislation, enforcement regimes, cross-government and cross-agency working, and partnership working with industry, food sector, and consumer bodies nationally and internationally.

Food and feed safety, including incidents, food poisoning, outbreaks, allergens and intolerances, recalls and risks associated with food crime are regulated by the Food Standards Agency (FSA) in England, Wales, and Northern Ireland, and by Food Standards Scotland (FSS) in Scotland. These independent government departments work with local authorities to enforce food safety regulations and check that standards are being met. The use of the best scientific evidence and analysis available enables effective responses to food incidents and outbreaks. This includes surveillance work to monitor and prevent potential risks to food.

Consumer trust in the FSA and FSS is high. In England, Wales, and Northern Ireland, 78% of consumers who have some knowledge of the FSA trust the FSA to make sure food is safe and what it says it is, and in Scotland 77% of consumers trust FSS. In England, Wales, and Northern Ireland 93% of consumers are confident that the food they buy is safe to eat and 89% are confident the information on food labels is accurate. In Scotland, 68% of consumers trust the information on food labels. In England, Wales, and Northern Ireland consumers report most confidence in farmers (88%) and shops and supermarkets (87%) and least confidence in takeaways (70%) and food delivery services (52%). While time series data is available in Scotland, for consistency trends are not presented due to changes in how data were collected by the FSA in 2020 in the rest of the UK.

Most consumers in England, Wales, and Northern Ireland (88%) report no concerns about the food they eat. When prompted, the most common concerns amongst respondents in England, Wales, and Northern Ireland are the amount of sugar in food (60%), food waste (60%), and animal welfare (57%). When presented with a separate list of issues, respondents in Scotland are most concerned about animal welfare (79%) and the use of pesticides, hormones, steroids, and antibiotics in growing or producing food (77%).

Food business compliance with food safety regulation

It is the responsibility of food businesses to ensure that all food placed on the market is safe. Compliance with food safety regulation is an indicator of good food hygiene practices among those who handle food and is associated with a lower risk to consumers. Across England, Wales and Northern Ireland the percentage of establishments that are found on inspection to be broadly compliant or better with food hygiene law has increased from 89% in FYE 2015 to 90.4% in FYE 2020. In Scotland, compliance with food hygiene increased from 88% in 2015/16 to 93% in FYE 2021, and compliance with food standards has remained high at 99% over the same period. Since FYE 2018 food hygiene and food standards inspections in Scotland have been combined into a single food law inspection, and the food law compliance status has increased from 92% in FYE 2018 (the first year of the scheme) to 96% in FYE 2021.

Food safety incidents, alerts and recalls

A food incident occurs when concerns around the safety or quality of food may require action to protect consumers. Incidents broadly fall into two categories: contamination during food processing, distribution, retail or catering, and environmental pollution such as fires and chemical leaks. Numbers of food safety incidents are not a direct measure of food security. Fluctuations in numbers reflect a diverse range of factors. However, whilst it is unlikely that a food safety incident would cause an overall shortage to food supply, it could impact specific products within the food supply chain and undermine consumer confidence in food safety.

Incidents, food poisoning, outbreaks, allergens and intolerances, recalls and risks associated with food crime, are regulated by the FSA in England, Wales, and Northern Ireland, and by FSS in Scotland. These independent government departments work with local authorities to enforce food safety regulations and check that standards are being met. The use of the best scientific evidence and analysis available enables effective responses to food incidents and outbreaks. This includes surveillance work to monitor and prevent potential risks to food.

The number of food safety incidents reported has increased; much of this is due to better ways of detection and increased voluntary reporting by food businesses and does not necessarily indicate a change in the food and feed safety profile of the UK. The types of incidents that are reported, however, provide an insight into the causes of incidents and the associated risks. These include detection of pathogenic micro-organisms, residues of veterinary medicinal products, chemical contamination, as well as allergens.

The number of food recall notices has remained relatively stable. The number of allergy alerts increased when new legislation required better labelling of allergenic ingredients in 2017 but has remained small: no more than 2 in any of the last 3 years.

Prevalence of foodborne pathogens and outbreak surveillance

For overall food security in the UK, it is important that the food consumed is safe to eat and does not constitute a threat to consumers’ health. While not all gastrointestinal infections caused by organisms such as bacteria, viruses, or protozoa, are foodborne, food is an important vehicle of transmission for many gastrointestinal pathogens that cause a substantial public health burden.^{[footnote 1]}

The UK Health Security Agency (formerly Public Health England), Public Health Wales (PHW), Public Health Scotland (PHS), and Public Health Agency Northern Ireland (PHA) are the lead agencies responsible for the protection of public health in the four nations. While these executive agencies do not have direct statutory powers to enforce legislation in relation to food safety, they are responsible for the surveillance of infectious gastrointestinal disease, including disease caused by pathogens that pose a food safety risk in the UK. This includes the identification, investigation, and management of foodborne disease outbreaks.

The four most significant bacterial pathogens that may contaminate food are Campylobacter, non-typhoidal Salmonella, Shiga toxin-producing E. coli O157 (STEC O157), and Listeria monocytogenes.

Campylobacter sp is the most commonly reported bacterial gastrointestinal (GI) pathogen. Campylobacter reporting showed a marginal overall increasing trend from 2015 to 2019, with a peak in reporting of 102.3 cases per 100,000 population in 2018. Salmonella is the second most commonly reported bacterial GI pathogen; reporting remained relatively stable during 2015-2019, with a peak of 15.2 cases per 100,000 population in 2018.

STEC O157 and Listeria monocytogenes are less commonly reported but reported cases have higher rates of severe illness than Campylobacter and Salmonella. For both STEC O157 and for Listeria monocytogenes there has been a slight decrease in laboratory confirmed reports between 2016 to 2019, although there are some year-to-year fluctuations. For STEC O157 the decrease in reporting rate was from 1.35 to 1.07 per 100,000 population, and for Listeria monocytogenes the decrease was from 0.29 to 0.23 per 100,000 population, although low numbers of reported cases complicate interpretation of trends for L. monocytogenes infection.

The 2020 foodborne pathogen surveillance data indicators cannot be compared to the data from previous years, as a substantial and sustained reduction in reporting of gastrointestinal pathogens to national surveillance has been observed coinciding with the SARS-CoV-2 (COVID-19) pandemic. The impact is likely multi-factorial and related to the introduction of non-pharmaceutical interventions (NPIs) to control the pandemic, as well as other factors so trend analysis for the data presented in this report should only be considered for 2015 – 2019, with exclusion of 2020 data.

An ‘outbreak’ is defined as an incidence of two or more human cases of the same disease, linked to the same source. Specifically in relation to foodborne disease outbreaks it is where the cases are linked, or are probably linked, to the same food source. In total, the UK public health agencies investigated and reported 276 foodborne disease outbreaks during the period 2015-2020, with nearly 10,000 associated human disease cases. The proportional trends in causative pathogens, hospitalisation rates, associated foods implicated in the outbreak investigations, and outbreak settings remained relatively stable over the period 2015 to 2019 and generally consistent with that seen in the previous decade. However, the implementation of whole genome sequencing since 2015 and the COVID-19 pandemic in 2020 have impacted on this data indicator.

Food Crime

Food crime interventions demonstrate the UK food safety authorities’ ability to receive, assess, and respond to intelligence concerning food crime. The FSS’s Scottish Food Crime and Incidents Unit (SFCIU) and the FSA’s National Food Crime Unit (NFCU) are responsible for tackling food crime in Scotland, and England, Wales, and Northern Ireland respectively.

Disruptions are a recently implemented measure of food crime interventions which stop or reduce the opportunity for food crime offending and in doing so, increase UK food security by ensuring food is safe. Recorded disruptions from the NFCU and successful operations by the SFCIU demonstrate the delivery of activity to stop or reduce the overall scale of food crime across the UK.

The NFCU began recording food crime disruptions in FYE 2021. Data shows a steady increase in the number of disruptions recorded through the year attributed to improvements in operational capability and a greater focus on, and awareness of, the full scope of disruption strategies. Overall, NFCU recorded 190 disruptions to food crime, with 52 Pursue disruptions and 138 Prepare, Prevent or Protect disruptions being delivered. The SFCIU was involved in a significant number of investigations during FYE 2021 which had various intervention and disruption strands, and are developing an approach to capture the percentage of actionable intelligence that resulted in a positive outcome.

Indicator 5.1.1 Consumer confidence in the food system and its regulation

Headline

Consumer trust in the FSA and FSS is high. Most respondents in England, Wales, and Northern Ireland are confident that the food they buy is safe to eat and that the information on food labels is accurate. In Scotland, the majority of respondents trust the information on food labels. Consumers in England, Wales, and Northern Ireland have more confidence in farmers and shops and supermarkets compared to takeaways and food delivery services

Context and rationale

A loss of consumer trust (either domestic consumers or international trade partners) in food safety can lead to reduced demand and significant economic impacts which in turn can threaten whole sectors of the economy. A fall in consumer confidence can also erode trust in how government and industry communicate risk to the public. Attributes such as safety, sustainability, and authenticity cannot be verified by the consumer at the point of purchase, so consumers must rely on others to communicate this information.

Data and assessment

Indicator: Proportion of consumers reporting confidence in food safety (FSA), proportion of consumers reporting confidence in accuracy of food labelling (FSA and FSS), trust in food regulators (FSA and FSS).

Source: FSA; FSS

Figure 5.1.1a: FSA respondents’ confidence that food is safe to eat: Food and You 2, Wave 2 (2021)

Figure 5.1.1b: FSA respondents’ confidence that information on food labels is accurate: Food and You 2, Wave 2 (2021)

Figure 5.1.1c: FSS respondents’ trust in the information on food labels: Consumer Tracker Survey, Wave 11 (2021)

In 2020 to 2021 the majority of respondents (93%) in England, Wales, and Northern Ireland reported that they were confident that the food they buy is safe to eat. 89% of respondents reported that they were confident that the information on food labels, for example, ingredients, nutritional information, country of origin, is accurate. 68% of respondents in Scotland agreed with the statement “I trust the information on food labels” with 4% disagreeing with the statement.

Figure 5.1.1d: FSA respondents’ trust in the FSA: Food and You 2, Wave 2 (2021)

Figure 5.1.1e: FSS respondents’ trust in FSS: Consumer Tracker Survey, Wave 11 (2021)

Amongst the sample in England, Wales, and Northern Ireland, 52% knew a lot or a little about the FSA and what it does. Of those consumers who have at least some knowledge of the FSA, trust in the FSA is high with 78% of respondents reporting that they trust the FSA to do its job (that is to make sure that food is safe and what it says it is). 1% of respondents reported that they distrust the FSA. Respondents in Scotland had very similar levels of trust in the FSS with 77% of respondents reporting that they trust FSS and only 1% reporting that they distrust the organisation.

Figure 5.1.1f: FSA respondents’ confidence in the food supply chain: Food and You 2, Wave 2 (2021)

Figure 5.1.1g: FSA respondents’ confidence that food supply chain actors ensure food is safe to eat in: Food and You 2, Wave 2 (2021)

Amongst consumers in England, Wales, and Northern Ireland, confidence in the overall food supply chain was high with 77% of respondents reporting that they were confident in the food supply chain. When respondents were asked to indicate how confident they were that key actors involved in the food supply chain ensure that the food they buy is safe to eat, respondents were more likely to report confidence in farmers, shops and supermarkets, restaurants, and food manufacturers compared to takeaways and food delivery services.

Trends

FSA undertook a wholesale review of its Food and You 2 survey methodology in 2020 to enable more frequent and more flexible surveying so robust trend data is not available for this report. However, the high levels of consumer confidence reported are similar to those recorded in the previous surveys.

Time series data is available for Scotland on some of these data, however for consistency these have not been included within this report.

Indicator 5.1.2 Consumer concerns

Headline

Most people in England, Wales, and Northern Ireland report no concerns about the food they eat. When a list of potential concerns are presented, the most common concerns amongst respondents in England, Wales, and Northern Ireland are the amount of sugar in food, food waste, and animal welfare. When presented with a separate list of issues, respondents in Scotland are most concerned about animal welfare and the use of pesticides, hormones, steroids, and antibiotics in growing or producing food.

Context and rationale

There are many constituent parts of the food system, and consumers may have concerns about one or more of these parts. Understanding which areas of the food system are of most concern to consumers is important for policy development, risk communications and advice, and ensuring consumers can make informed choices about the food and drink they purchase.

Data and assessment

Indicator: Proportion of respondents reporting concern from a list of issues

Source: FSA; FSS

Figure 5.1.2a: FSA respondents – ten most common prompted concerns: Food and You 2, Wave 2 (2021)

Most respondents in England, Wales, and Northern Ireland (88%) had no concerns about the food they eat. However, when asked to indicate if they had concerns about a number of food-related issues from a list of given options, the most common concerns amongst consumers in England, Wales, and Northern Ireland were the amount of sugar in food (60%), food waste (60%), and animal welfare (57%). 43% of respondents reported being concerned about food fraud or crime (for example, food not being what the label says it is).

Figure 5.1.2b: FSS respondents – ten most common prompted concerns: Consumer Tracker Survey, Wave 11 (2021)

Animal welfare was the top concern amongst consumers in Scotland, with 79% of respondents in Scotland choosing this. 77% of respondents reported that some food production methods or inputs such as pesticides or antibiotics were also a concern. 69% of respondents were concerned about food not being what the label says it is.

It should be noted that respondents in Scotland would have selected concerns from a different set of survey options compared to respondents in England, Wales, and Northern Ireland as the methods of data collection differ substantially between surveys.

Figure 5.1.2c: FSA respondents’ concern about availability of food: Food and You 2, Wave 2 (2021)

Respondents in England, Wales, and Northern Ireland were also asked specifically about the extent to which they were concerned about the availability of a wide variety of food; 13% of respondents were highly concerned, 34% somewhat concerned, 38% not very concerned and 11% not at all concerned.

Trends

FSA undertook a wholesale review of its Food and You 2 survey methodology in 2020 to enable more frequent and more flexible surveying so robust trend data is not available for this report. However, the consumer concerns reported are similar to those recorded in previous surveys.

Time series data is available for Scotland on some of these data, however for consistency these have not been included within this report.

Case Study 5.1 Allergen information on Food Pre-packed for Direct Sale

Overview

Government has a key role to play in setting the regulatory framework to ensure that consumers are provided with the information they need to allow them to make safe food choices.

In 2019, following the death of teenager Natasha Ednan-Laperouse, Defra, the FSA, and FSS reviewed the legal framework for allergen information for food which is pre-packed for direct sale (PPDS). They also consulted on proposed amendments relating to the provision of mandatory information, the form of expression and the presentation of allergen labelling information for PPDS foods.

Background

PPDS is food packaged at the same premises where it is sold or offered to consumers and is also in its packaging before it is ordered or selected.

In the UK, it is estimated that 1% to 2% of adults and 5% to 8% of children have a food allergy. This equates to around 2 million people living in the UK with a food allergy, but this figure does not include those with food intolerances.

There is no cure for food allergies and intolerances. The only way to manage the condition is to avoid food that makes the person ill. Therefore, it is important that consumers are provided with accurate information about allergenic ingredients in products to allow them to make safe food choices.

Discussion

Natasha died as a result of an allergic reaction to sesame in a baguette she had eaten. The inquest into Natasha’s death highlighted that food which is offered to consumers in a package without any allergen information can be dangerous.

During the consultation, consumers were clear that they wanted more information about the food they are eating provided on food labels.  

Defra, the FSA, and FSS worked together to introduce the Pre-packed food for Direct Sale Regulations from 1 October 2021. The introduction of this new requirement is supported by online training and guidance.

This will help protect food hypersensitive consumers by requiring potentially life-saving allergen information to be highlighted with an ingredients list with the 14 major allergens emphasised on the label of pre-packed food for direct sale. The change means more food products will now have allergen labelling.

Case Study 5.2 Codex

Overview

The UK is widely respected for its technical expertise and is influential in international standard setting. By working to deliver improved global food standards, the UK supports both global and domestic food safety and security.

Background

The Codex Alimentarius is a collection of internationally adopted food standards and related texts that aims to protect consumer health whilst ensuring the safety, quality, and fairness of international food trade. While voluntary, Codex standards serve in many cases as the basis for national legislation. In 2019, the UK provided £500k to the Codex Trust Fund to support eligible developing countries’ participation in Codex. Understanding and participating in the work of Codex means countries benefit from increased food safety, security, and harmonisation with global standards which in turn increases their opportunity to trade internationally.

Discussion

The UK is an influential member of Codex and is widely respected for its technical expertise. Steve Wearne, the FSA Director of International Affairs, was one of three Codex Vice-Chairs from 2017 to 2021 and notably led the work on creating and adopting the current Codex Strategic Plan. Steve Wearne has recently been elected as the new Codex Chairperson and this role will help the UK build stronger relations with all Codex members.

To improve global food standards and protect consumers, the UK will share its expertise as co-chair for new Codex work on food fraud. The work aims to develop guidance to improve risk management activities and the exchange of information between authorities and government agencies related to the prevention of food fraud that may impact the health and safety of the consumer and/or disruption of trade.

The COVID-19 pandemic highlighted more than ever the need for good hygiene practices and the importance of the General Principles of Food Hygiene which is used globally as a benchmark for national hygiene rules. The ‘General Principles’ serves as the foundation hygiene text. It is cross-referenced with other Codex guidelines and sector and product-specific codes of practice as a means of ensuring that basic food hygiene measures are adopted in the production, processing, and distribution of food commodities along the entire food supply chain.

The UK successfully led the work to update this Codex text when it chaired the working group on the revision of the principles. The key actions for change were to revise the text to clarify the key concepts and terms used and simplify the text. Through the electronic working group and plenary discussions, additional changes were made. This included moving to a risk-based approach to water being fit for its intended purpose and introducing significant text on ‘food safety culture’ within the section on management commitment.

The UK has long recognised the value of food safety culture in determining compliance and influencing behavioural change to improve compliance. In 2012 the FSA developed a Food Safety Culture Diagnostic toolkit for inspectors for local authorities. This was to support the assessment of food safety management during food hygiene official controls, with a particular focus on micro and small businesses.

With the increasing global and national interest in business culture and its relationship with regulation, the FSA decided to look again at food safety culture and its potential role as part of a modernised regulatory system, work on which is ongoing.

Indicator 5.1.3 Food business compliance with food safety regulation

Headline

Across England, Wales and Northern Ireland the percentage of establishments that are found on inspection to be broadly compliant or better with food hygiene law has remained high. In Scotland the compliance status in terms of food hygiene within food business establishments has continued to increase for the same period, and compliance status for food standards has stayed consistent over the period.

Context and Rationale

Compliance with food safety regulation is an indicator of good food hygiene practices among those who handle food. The FSA is responsible for monitoring and reporting on the performance of local authority food law enforcement services in England, Wales, and Northern Ireland. Within Scotland, FSS is responsible for monitoring and reporting on local authority food law enforcement.

Local authorities carry out a range of proactive and reactive interventions at food establishments. Planned checks and interventions, including inspections are carried out in line with the Food Law Codes of Practice in England, Wales, and Northern Ireland.^{[footnote 2]} In Scotland planned checks and interventions, including inspections are carried out in line with the Food Law Code of Practice 2019 for food hygiene, at a planned frequency in accordance with a business’ risk rating. In England, Wales, and Northern Ireland businesses are rated from A to E, with ‘A’ being highest risk and ‘E’ lowest risk. Higher risk businesses receive such interventions more frequently than lower risk ones. The Local Authority Enforcement Monitoring System (LAEMS) was used to collect annual data until FYE 2020. For food standards a new delivery model is being developed and is currently being piloted. For this reason, comparable compliance data is not available.

In Scotland, these category descriptors were reversed when FSS started to gradually move from the previous risk rating scheme to the new Food Law Rating System (FLRS) in 2018. Within this E and D premises are the highest risk and A, B and C are lower risk. Until 2017, annual data in Scotland was collected electronically from the LAEMS. However, following the introduction of the Scottish National Database (SND), data was collated electronically from that system.

Compliance data for 2020 to 2021 in England, Wales and Northern Ireland is not available due to the implementation of the local authority Recovery Plan as part of the COVID-19 response. This suspended the LAEMS data collection and has been temporarily replaced with bespoke surveys to monitor progress against the plan. A new system of reporting is under development in England, Wales, and Northern Ireland.

Data and assessment

Indicator: Food business operation compliance status

Source: England, Wales, and Northern Ireland: The Local Authority Enforcement Monitoring System (LAEMS) data; Scotland: The Local Authority Enforcement Monitoring System data and the Scottish National Database (SND).

In England, Wales and Northern Ireland the FSA tracks the proportion of food establishments that are broadly compliant (equivalent to a Food Hygiene Rating Scheme score of 3 or above).

In Scotland, Food Law (FL) compliance refers to the compliance status under the Food Law Rating Scheme (FLRS), the new risk rating scheme gradually implemented in Scotland in 2018. The compliance categories for the FLRS are A-C. In 2015/16 and FYE 2017 the FLRS had not been implemented, therefore there were no FL interventions carried out. Within the former risk rating scheme, which was previously set out in Annex 5 of the Food Law Code of Practice in Scotland, food hygiene (FH) and food standards (FS) compliance categories were E-C for food hygiene and C and B for food standards. Since 2018, new inspection cycles within existing premises and initial inspections in new premises has seen more premises move across to the FLRS risk rating and less premises being inspected under the previous Annex 5 scheme.

While the precise definitions of compliance between Scotland and other three countries are slightly different, both relate to the assessment of an establishment’s adherence to food law during an inspection, and so are broadly comparable.

Figure 5.1.3a: Compliance status of inspected food business operators in England, Wales, and Northern Ireland (including unrated establishments).

	FYE 2015	FYE 2016	FYE 2017	FYE 2018	FYE 2019	FYE 2020	FYE 2021
	[footnote 3]					[footnote 4]
England
% broadly compliant or better	88.7%	89.2%	89.8%	89.8%	90.4%	90.0%	Not collected
Wales
% broadly compliant or better	92.1%	92.6%	92.6%	93.5%	93.1%	92.7%	Not collected
Northern Ireland
% broadly compliant or better	91.5%	93.0%	91.2%	95.4%	94.1%	95.4%	Not collected
Total
% broadly compliant or better	89.0%	89.5%	90.0%	90.2%	90.7%	90.4%	Not collected

Figure 5.1.3b: Compliance Status of premises within Scotland (excluding unrated establishments).

The data within Figure 5.1.3b represents percentage calculations on inspected premises.

Year	FYE 2016	FYE 2017	FYE 2018	FYE 2019	FYE 2020	FYE 2021
Compliance Status Food Law (%)	Not collected	Not collected	92	97	97	96
Compliance Status Annex 5 (%) Food Hygiene	88	88	89	90	93	93
Compliance Status Annex 5 (%) Food Standards	99	99	99	99	99	99

From FYE 2015 to FYE 2020, the percentage of establishments broadly compliant or better for food hygiene requirements has remained high across all four countries.

Trends

Between FYE 2015 and FYE 2020 the proportion of food establishments that were ‘broadly compliant’ with food hygiene requirements or better (equivalent to an FHRS rating of 3 or higher) across England, Wales and Northern Ireland has been relatively consistent (89% in FYE 2015; 90.4% in FYE 2020).

In Scotland the compliance status of food establishments has increased slightly; in FYE 2015 food hygiene (FH) compliance status was 88%, this rose to 93% in FYE 2020. The food standards (FS) compliance status has stayed consistent. In addition, for FLRS the compliance has increased from 92% in FYE 2018 to 96% in FYE 2021.

Levels of compliance have been consistently high over the last 6 years. Compliance with food safety and standards regulations is associated with a lower risk to consumers, with higher levels of compliance associated with less risk of foodborne outbreaks and unsatisfactory microbiological samples.^{[footnote 5]}

Indicator 5.1.4 Food safety incidents, alerts, and recalls

Headline

The number of food safety incidents reported has increased; much of this is due to better ways of detection and increased voluntary reporting by food businesses and does not necessarily indicate a change in the food and feed safety profile of the UK. The types of incidents that are reported, however, provide an insight into the causes of incidents and the associated risks. These include detection of pathogenic micro-organisms, residues of veterinary medicinal products, chemical contamination, as well as allergens.

The number of food recall notices has remained relatively stable. The number of allergy alerts increased when new legislation required better labelling of allergenic ingredients in 2017.

Context and Rationale

The Food Law Codes of Practice, which cover the UK, outline the definition of a food incident, and the roles and responsibilities of the FSA, FSS, and enforcement authorities for food incidents. The Codes define a ‘food incident’ as “any event where, based on the information available, there are concerns about actual or suspected threats to the safety, quality or integrity of food that could require intervention to protect consumers’ interests.” The Feed Law Codes of Practice, which cover the UK, define feed incidents in a similar way.

The number of notified incidents is influenced by several factors such as the introduction of new regulations, consumer trends, advancement in science and technologies, various government led initiatives and increased reporting. Therefore, the data included in this report on the number of incident notifications is only meant to provide an understanding of the number of incidents the FSA and FSS have been made aware of in each Reporting Year. The data is not a clear indicator of any changes in risks to the UK’s food security. The break-down of the incidents into various categories, on the other hand, provides an insight into the various hazards or areas of concern that cause food incidents in the UK. The trends in these categories can be a useful indicator to assess where key risks lie.

The FSA and FSS investigate the same incident types but have different categorisation or reporting systems. Incident notifications are categorised according to the potential hazard that is under investigation or that is ultimately of concern. So, where no risk to the safety, quality or integrity of food and feed is identified, the incident may still be classified by the potential issue of concern.

The food, feed and drink supply chains are complex and involve numerous food chain actors from primary producers, to processors, packaging providers and retailers or restaurants. There are multiple points in the supply chain where potential hazards can be detected and communicated to regulators who can then in turn alert consumers.

The FSA and FSS issue alerts to let consumers and food businesses know about problems associated with food, feed, and drink and what action they need to take. These notices and alerts are an important way of communicating to consumers where they need to act and are issued at the FSA’s and FSS’s earliest opportunity and published online. In addition, point of sale notices are displayed at each of the affected stores for a given time. This is aimed at informing consumers who may have not received the alert through the online platforms.

The alerts indicate a formal response to food safety risks in the food supply chain. The majority of food alerts issued by the FSA and FSS are Product Recall Information Notices and Allergy Alerts (AAs).

A Food Alert for Action (FAFA) is issued to local authorities in cases where a food business operator demonstrates that it cannot or will not adequately recall or withdraw products which fail to meet the safety requirement, and which require specific urgent actions to be taken by local authorities. Very few Food Alerts for Action, which are issued when a food business operator does not adequately comply with safety requirements, have been issued. This indicates that most food business operators comply with the safety requirements laid out in law.

UK food safety bodies are rolling out several incident prevention strategies, the initial focus is the full implementation of the use of root cause analysis (RCA) by industry, enforcement authorities and FSA with analysis and reporting of data; such that root causes can be used to identify themes and underlying trends to help prevent incidents occurring. In addition, strategic surveillance workstreams have developed a number of models based on open and non-open-source data which harness the power of data science to identify emerging risks before they become risks to public health.

Data and assessment

Indicator: Total number of incident notifications received by the FSA and FSS from 2010 to 2021, recalls and alerts issued by the FSA and FSS from 2010 to 2021.

Source: FSA and FSS

Figure 5.1.4a: Total number of incident notifications received by the FSA and FSS from 2010 to 2021

In 2017 and 2018, FSS moved to a new data reporting format. Hence, there may be some duplications in the incident figures if the same incident is investigated by both the FSA and FSS.

In 2015 Reporting Year, the 1,514 figure is inclusive of 152 FSS incident notifications. In 2016/2017 Reporting Year, the 2,265 figure is inclusive of 104 FSS incident notifications. From 2017/2018 Reporting Year onwards, there may be some duplications if an incident is investigated by both the FSA and FSS.

Overall, there was a steady rise in incident notifications between 2010 and 2020 with a notable increase in years 2016 to 2017 due to a reporting change, from reporting year to financial year. More broadly, the year-on-year increase can be attributed to several factors including the introduction of new regulations, advancements in technology, science and analytical methods. These have led to better detection and reporting as well as detection of new hazard types including clandestine traveller (stowaways) in food vehicles. The number of notifications received represents how many incidents the FSA and FSS have been made aware of and is not indicative of a change in the UK’s food and feed safety profile. Instead, it is more instructive of changes in behaviours, technology, and statutory requirements.

Figure 5.1.4b: FSA breakdown of incidents by category during 2013 to 2021 Reporting Years^{[footnote 6]}

	FYE 2013	FYE 2015	FYE 2016	FYE 2017	FYE 2018	FYE 2019	FYE 2020	FYE 2021
Biological Origin	477	509	478	504	470	468	531	475
Pathogenic Micro-Organisms	307	348	304	307	376	362	376	350
Non-Pathogenic Micro-Organisms	26	20	35	27	0	4	37	49
Mycotoxins	88	54	58	113	80	87	94	61
Biotoxins (Other)	52	68	56	21	5	6	15	9
Parasitic Infestations	4	0	4	3	9	3	1	0
Bio-contaminants	0	19	21	33	0	6	8	6
Farming Practices	210	251	168	295	324	327	268	242
Residues of Veterinary Medicinal Products	75	210	116	212	218	144	140	114
Pesticide Residues	114	30	41	72	98	177	106	100
Feed Additives	11	9	8	10	7	4	19	27
TSEs (Transmissible Spongiform Encephalopathies)	10	2	3	1	1	2	3	1
Industrial / Chemical	369	290	332	298	123	128	152	109
Heavy Metals	75	74	64	73	39	42	46	43
Migration	29	17	8	14	18	16	33	15
Radiation	4	4	8	3	4	0	1	1
Industrial Contaminants	20	28	63	67	1	4	3	2
Chemical Contamination (Other)	241	167	189	141	61	66	69	48
Other	506	513	757	1168	1408	1400	1527	1152
Allergens	89	140	213	187	260	302	350	187
Adulteration / Fraud	63	62	66	91	18	28	30	12
Labelling Absent / Incomplete / Incorrect	97	69	81	118	160	170	210	155
Genetically Modified Organism / Novel Food	10	9	16	41	64	59	100	54
Food Additives and Flavourings	52	49	35	62	42	43	52	84
Composition	18	46	38	58	100	86	76	89
Foreign Bodies	105	65	97	104	110	104	120	106
Poor or Insufficient Controls	34	25	57	136	287	188	164	91
Organoleptic Aspects	5	9	16	19	5	8	4	0
Packaging Defective / Incorrect	1	5	20	21	10	21	23	6
Environmental Pollutants[footnote 7]	n/a	n/a	n/a	n/a	n/a	n/a	n/a	3
Clandestine Detection	n/a	n/a	n/a	n/a	179	198	193	111
CHEMET	n/a	n/a	n/a	n/a	169	181	203	146
Undefined	n/a	n/a	n/a	n/a	n/a	0	0	6
Not Determined / Other	32	34	118	331	4	12	2	26
COVID-19 Outbreaks[footnote 8]	0	0	0	0	0	0	0	76
Total	1562	1563	1733	2265	2326	2323	2478	1978

This table shows the breakdown of incidents by category reported to the FSA between FYE 2013 and FYE 2021. Overall, there has been a steady increase in incidents with the exception of 2020 to 2021, where a 20% downturn was observed. This downturn is attributed to changes in consumer behaviours, fewer food businesses operating due to the COVID-19 pandemic control procedures and streamlined food production lines. More information on the categories is provided in the appendix.

Figure 5.1.4c: FSS breakdown of incidents by category between 2015 to 2016 and 2020 to 2021

Category	FYE 2016	FYE 2017	FYE 2018	FYE 2019	FYE 2020	FYE 2021
Allergens	11	8	21	20	18	13
Animal Feed	5	3	7	9	4	4
Chemical	5	1	14	8	10	17
Emergency	4	9	11	6	4	2
Genetically Modified Organism / Novel Food	1	0	0	1	3	5
Illegal Activity	10	5	1	1	3	6
Microbiological	20	23	23	24	27	17
On-farm	12	18	9	6	7	11
Other	3	1	2	3	1	0
Physical	1	1	3	7	7	2
Production Error	3	3	6	7	7	4
Regulatory Breach	11	17	22	17	4	8
Shellfish[footnote 9]	66	15	15	3	3	5
Total	152	104	134	112	98	94

This table shows the number of incidents by category reported to FSS between 2015 and 2021. Overall, there has been a reduction in the number of incidents recorded by FSS since 2015. The main reason for this is a change in how FSS record their incidents, in particular Shellfish incidents. There are several factors explaining why incidents fluctuate from year to year. These include the introduction of new – or changes to – regulations, advancements in technology, science and analytical methods.

Figure 5.1.4d: Total number of food alerts issued by the UK during FYE 2016 to FYE 2021 Reporting Years

Led by	FYE 2016	FYE 2017	FYE 2018	FYE 2019	FYE 2020	FYE 2021
FSA	166	179	140	190	178	141
FSS	12	26	12	17	8	3
Total	178	205	152	207	186	144

In total, the FSA and FSS issued 144 food alerts during the FYE 2021 Reporting Year in comparison to 186 alerts issued in the previous Reporting Year. This represents a 23% decrease when compared to FYE 2020. This reduction was primarily driven by the fall in Allergy Alerts.

Figure 5.1.4e: Number of Allergy Alerts issued by the UK during FYE 2016 to FYE 2021 Reporting Years

Led by	FYE 2016	FYE 2017	FYE 2018	FYE 2019	FYE 2020	FYE 2021
FSA	84	98	92	118	106	67
FSS	10	6	1	12	4	3
Total	94	104	93	130	110	70

An Allergy Alert (AA) is issued when the product has been, or is being, recalled from consumers because allergen information on food labels is undeclared or incorrect. The FSA and FSS issued a total of 70 Allergy Alerts during the FYE 2021 Reporting Year in comparison to 110 Allergy Alerts issued in the previous Reporting Year. This represents a 36% decrease when compared to FYE 2020.

Figure 5.1.4f: Number of Product Recall Information Notices (PRINs) issued by the UK during FYE 2016 to FYE 2021 Reporting Years.

Led by	FYE 2016	FYE 2017	FYE 2018	FYE 2019	FYE 2020	FYE 2021
FSA	80	77	46	72	70	73
FSS	1	14	9	5	4	0
Total	81	91	55	77	74	73

A Product Recall Information Notice (PRIN) will be issued when the product has been, or is being, recalled from the final consumer. The FSA and FSS issued a total of 73 Product Recall Information Notices during FYE 2021, much the same as in the previous year (74).

Figure 5.1.4g: Number of Food Alert for Action (FAFA) issued by the UK during FYE 2016 to FYE 2021 Reporting Years

Led by	FYE 2016	FYE 2017	FYE 2018	FYE 2019	FYE 2020	FYE 2021
FSA	2	4	1	1	2	1
FSS	1	6	2	0	0	0
Total	3	10	3	1	2	1

A Food Alert for Action (FAFA) is issued when intervention by enforcement authorities is required. These notices and alerts are often issued in conjunction with a product withdrawal or recall. While the number of recall notices issued has remained stable, very few FAFAs have been issued.

Trends

The number of incidents recorded in any given year can be affected by many factors including new consumer trends, legislative changes, technological and scientific developments, the amount of testing performed, and even the weather. There is a steady year on year increase in incidents from FYE 2013 onwards with the exception of FYE 2021 where there was a 20% downturn caused by the pandemic driving changes in consumer behaviour; the streamlining of food production lines; fewer food businesses operating and a reduction in the complexity of the product ranges on offer. The number of incidents reported has now increased following the easing of the national lockdown and is returning to near pre-pandemic levels.

The FSA and FSS highlighted the benefits of Root Cause Analysis (RCA) in food, feed, and outbreak investigations in communications to the enforcement community, and have since committed to the use of RCA as a mechanism for working with industry to prevent incidents.

Between 2015 and 2017, FSS saw an increase in relation to their on-farm incidents. As a result, FSS carried out an incident prevention initiative which involved working with partners to produce a leaflet providing guidance on how farmers could help avoid on-farm incidents. This initiative started at the beginning of 2017 and has helped to reduce the number of on-farm incidents in this category.

There was a rise in the detection of allergen incidents resulting from incorrectly labelled packaging after the implementation of the new Food Information for Consumers Regulation (FICR) in 2014, though changes in dietary trends and international supply chains may also be partially attributable to the observed increases.

Between June 2016 and June 2021, the FSA was notified of 11 allergen related deaths and 11 food related allergic reactions. Notifications from members of the public related to allergies and/or intolerances are referred to the local enforcing authority in the first instance. During the same period, FSS were notified of seven food related allergic reactions.

The reduction of AAs issued in recent years may be partially attributed to:

• High-profile cases resulting in heightened media coverage, leading to greater emphasis on allergen control by food business operators

• Increased allergen awareness campaigns, including by the FSA and FSS

• Impact of Food Information to Consumers Regulation, resulting in greater awareness and allergen risk assessments by food business operators.

Almost all the incidents in the ‘Industrial/Chemical’ group related to fires which resulted in some potential chemical contamination incident. From FYE 2018 Reporting Year onwards, a dedicated CHEMET (Chemical Meteorology) category was introduced for such incidents.

Additionally, each year the FSA runs a Coordinated Food Standards Sampling Programme. This sets different priorities for enforcement authority risk-based sampling and surveillance. The levels of investigation may influence the numbers and types of incidents identified. FSS co-ordinates its own Local Authority Sampling Grants Programme which is designed to take account of UK food standards priorities in addition to areas of particular interest to Scotland.

Finally, during the COVID-19 pandemic, data indicates a downturn of 20% and 4% in the number of incident notifications received by the FSA and FSS respectively. This may reflect fewer food businesses trading over the pandemic and fewer new products coming to the market, as well as a reduction in the complexity of the product ranges offered during this period, and a reduction in local authority inspections. The number of incidents being reported has increased as the national lockdown eased and has now returned to normal level.

Case Study 5.3 Product recalls instigated by malicious tampering with retail consumer products

Overview

In 2019, the FSA and FSS worked with UK law enforcement agencies and Public Health England (PHE) in response to an attempt to blackmail a high-profile supermarket company based in the UK. Prompt responsive action to the threat, including notification to the public by both the FSA and FSS, saw the supermarket company voluntarily recall 182,000 jars of baby food. Direct harm to consumers was avoided, and the impact on wider consumer confidence in the food supply chain was estimated to be at a low level.

Background

The FSA was initially notified by UK law enforcement agencies in October 2019 that a blackmail demand had been received by a supermarket company, threatening the contamination of baby food products from a food producer (‘Company 1’), and that the matter was under investigation with those agencies. Subsequently, the FSA and FSS were notified by UK law enforcement agencies in December 2019 that a complaint had been received by the supermarket company of sharp pieces of metal having been discovered in a jar of baby food purchased in a store in Scotland by a consumer, while feeding their baby. Another jar of contaminated baby food was reported to the police having been purchased from a store in the North West of England.

In light of the first discovered tampered product, a voluntary product recall of 8 varieties within the specific baby food range sold by the supermarket company was undertaken as a precautionary measure following close co-operation and discussion between the companies and agencies. A Product Recall Information Notice to the public to highlight the recall was undertaken by both the FSA and FSS.

A further threat was received by the retailer in January 2020 in relation to jars of baby food produced by a second food company (‘Company 2’). Neither the retailer nor producer had received complaints, and the threat did not specify locations or product lines. A voluntary recall of 15 varieties within the baby food range was again undertaken as a precautionary measure and the FSA and FSS issued a Product Recall Information Notice to the public to highlight the recall.

Following a successful investigation and prosecution by co-operating UK law enforcement agencies, in what became the UK’s largest ever blackmail investigation, the offender was convicted of offences related to this incident as well as other offences. In October 2020, the offender received a sentence of 14 years in prison, including an 11-year sentence in relation to this incident. There are no known cases of injury associated with the incident.

Discussion

The Food Law Code of Practice issued by both FSS and the FSA to competent authorities responsible for the delivery of official food controls and other official activities defines ‘malicious tampering’ as the deliberate contamination of food by terrorist activity, or with a view to blackmail or extortion. Arrangements for dealing with malicious tampering incidents have been established between the FSA, FSS, and appropriate law enforcement agencies throughout the UK.

If there is a suspected or confirmed safety or quality problem with a food product that means it should not be sold, then it can be ‘withdrawn’ (taken off the shelves before the product reaches the consumer) and/or ‘recalled’ (when customers are asked to return the product). The FSA and FSS issue Product Recall Information Notices to let consumers and other stakeholders know about hazards associated with food and/or feed. All alerts published by the FSA and FSS are sent to the local authorities and other stakeholder groups to inform them. In some cases, a Food Alert for Action is issued. This provides local authorities with details of specific action to be taken on behalf of consumers.

The potential for criminal behaviour of this nature to affect the health and wellbeing of consumers directly is obvious, and it also presents a serious risk of harm to food businesses such as retailers and the food industry in general through loss of consumer confidence in the security of the food supply chain. In this particular incident, a careful assessment of the risks presented by the threats identified that while the impact for the wider general public might be considered low, it could be high for the individuals that might be affected by products that had been tampered with. This precautionary principle informed the strategies and contingencies which emerged from the close co-operation between the companies and agencies responding to the incident.

In total, the supermarket company voluntarily recalled 42,000 jars of Company 1’s baby food and 140,000 jars of Company 2’s baby food, which will have had substantial costs for the companies involved. Against those costs, however, the reported level of consumer concern detected following the recalling of the products and the notification of the recalls by the FSA and FSS appears to have been low. The risk of a wider loss of consumer confidence may well have been mitigated by the prompt responsive action taken as well as the successful subsequent prosecution of the offender.

Additionally, the press coverage of the criminal trial identified that the reporting of at least one of the tampered products to the police was prompted by the first product recall and the value of such action might also be seen in that outcome.

Indicator 5.1.5 Prevalence of foodborne pathogens

Headline

During the period 2015 to 2020, Campylobacter continued to be the most frequently reported bacterial pathogen causing infectious gastrointestinal disease in the UK. Campylobacter reporting showed a marginal overall increasing trend from 2015 to 2019, while Salmonella case reporting remained relatively stable. A decreasing trend in reports of Shiga toxin-producing E. coli (STEC) O157 has been observed since 2016 and, although reported case numbers are low, reports of Listeria monocytogenes infection have also declined marginally since 2016. The COVID-19 pandemic had variable impacts on the reporting of case numbers of these four bacterial pathogens in 2020.

Context and Rationale

The UKHSA, PHW, PHS and PHA are responsible for the surveillance of infectious diseases, including gastrointestinal pathogens that cause foodborne disease. Laboratory testing data and epidemiological information on each reported case is recorded in national surveillance databases and case management systems. The aim is to monitor trends in reporting of gastrointestinal pathogens, changes in disease epidemiology and to detect new and/or emerging disease threats, including foodborne disease outbreaks, so that timely and appropriate action to protect public health can be taken.

For overall food security in the UK it is important that the food consumed is safe to eat and does not constitute a threat to consumers’ health. While not all gastrointestinal infections caused by organisms such as bacteria, viruses or protozoa are foodborne, food is an important vehicle of transmission for many gastrointestinal pathogens that cause a substantial public health burden.^{[footnote 10]} Food poisoning leading to diarrhoea and vomiting as well as other more serious health problems, such as haemolytic uraemic syndrome (HUS).^{[footnote 11]} Guillain-Barré syndrome, irritable bowel syndrome),^{[footnote 12]} and reactive arthritis,^{[footnote 13]} can result in significant negative impacts on both individuals and society as a whole. Published estimates suggest that around one in four people in the UK suffers an episode of infectious gastrointestinal disease each year and foodborne disease in England and Wales results in costs of around £9.1 billion per year to the NHS, the economy and individuals).^{[footnote 14]}

There are many gastrointestinal pathogens and microbial contaminants that have a food safety impact. However, four major bacterial pathogens are considered priority pathogens for national surveillance due to the substantial implications for food safety in the UK: Campylobacter, non-typhoidal Salmonella, STEC O157, and L. monocytogenes. This indicator focusses on these pathogens. Campylobacter causes a high disease burden because of the considerable numbers of cases reported at a population level each year. Salmonella causes the second highest burden in terms of reported numbers of disease cases, with the highest reporting rate seen in children under the age of 10; a population group which is at higher risk of more severe clinical disease. STEC O157 causes gastrointestinal disease with potentially severe complications, especially in children under the age of 5, such as development of HUS.^{[footnote 15]} Listeriosis can have severe health consequences in people who are immunosuppressed or have underlying health conditions, people over the age of 60, pregnant women and new-born babies (typically through infection during pregnancy). Although annual reports of cases of L. monocytogenes are relatively small compared to other foodborne pathogens, listeriosis has a high mortality rate (20% to 30%).^{[footnote 16]}

No disease surveillance system is perfect and there are both surveillance biases and under-ascertainment of infectious gastrointestinal disease, further information on which is included in the annex to this report.^{[footnote 17]} Additionally, it is important to note that the surveillance indicators for 2020 were adversely impacted by the COVID-19 pandemic so the 2020 surveillance data cannot be compared to the data from previous years.

Data and assessment

Indicator: Reported infections of Campylobacter, non-typhoidal Salmonella species (sp)., STEC O157 and Listeria monocytogenes in the United Kingdom, 2015 to 2020

Source: Second Generation Surveillance system (SGSS) and Electronic Communication of Surveillance in Scotland (ECOSS).

Figure 5.1.5a: Number of laboratory-confirmed reported infections in the United Kingdom^{[footnote 18]}, 2015 to 2020

Year	Campylobacter sp.	Non-typhoidal Salmonella sp.	STEC O157	Listeria monocytogenes
2015	63,193	9,479	880	186
2016	58,149	9,610	981	201
2017	63,623	10,010	773	156
2018	67,984	10,107	836	174
2019	68,006	9,724	717	154
2020	54,979	5,329	577	148

Figure 5.1.5b: Rate of reported Campylobacter sp., non-typhoidal Salmonella sp., STEC O157 and Listeria monocytogenes infections per 100,000 population per year in the United Kingdom, 2015 to 2020

The pathogen with the highest number of reported cases annually across all years from 2015 to 2020 was Campylobacter. Case reporting is particularly high in the summer months, with annual peaks usually seen across the months June to August.

Non-typhoidal Salmonella was the second most commonly reported pathogen. Peak reporting is usually during the late summer and autumn months.

STEC O157 and L. monocytogenes had lower numbers of cases reported, with reporting rate peaks in 2016 of 1.49 cases per 100,000 population for STEC O157 and 0.31 cases per 100,000 population for L. monocytogenes.

As illustrated by figure 5.1.5b, the impact of the COVID-19 pandemic on gastrointestinal pathogen reporting rates varied by pathogen. In 2020, there were 5,329 reported salmonellosis cases, a reduction of 45% compared to 2019. Campylobacter reporting appeared to be less impacted by the pandemic. Initially there was a substantial reduction in Campylobacter reports in April 2020 (between 19% to 33% reduction) but reports had increased to similar levels to those recorded before the COVID-19 pandemic by August 2020 (1% to 7% reduction) and this return to reporting levels seen in previous years was sustained throughout the remainder of 2020 (data not shown) with an overall reduction in reports in 2020 compared to 2019 of 19%.^{[footnote 19]} The number of reported cases of STEC O157 fell from an average of 837 cases between 2015 and 2019 to 577 cases in 2020 (overall reduction of 31%). Like Campylobacter, there were fewer than expected STEC O157 cases from April 2020 but with levels rising to numbers comparable to the five-year average by August 2020 (data not shown). The reporting rate of L. monocytogenes decreased marginally in 2020 (148 cases compared to an average of approximately 170 cases reported in the previous five years, a decrease of 13%).

Trends

After an initial decline in reporting rate between 2015 to 2016, the reporting rate for Campylobacter increased from 2017 and reached a peak of 102.33 cases per 100,000 population in 2018. Overall, there has been a marginal but sustained upward trend in Campylobacter reports seen over the last decade.

The decreasing trend seen at the start of the decade in reports of Salmonella was not sustained in recent years, but case reporting remained lower than pre-2010 levels and relatively stable at approximately 10,000 reports each year until 2020, peaking in 2018 with a reporting rate of 15.21 per 100,000 population.^{[footnote 20]}

Reported cases of STEC O157 have shown an overall decreasing trend since 2016. The reason for this decline is unclear, although phage typing indicates a decrease in numbers of one of the most frequently detected types (PT 21/28) (data not shown). In contrast, the number of cases infected with other STEC serogroups (called non-O157 STEC), in particular STEC O26, has been increasing over the last decade (data not shown), likely predominantly due to the increasing number of laboratories implementing enhanced testing methods which enable the detection of all STEC and not just STEC O157.^{[footnote 21]} However, a real increase in the number of gastrointestinal infections caused by non-O157 STEC cannot be ruled out and the UK public health agencies are assessing these changes in trends.

Low numbers of reported cases complicate interpretation of trends for L. monocytogenes infection. However, the number of reported cases in the UK has declined marginally from 2016 to 2020, following a small increase in 2016.

The 2020 surveillance data indicators 5.1.5a and 5.1.5b cannot be compared to the data from previous years, as an overall substantial and sustained reduction in reporting of gastrointestinal pathogens to national surveillance has been observed coinciding with the COVID-19 pandemic. This may be due to the effects of lockdowns and restrictions on peoples’ behaviours, making them less at risk of acquiring certain infections. Examples could include changes in eating out patterns and changes in travel patterns. However, changes in health care seeking behaviours are also likely to have contributed, with fewer people visiting general practitioners and hospitals and having samples taken for testing, as well as changes in laboratory testing practices. Therefore, trend analysis should only be considered for 2015 to 2019, with exclusion of 2020 data.

The significantly lower number of Salmonella reports in 2020 was likely driven by multiple reasons, but a marked reduction in number of reports of travel-associated cases due to a reduction in foreign travel during the pandemic was likely to have played a notable role. Travel-associated Salmonella in the UK in the pre-pandemic era is estimated to constitute as much as 45% of overall disease burden).^{[footnote 22]} Similarly, the reduction in STEC O157 reports reflected a marked reduction in cases reporting foreign travel which normally account for approximately 20% of cases.^{[footnote 23]}

The less notable reduction in reports of L. monocytogenes throughout 2020 may be due to the fact that reported cases of Listeria are typically very unwell and often require hospitalisation, therefore ascertainment is less impacted by a decrease in people visiting their general practitioners and other healthcare settings.

Indicator 5.1.6 Foodborne disease outbreak surveillance

Headline

In total, the UK public health agencies, together with partner organisations, investigated and reported 276 foodborne disease outbreaks during 2015 to 2020, with nearly 10,000 associated human disease cases. The proportional trends in causative pathogens, hospitalisation rates, associated foods implicated in the outbreak investigations and outbreak settings remained relatively stable over the period 2015 to 2019 and generally consistent with that seen in previous years. However, the implementation of whole genome sequencing since 2015 and the COVID-19 pandemic in 2020 have impacted on this data indicator.

Context and Rationale

The UKHSA, PHW, PHS, and the PHA are the lead organisations responsible for the detection, investigation and management of outbreaks of foodborne disease in the UK, working in partnership with food safety, animal health and local authority colleagues for the implementation of food safety controls (see appendix for further detail).

There are inherent biases which should be considered when assessing the data presented in this indicator. The data derived through systematic national surveillance of foodborne disease outbreaks nonetheless provides an important source of information for foodborne disease trend analysis. This data is used alongside other surveillance indicators for foodborne gastrointestinal pathogens to inform risk assessment and policy development for the protection of UK consumers against risks posed by foodborne disease.

An ‘outbreak’ is defined as an incidence of two or more human cases of the same disease, linked to the same source. Specifically for foodborne outbreaks, the definition usually applied is ‘an incidence, observed under given circumstances, of two or more human cases of the same disease and/or infection, or a situation in which the observed number of human cases exceeds the expected number and where the cases are linked, or are probably linked, to the same food source (including potable water)’ (Directive 2003/99/EC).^{[footnote 24]}

Public Health Agencies in the UK now routinely perform whole genome sequencing (WGS) for genomic characterisation of several bacterial gastrointestinal pathogens, including Salmonella sp., Listeria monocytogenes, Shigella sp., Yersinia sp. and shigatoxin producing E. coli (STEC). The data derived from the systematic national surveillance of foodborne disease outbreaks pre and post the implementation of WGS is not directly comparable.

Data and assessment

Indicators:

• Number of foodborne outbreaks investigated and reported in the UK and associated number of human cases and hospitalisations 2015 to 2020

• Foodborne disease causative agents and food vehicles implicated in the foodborne outbreaks investigated and reported from 2015 to 2020 and outbreak settings

Source: Electronic Foodborne and non-foodborne outbreak surveillance system (eFOSS) in England and Wales, ObSurv in Scotland and the outbreak surveillance dataset in Northern Ireland

Figure 5.1.6a: Number of foodborne outbreaks by causative agent investigated and reported to national public health surveillance in the UK, 2015 to 2020

Of the 276 outbreaks reported, 251 outbreaks were investigated where a causative agent was identified between 2015 and 2020. Salmonella sp. was the most frequently reported in most years (68 out of 251 outbreaks in total, 27%), with enteric viruses second (49 outbreaks, 20%), followed by Campylobacter (42 outbreaks, 17%) and Clostridium perfringens (39 outbreaks, 16%). There were between 2 and 8 outbreaks of STEC reported each year during this time period. There were no outbreaks of Listeria monocytogenes reported in 2015 and 2016, but 8 outbreaks in total reported between 2017 and 2020.

Table 5.1.6b. Total number of associated human cases and percentage hospitalised (X%) associated with foodborne outbreaks reported to national public health surveillance by causative pathogen in UK, 2015 to 2020^{[footnote 25]}

Causative agent	2015	2016	2017	2018	2019	2020	Total
Salmonella sp.	274 (4%)	540 (4%)	688 (11%)	673 (5%)	549 (7%)	732 (7%)	3,456 (7%)
Enteric viruses [footnote 26]	210 (0%)	1,407 (0%)	317 (1%)	370 (0%)	476 (1%)	180 (0%)	2,960 (0%)
Campylobacter sp.	190 (2%)	173 (0%)	146 (6%)	140 (4%)	39 (0%)	28 (4%)	716 (3%)
Clostridium perfringens	205 (1%)	163 (2%)	114 (0%)	293 (0%)	141 (0%)	90 (8%)	1,006 (1%)
STEC/ Other **E. coli	106 (21%)	306 (32%)	48 (25%)	55 (36%)	65 (40%)	93 (32%)	673 (31%)
Listeria monocytogenes	N/a	N/a	N/a	17 (100%)	17 (100%)	9 (100%)	43 (100%)
Shigella sp.	17 (47%)	N/a	N/a	34 (12%)	N/a	N/a	51 (24%)
Cryptosporidium sp.	16 (0%)	N/a	N/a	N/a	N/a	N/a	16 (0%)
Other [footnote 27]	2 (0%)	23 (0%)	14 (0%)	5 (60%)	13 (0%)	3 (0%)	60 (5%)
Unknown [footnote 28]	177 (0%)	15 (0%)	N/a	119 (1%)	140 (0%)	13 (0%)	464 (0%)
Total	1,197 (4%)	2,627 (5%)	1,327 (7%)	1,706 (5%)	1,440 (6%)	1,148 (9%)	9,445 (6%)

There were 9,445 cases of foodborne illness reported to be associated with the total 276 outbreaks investigated and reported during 2015 to 2020. The majority of cases (3,456 cases, 37%) were associated with Salmonella outbreaks and enteric viruses (2,960 cases, 31%). While just under 6% of the total associated outbreak cases between 2015 and 2020 reported hospitalisation, this varied substantially by pathogen from 0% to 100%.

The effect of routine implementation of WGS for surveillance of bacterial gastrointestinal pathogens has been particularly notable for Salmonella. The proportion of all Salmonella outbreaks detected at the national level has increased since 2015 from 27% to 67% in 2019, with outbreak associated case numbers per outbreak showing an overall increasing trend (see the appendix for further detail).

Table 5.1.6c. Foodborne outbreaks by food vehicle investigated and reported to national public health surveillance per year, 2015 to 2020 in the UK^{[footnote 29]}

Food vehicle	2015	2016	2017	2018	2019	2020	Total
Poultry meat and poultry meat products	12	7	6	5	4	4	38
Composite or mixed foods	6	6	4	5	11	0	32
Other mixed meat/poultry/products	7	5	2	4	2	1	21
Eggs and egg products	3	5	2	2	6	1	19
Beef/bovine meat and products	3	4	2	4	2	2	17
Crustaceans/shellfish/molluscs	1	1	2	6	3	3	16
Fruits and vegetables	0	3	3	3	0	3	12
Dairy	0	1	3	1	1	4	10
Pork meat and products	3	0	2	2	2	0	9
Lamb meat and products	2	0	1	3	2	0	8
Finfish and products	1	0	0	2	0	1	4
Herbs/spices/cereal products/nuts and seeds	0	0	1	1	1	1	4
Potable water	1	0	0	0	0	0	1
Unknown[footnote 30]	14	17	10	11	23	10	85
Total	53	49	38	49	57	30	276

For the 191 outbreaks investigated between 2015 and 2020 with a food vehicle reported as implicated or suspected to be implicated, poultry meat and poultry meat products were most commonly reported as vehicles of infection (38 outbreaks, 20%), followed by composite/mixed foods (32 outbreaks, 17%) and other mixed meat/poultry/products (21 outbreaks, 11%).

The overall number of reported outbreaks in 2020 (30 outbreaks) was lower than any other year (2015 to 2019) and 40% lower than the average for this 2015 to 2019 (49 outbreaks). Although the total number of cases (1,148) in 2020 was lower compared to the five-year (2015 to 2019) average (1,659) the percentage hospitalised (9%) was higher than the five-year average (5%).

Figure 5.1.6d: Foodborne outbreaks by food vehicle investigated and causative agent reported to national public health surveillance, 2015 to 2020 in the UK

Reported Campylobacter outbreaks were predominantly associated with poultry products (implicated as the vehicle in 62% of all reported Campylobacter outbreaks with 583 associated outbreak cases), with chicken liver pate/parfait being the most commonly reported vehicle. Eggs and poultry meat products were most commonly implicated in Salmonella outbreaks (being the implicated vehicles in 26% and 10% of Salmonella outbreaks respectively with a total of 1,089 and 561 associated outbreak cases respectively). Ruminant meat and meat products (lamb and beef) were associated with a total of 28 outbreaks, involving 1,064 associated human cases, nearly half of which (517 cases) were associated with Salmonella outbreaks. Beef products were the most commonly reported vehicle in Clostridium perfringens outbreaks (implicated as the vehicle in 31% of C. perfringens outbreaks with 267 associated outbreak cases). All of the 16 reported outbreaks associated with crustaceans/shellfish/ molluscs were norovirus outbreaks (involving 587 cases).

Outbreaks associated with fruit and/or vegetables were reported as implicated food vehicles in 14% of outbreaks caused by STEC (with 277 associated foodborne illness cases), in 6% of Salmonella outbreaks (186 associated cases), in 4% enteric virus outbreaks (93 cases) and 13% Listeria monocytogenes outbreaks (12 cases, associated with one outbreak). Outbreaks with dairy products reported as implicated food vehicles were associated with Campylobacter and STEC most frequently. The single outbreak reported during this period associated with potable water was an STEC O157 outbreak linked to a private water supply.

Figure 5.1.6e: Percentage of foodborne outbreaks reported by setting, 2015 to 2020^{[footnote 31]}

By overall reported number and by number of associated outbreak cases, the majority of outbreak investigations reported between 2015 to 2020 were associated with catering settings (54% with specific restaurants/food service establishments and 3% associated with takeaways or fast-food outlets, together contributing 51% of total associated human disease cases). Only 4% of outbreaks were associated with school or other institutional settings. The largest outbreaks (28% of total number of reported outbreaks but constituting 39% of overall number of reported outbreak associated cases), were designated as multiple places of exposure, when a contaminated food product that caused the outbreak is consumed in the home or at multiple locations, including in institutions and multiple different food service establishments. Outbreaks associated with the farm setting were exclusively outbreaks associated with raw drinking milk, caused by Campylobacter or STEC O157. There was a significant reduction in the proportion of outbreaks associated with the food service sector in 2020 (6% versus a range of 39% to 67% in previous years).

Trends

The number of foodborne outbreaks reported each year is small but overall, proportionally, the 2015 to 2019 surveillance data demonstrates trends not significantly dissimilar to previous years’ data. Several key aspects were generally consistent with some of the long-term trends observed since systematic national surveillance for foodborne outbreaks was first instituted in 1992.^{[footnote 32]} There are some notable exceptions. The overall number of outbreaks reported, especially those due to salmonellosis, has declined to levels significantly lower than in the 1990s and 2000s. For Salmonella, this is likely due, at least in part, to the implementation of EU wide controls for Salmonella in chickens under Regulation (EC) No 2160/2003^{[footnote 33]}. There were also several large Salmonella Enteritidis outbreaks reported during 2015 - 2020 associated with imported poultry products (ECDC, 2017; ECDC, 2020; ECDC, 2021).^{[footnote 34]} This indicates that Salmonella contamination of poultry products at the EU level is still an ongoing public health concern. When considering the data for pathogens subject to routine whole genome sequencing (Salmonella sp, STEC, Listeria monocytogenes and Shigella sp), there has been a year-on-year increase in the proportion of reported national level outbreaks ranging from 26% in 2015 to 94% in 2020 and the average size of outbreaks has steadily increased since 2015, particularly notable for Salmonella. Although sporadic campylobacteriosis places a significant health burden on the community, the number of outbreaks investigated and reported does not reflect this burden. This is likely because Campylobacter outbreaks are difficult to detect through existing surveillance systems.^{[footnote 35]}

The proportion of outbreaks linked specifically to food service establishments remains significant. Outbreaks associated with these settings are most commonly related to and amplified by poor hygiene controls, environmental contamination and cross-contamination in the kitchen. Therefore, continued efforts to improve hygiene and lower the risk of introducing contaminated products and ingredients into food service establishments are needed in order to realize further public health benefits.

There are some notable differences in the 2020 data compared to the data collected from the previous five years. There was a higher overall hospitalisation rate seen in 2020, potentially indicating that during the pandemic less clinically severe cases may not have been identified and associated with foodborne outbreaks. There was also a reduction in the number of Salmonella, Campylobacter, norovirus and Cl. Perfringens outbreaks, likely associated with the COVID-19 pandemic restrictions on the hospitality and catering sector and a notable reduction overall in outbreaks associated with food service settings (see report annex for further detail).

Case Study 5.4 Listeria outbreak linked to consumption of pre-prepared hospital sandwiches in England

Overview

Listeriosis is a rare disease in the UK, but its clinical severity renders it a public health concern, particularly in the context of clinically vulnerable groups. Identification of Listeria monocytogenes from a patient sample is notifiable in England. Public health investigation and follow-up including completion of a questionnaire on what foods individuals who have been diagnosed with listeriosis have eaten prior to illness onset is attempted for all reported cases of listeriosis as an integral part of the enhanced surveillance system for listeriosis in England.

An outbreak of listeriosis in hospitals in England, which caused nine cases and seven deaths, was identified and investigated between May and July 2019 and confirmed to be linked to consumption of pre-prepared sandwiches served to patients in hospitals across England.

The epidemiological, microbiological and food chain investigations, carried out by the multi-disciplinary Incident Management Team (IMT) identified the cause of the outbreak to be contaminated poultry meat used in the production of sandwiches. This was exacerbated by inadequate food safety protocols in hospital catering facilities. Whole genome sequencing confirmed that isolates from all nine cases were closely genetically related and isolates sampled from chicken and other sandwich ingredients had indistinguishable genetic profiles, providing microbiological evidence of the common source of foodborne transmission.

Background

In May 2019, the UKHSA (formerly Public Health England) notified partner agencies of an outbreak detected using analysis of whole genome sequencing data after two patients, with pre-existing medical conditions, contracted listeriosis in the same hospital. Both had overlapping hospital admission dates and had consumed sandwiches whilst in hospital. Between May and June 2019, 9 confirmed cases of listeriosis associated with the outbreak were identified in England in 8 hospitals across 7 NHS Trusts. By the time the outbreak was declared over, 7 patients had died.

An IMT was convened by UKHSA, involving colleagues from UKHSA, local authorities, the FSA and FSS, Public Health Scotland (formerly Health Protection Scotland), Public Health Wales, NHS England, and NHS Scotland.

The individuals diagnosed with listeriosis were interviewed (or family members, where direct interview of the confirmed cases was not possible) to ascertain what foods they had eaten prior to becoming ill and inspection of hospital catering records where available, was carried out as part of the food tracing investigations. This identified that the first three cases had all consumed chicken sandwiches, which the FSA identified to be sourced from a common supplier, which supplied sandwiches to NHS hospitals across Great Britain and were manufactured by one specific business.

In turn, the contamination was traced back to diced chicken which tested positive for L. monocytogenes at high levels and whole genome sequencing confirmed that it matched the outbreak strain identified from the cases. Not all cases consumed sandwiches made with the chicken, and some other sandwiches from the same producer were consumed, suggesting that both cross-contamination within the manufacturing environment and a lack of food safety controls in place at the hospitals had contributed to the outbreak.^{[footnote 36]}

Discussion

The outbreak posed food safety and public health concerns for vulnerable consumers and patients attending hospitals, and attracted prolonged media and public interest. This risked loss of confidence in hospital food, and particularly sandwiches served in hospital, with pre-prepared sandwiches having been commonly associated with outbreaks of listeriosis in the UK in previous years.

The FSA has a key role as the Central Competent Authority (CCA) in overseeing official food safety controls undertaken by Local Authority (LA) food law enforcement authorities in England, Wales, and Northern Ireland. It is important to understand that, in most cases, enforcement of food law is a direct statutory duty of the competent authority (in this case, the LA).

Following the outbreak, a full cross-government strategic lessons learned exercise was undertaken to identify best practice in the supply chain for NHS food. This also focused on the actions required to prevent future recurrence. The FSA and FSS contributed to a ’root and branch‘ review commissioned by the Secretary of State for Health and Social Care. The subsequent Report of the Independent Review of NHS Food made 8 recommendations for system-level changes to be taken forward by an expert group with representation drawn from across the sector and government.^{[footnote 37]} Both the evidence obtained during this specific outbreak and provided by the FSA and FSS contributed to the report which was later published on the FSA’s website.

In summary, this outbreak of listeriosis led to a thorough investigation of what happened and why. To help avoid repetition of the incident, the report recommended that NHS purchasers must have effective mechanisms in place to assure food safety within their supplier base and drive improvements where necessary to ensure all businesses supplying high-risk foods meet the highest standards.

The report recommended that the standards of food-safety audits for high-risk food manufacturers be raised, to give confidence that legal and contractual requirements were being met. It was noted that most NHS trusts used a private company to accredit food suppliers as safe, but they must be aware that third-party accreditation was not a guarantee that a product was safe.

The report also recommended that NHS trusts must recognise their legal obligations as food business operators and ensure effective compliance with robust food safety procedures is achieved across their supply base. These procedures must be clearly understood, properly implemented, and verified to ensure compliance.

Indicator 5.1.7 Food Crime

Headline

Recorded disruptions from the FSA’s NFCU and successful operations by the SFCIU help to quantify the successful delivery of activity to stop or reduce the opportunity for food crime offending within the UK food chain. The NFCU began recording food crime disruptions in 2020 to 2021, with a steady increase in the number of disruptions recorded through the year. Increases can be attributed to improvements in operational capability and a greater focus on, and awareness of, the full scope of disruption strategies. While still in an early phase, food crime interventions are an important indicator for the security of UK food, demonstrating the UK food safety authorities’ ability to receive, assess, and respond to intelligence concerning food crime.

Context and Rationale

Following the horsemeat incident in 2013 that affected consumers in the UK and Europe, government-commissioned reviews recommended the establishment of food crime units to prevent further food crime incidents. As a result, the FSA set up its NFCU, operating in England, Wales, and Northern Ireland, and FSS created the SFCIU.

The Units define food crime as serious fraud and related criminality in food supply chains.^{[footnote 38]} Most food crime relates to two broad classes of activity: - The deliberate inclusion of lower-grade, unsafe or alternative ingredients as edible and marketable.

• The sale of passable food, drink, or feed as a product with greater volume or more desirable attributes.

In many cases, consumers will be unable to identify they have been victims of fraud. However, in some instances, especially when ingredients are misrepresented, they can have significant impacts. These can come from individuals consuming products they avoid due to dietary requirements, religious or cultural observances, and/or allergies which can lead to serious physical harm, or even death. By tracking food crime interventions, it is possible to better articulate where food crime incidents have manifested (and have required some form of response).

The NFCU and SFCIU both follow similar investigative and disruption strategies, 4P and 4D, respectively as detailed below:

NFCU 4P Approach (taken from the Home Office’s Serious and Organised Crime Strategy)^{[footnote 39]}

Pursue	Prepare	Protect	Prevent
Deal with offenders through prosecution and disruption	Build capacity and capability to identify and mitigate the impact of food crime	Protect industry and the public from the effects of food crime	Prevent people from committing food crime

SFCIU 4D Approach (taken from the Scottish Government’s Serious Organised Crime Strategy)^{[footnote 40]}

Disrupt	Detect	Deter	Divert
Target those committing food crime and related fraudulent activity and identify opportunities to take enforcement action	Identify those involved in food crime and related fraudulent activity using all power available to the organisation, local authorities and partner agencies	To deter individuals involved in food crime and related fraudulent activity through intelligence gathering, investigation, regulatory compliance and surveillance of the supply chain	To divert people from becoming involved in food crime and related fraudulent activity

The NFCU record operational outcomes across the 4P approach as disruptions. These are achieved where the NFCU leads or supports action in response to a food crime threat which has a measurable impact. It is a measure of impact, not the activity or effort to achieve it.

The way this data is recorded and reported may change in coming years, so this indicator might be subject to change in future iterations to reflect these developments.

Data and assessment

Indicator: Total number of disruptions recorded by FSA

Source: NFCU

190 Number of disruptions in 2020 to 2021

45 Disruptions led by FSA

145 Disruptions supported or coordinated by FSA

During 2020 to 2021, the number of disruptions recorded each quarter by the NFCU increased steadily across the year, with 52 Pursue disruptions and 138 Prepare, Prevent or Protect disruptions being delivered overall. This was driven by the NFCU achieving full operating capability, applying greater focus to prepare, prevent, and protect outcomes, and increasing awareness amongst staff with regards to identifying and recording disruptions resulting from their work.

SFCIU was involved in a significant number of investigations during 2020 to 2021 which had various intervention and disruption strands. As part of developing a disruption activity indicator SFCIU are developing an approach to capture the percentage of actionable intelligence that has resulted in a positive outcome.

Trends

Due to limited time series data it is not possible to provide an assessment of the trends, however this will be possible in coming years.

Case Study 5.5 Unlawful processing in the red meat sector

Overview

NFCU worked in partnership with other agencies and authorities to tackle a case of unlawful processing in the red meat sector. This led to the seizure of 5.3 tonnes of meat, which had been prepared in unsanitary conditions and was being sold to consumers online. This case also started the process of considering further policy development in the online food sales space.

Background

Unlawful processing in unregulated premises can lead to unsafe product being placed in the human food chain posing a risk to human health. In addition, this sort of food crime is often linked to other manifestations of food crime, such as livestock theft, document fraud, and misrepresentation. Such practices are damaging to law-abiding food business operators, who comply with the regulatory requirements, both as there are lower costs associated with operating outside of approval, and as the existence of unregulated business could undermine confidence in the UK food industry.

The NFCU worked to support and coordinate a local authority led investigation into a suspected illegal meat supplier. The initial concerns were that the meat was derived from stolen livestock. The subject of the investigation used an identified social media Facebook page as a ‘shop window’ to advertise the product and direct customers on how to buy the meat.

The NFCU worked with the police, local authority food teams, and other partners to co-ordinate activity at the suspect’s premises. On two separate occasions, a total of 5.3 tonnes of meat, roughly translating to three full transit vans, was discovered being prepared in unsanitary conditions rather than a registered and hygienic food preparation environment. It is suspected that a significant amount of meat had already been supplied to consumers in addition to the meat seized.

Whilst initial concerns regarding stolen livestock were not proven in this instance, support from local rural policing partners aided enquiries and produced useful information for the future.

An investigation into identified regulatory offences continues to be led by the local authority, and the NFCU are supporting financial investigation into the subject as a result of this activity.

Discussion

The product was due to be distributed across a large geographical area, spanning the north and south of England, which demonstrates the reach that such interventions can have in protecting consumers across the UK. The FSA’s assessments of potential risk, including details of how and where the meat was produced, resulted in a FAFA notice being issued. FAFAs are issued by the FSA and provide local authorities with details of specific action to be taken on behalf of consumers. In this instance, authorities were asked to contact premises who may have purchased the product and to ensure they were withdrawn from the market and recalled from consumers.

NFCU’s support and co-ordination resulted in a significant amount of meat being removed from the market and protected consumers from unsafe meat. Working across teams with both internal and external partners also led to:

• the service of a Remedial Action Notice and Hygiene Emergency Prohibition notice stopping the unlawful business from operating;

• discussions with FSA teams responsible for policy development to ensure any appropriate preventative measures regarding online sales are taken forward;

• applications from the operator of the unregistered food business for appropriate approvals, making their activities visible to the regulators, who can ensure the safety and hygiene of production. This also ensured a potential food business operator was aware of food safety law, further protecting their consumers.

There is still work to be done to increase the understanding and ability to prevent criminality associated with unlawful processing, as well as to understand the demands for products within specific communities in the UK. Strong partnership action such as this has, however, strengthened NFCU knowledge and ability to tackle similar issues in the future, has protected consumers from potential harm, and helped level the playing field for legitimate businesses in this sector.

Case Study 5.6 Operation OPSON and the Food Industry Intelligence Network

Overview

The Food Industry Intelligence Network (FIIN) supported UK Regulators during Operation OPSON VII (2017-18), which focused on illegal treatment of tuna in the supply chain. Information and expertise provided on the supply chain were invaluable in supporting intelligence gathering and enforcement activities in the UK and across Europe. The activity strengthened relations between regulators and FIIN and assisted in outlining the scale of illegal activity from a global perspective.

Background

The FIIN consists of 46 major food businesses active in the UK. They co-operate to share anonymised and aggregated authenticity testing data to enhance their response to potential food crime threats such as product adulteration or misrepresentation, discernible either from regulatory activity and intelligence, or from industry supply chain assurance. UK food standards agencies have signed Information Sharing Agreements (ISAs) with FIIN. This relationship continues to develop and has allowed for the sharing of valuable information including tens of thousands of lines of data each year, contributing to the identification and investigation of food crime, and supporting a number of national operations.

Discussion

The ISA between FIIN and both SFCIU and NFCU has provided a collaborative gateway to share intelligence and data in relation to vulnerabilities across the supply chain. This has supported threat assessment, targeting of authenticity sampling, and general situational awareness. NFCU and SFCIU are also involved in the FIIN’s plenary meetings and the development of food fraud awareness training.

Operation OPSON is a yearly Europol/Interpol joint operation focused on counterfeit and substandard food and beverages which is coordinated by SFCIU and NFCU in the UK.

The relationship between the NFCU, SFCIU, and FIIN was particularly effective during OPSON VII which targeted the production and distribution of illegally treated processed tuna. This related to extension of durability dates and use of chemicals and additives to enhance the visual appearance of poorer quality tuna. This issue was a concern at a global level, involving organised crime, and it was suspected that fraudulent product was entering the UK supply chains. This not only defrauds UK businesses and consumers but poses a health risk to consumers from histamine and high levels of chemical and additives injected into the tuna.

Due to the complex nature of the tuna supply chain and sophistication of the fraud, support from FIIN provided an enhanced understanding of these issues and allowed access to experts in this area. These insights provided by FIIN were shared with other agencies and supported a number of significant enquiries across Europe. The specialist knowledge provided from FIIN also assisted in directing the focus of the sampling undertaken in the UK, where a picture on illegal treatments could be developed and patterns drawn from the findings.

Along with sampling and intelligence activity occurring in the UK for the operation, there were more than 51 tonnes of tuna suspected to have been illegally treated seized across Europe.^{[footnote 41]} The operation found that the fraud was an established, on-going, and highly organised criminal practice. An assessment by the SFCIU capturing the findings of the operation was presented to the EU Food Fraud Network which included a number of recommendations informed by consultation with FIIN. The link between the regulator and industry was key in understanding the threat and vulnerability to consumers and responsible businesses in the UK from criminality within the tuna supply chain, and as part of seeking to develop a preventative approach moving forward.

The fusion of FIIN’s insight and expertise and the NFCU’s and SFCIU’s intelligence and operational co-ordination makes clear the importance of the regulatory relationship with FIIN. The success of the operation highlights the value of similar activities as well as the importance of creating and expanding relationships with other industry bodies as part of a holistic food crime response.

Case Study 5.7 Activities of the Food Authenticity Network and Centres of Expertise

Overview

The Food Authenticity Network (FAN) is helping to build a more resilient, secure, global food supply chain. This is achieved through collating, curating, and raising awareness of the tools available to check for and mitigate against food fraud, providing an accessible and valuable network for an increasingly global stakeholder community.

FAN also helps to ensure that the UK has access to a resilient network of laboratories by providing fit for purpose testing through the food authenticity Centres of Expertise (CoE) acknowledged on its website.

FAN now has over 2,600 members from 81 countries and territories. In 2020, it attracted over 21,500 unique users from 133 different countries to its open access website. Its international membership enables sharing of best practice information for the benefit of all stakeholders, helping to raise standards worldwide, whilst showcasing UK global leadership in food authenticity testing and food fraud detection.

Background

The FAN was set up in July 2015 by LGC (formerly known as Laboratory of the Government Chemist) with funding from Defra, as a response to recommendations in the Elliott Review.^{[footnote 42]} The Elliot Review was an independent review into the integrity and assurance of food supply networks that was commissioned following the horsemeat incident in 2013. The report highlighted the need for access to resilient and sustainable laboratory services that use standardised validated approaches. FAN gathers information on food authenticity testing, food fraud mitigation, and food supply chain integrity and disseminates it via its open access website. FAN is led by LGC and funded through a public-private partnership approach.

Discussion

Recognising that no one organisation will be equipped with all the necessary expertise in all methods and techniques used in food authenticity testing and all of the different commodity groups impacted by food fraud, fourteen CoEs covering different disciplines and techniques are acknowledged on the FAN. Following a recent workshop and incident simulation exercise for CoEs, a framework of collaboration is being developed to lay out how a collective technical view can be formulated during an emergency national or international food fraud incident. The framework also considers how laboratory capability and capacity issues could be mitigated during a serious future incident, minimising the impact of such an event on legitimate businesses and consumers.

FAN also undertakes a range of knowledge transfer activities to disseminate best practice information to industry, enforcement, and analysts, through publication of e-seminars and a new programme of quarterly webinars covering topics from allergen risk assessments to fish speciation.

FAN recently collaborated with Mérieux NutriSciences to undertake a detailed assessment of data presented at a webinar in April 2020, which showed a ‘dramatic’ increase in food fraud activity at the beginning of 2020 and attributed this to the COVID-19 pandemic. The assessment found that although the pandemic had increased food fraud vulnerability, there was insufficient evidence of ‘dramatic’ increases in specific COVID-19 related food fraud incidents.

Figure 5.7a: FAN number of unique users by country, 2020^{[footnote 43]}

Figure 5.7b: FAN membership by professional category in 2021

About the UK Food Security Report

The UK Food Security Report sets out an analysis of statistical data relating to food security, examining past, current, and predicted trends relevant to food security to present the best available understanding of food security. It fulfils a duty under Part 2, Chapter 1 (Section 19) of the Agriculture Act 2020 to prepare and lay before Parliament “a report containing an analysis on statistical data relating to food security in the United Kingdom”. The first report must be published before Christmas Recess 2021, and subsequent reports must be published at least once every three years thereafter. 

It contains statistics for different time periods, but always using latest available data at the time of release. Data comes from surveys run by Defra and from a wide range of other sources including government departments, agencies and commercial organisations, in the UK and internationally.

Associated datasets from this publication are also available. Data are a mixture of National Statistics, Official Statistics and unofficial statistics. Unofficial statistics are used where there are gaps in the evidence base. Further information on National Statistics can be found on the Office for Statistics Regulation website.

Contact and feedback

Enquiries to: foodsecurityreport@defra.gov.uk

You can also contact us via Twitter: @DefraStats

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Production team: Michael Archer, Matt Bardrick, Jasmin Eng, Ros Finney, Luke Hamilton, Jenny Kemp, David Lee, Jeremy Levett, Will Norman, Maria Prokopiou, Andrew Scaife, Chris Silwood, Jonathan Smith, Beth White, Isabella Worth.

We are extremely grateful to the following for their expert contributions and guidance throughout the synthesis of this Report, helping to ensure it delivers a thorough analysis of a robust evidence base:

• Professor Tim Benton, Chatham House

• Dr Tom Breeze, University of Reading

• Professor Bob Doherty, University of York and FixOurFood

• Selvarani Elahi MBE, UK Deputy Government Chemist, LGC

• Dr Pete Falloon, Met Office, Climate Service Lead - Food Farming & Natural Environment

• Alan Hayes, Food Systems and Sustainability Advisor

• Dr John Ingram, University of Oxford

• Professor Peter Jackson, Institute for Sustainable Food, University of Sheffield

• Dr Ian Noble, Mondelez International

• Dr Bill Parker, Head of Technical Programmes, AHDB

• Dr Maddy Power, Wellcome Trust

Return to Theme 4: Food Security at Household Level

Appendix

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1. World Health Organisation, ‘Estimates of the global burden of foodborne diseases’, 2015 https://apps.who.int/iris/bitstream/handle/10665/200046/WHO_FOS_15.02_eng.pdf ↩

2. FSA, ‘Food and Feed Codex of Practice’ (2021), https://www.food.gov.uk/about-us/food-and-feed-codes-of-practice. ↩

3. Based on nine months data for Northern Ireland. During FYE 2014 preparations were underway for local government reorganisation. In view of this, it was agreed that returns for councils for FYE 2015 should be made in advance of the changes becoming effective and would cover the first three quarters of the reporting period. ↩

4. The FYE 2020 data for England was based on 98% of expected food hygiene returns (all but six returns were received). Wales and Northern Ireland data was for 100% returns received. ↩

5. FSA, ‘Evidence of relationship between food business hygiene compliance and measures of food safety (2019), https://www.food.gov.uk/research/research-projects/evidence-of-relationship-between-food-business-hygiene-compliance-and-measures-of-food-safety. ↩

6. FSA (including FSS) breakdown of incidents by category during 2013 to 2014 Reporting Years. From 2015 to 2016-2017 Reporting Years figures include FSA and FSS incidents. From 2017-2018 Reporting Years figures include FSA incident notifications only. ↩

7. n/a means data is unavailable for a particular year. This is attributed to a review of incident categories. For example ‘Water Quality’ incident notifications have been refined and categorised as ‘Environmental Pollutants’. This categorisation will capture food incidents resulting from flooding and sewage spillage. ↩

8. The COVID-19 Outbreak figure reflects the number of notifications logged within the FSA incident management system only. However, we hold additional information on over 200 COVID-19 Outbreaks within a separate record. Other Government Departments and relevant stakeholders also hold additional data on a number of COVID-19 Outbreaks. ↩

9. FSS amended the way Shellfish incidents are recorded from the 2016 to 2017 Reporting Year. Shellfish incidents are now recorded and investigated when harvesting is known to have taken place. ↩

10. World Health Organisation, ‘Estimates of the global burden of foodborne diseases’ (2015), https://www.who.int/publications/i/item/9789241565165. ↩

11. Byrne, L., and others, ‘The epidemiology, microbiology and clinical impact of Shiga toxin-producing Escherichia coli in England, 2009-2012’, Epidemiology and Infection, 143(16) (2015), pages 3475 to 3487. ↩

12. McCarthy, N. and J. Giesecke, ‘Incidence of Guillain-Barre syndrome following infection with Campylobacter jejuni’, American Journal of Epidemiology 153(6) (2001), pages 610 to 614; Neal, K.R., L. Barker, and R.C. Spiller, ‘Prognosis in post-infective irritable bowel syndrome: a six year follow up study’, Gut 51(3) (2002), pages 410 to 413. ↩

13. Dworkin, M.S., and others, ‘Reactive arthritis and Reiter’s syndrome following an outbreak of gastroenteritis caused by Salmonella enteritidis’ Clinical Infectious Diseases 33(7) (2001), pages 1010 to 1014. ↩

14. FSA, ‘The second study of infectious intestinal disease in the community (IID2 Study)’, (2016), https://www.food.gov.uk/research/research-projects/the-second-study-of-infectious-intestinal-disease-in-the-community-iid2-study; FSA, ‘The Burden of Foodborne Disease in the UK 2018’, 2020, https://www.food.gov.uk/research/research-projects/the-burden-of-foodborne-disease-in-the-uk-2018. ↩

15. Adams, N. and others, ‘Sociodemographic and clinical factors for paediatric typical haemolytic uraemic syndrome: retrospective cohort study’, British Medical Journal Paediatrics Open 3 (1) (2019). ↩

16. PHE, ‘Listeriosis in England and Wales’ (2021), https://www.gov.uk/government/publications/listeria-monocytogenes-surveillance-reports/listeriosis-in-england-and-wales-summary-for-2018; Scobie, A. and others, ‘Mortality risk factors for listeriosis - a10 year review of non-pregnancy associated cases in England 2006-2015’, Journal of Infection 78 (3) (2019), pages 208 to 214. ↩

17. FSA, ‘The second study of infectious intestinal disease in the community (IID2 Study)’ (2016), https://www.food.gov.uk/research/research-projects/the-second-study-of-infectious-intestinal-disease-in-the-community-iid2-study. ↩

18. Scottish data include serum positive cases and cases that were polymerase chain reaction (PCR) test positive but bacterial culture test negative (pcr+/culture neg). Northern Irish totals for 2019 and 2020 are provisional. ↩

19. Ondrikova, N. and others, ‘Differential impact of the COVID-19 pandemic on laboratory reporting of norovirus and Campylobacter in England: A modelling approach’, PLOS One 16 (8) (2021). ↩

20. Lane, C. R. and others, ‘Salmonella enterica serovar Enteritidis, England and Wales, 1945-2011’, Emerging infectious diseases, 20(7), pages 1097 to 1104. ↩

21. Vishram, B. and others, ‘The emerging importance of Shiga toxin-producing Escherichia coli other than serogroup O157 in England’, Journal of Medical Microbiology 70 (7) (2021). ↩

22. Zenner, D. and I. Gillespie, ‘Travel-associated Salmonella and Campylobacter gastroenteritis in England: estimation of under-ascertainment through national laboratory surveillance’, Journal of Travel Medicine 18 (6) (2011); PHE, ‘Travel-associated non typhoidal Salmonella infection in England, Wales and Northern Ireland: 2014’ (2017). ↩

23. Byrne, L. and others, ‘The epidemiology, microbiology and clinical impact of Shiga toxin-producing Escherichia coli in England, 2009-2012’, Epidemiology and Infection, 143(16) (2015), pages 3475 to 3487. ↩

24. European Union and Council, ‘Directive 2003/99 EC of the European Parliament and of the Council of 17 November 2003 on the monitoring of zoonoses and zoonotic agents, Official Journal 325 (2003), https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX:32003L0099. ↩

25. Hospitalisation data not known for all cases; ascertainment of both cases and hospitalisation varies according to the pathogen, clinical severity and differences in laboratory testing. ↩

26. Includes foodborne norovirus outbreaks or norovirus outbreaks related to infected food handlers. ↩

27. ’Other’ includes marine biotoxins such as scrombotoxin and okadaic acid as well as other entero-toxin producing bacteria such as Staphylococcus or Bacillus spp. ↩

28. Unknown’ are outbreaks where a causative agent was not identified as the cause of the disease in the outbreak associated human disease cases. ↩

29. Not all outbreaks are microbiologically linked to the implicated food vehicle. ↩

30. Epidemiological investigations may not always be able to identify the food causing the outbreak, and food sampling may not always be undertaken. For those outbreaks where a food vehicle could not be identified, these outbreaks are reported as ‘unknown food vehicle’. ↩

31. ‘Multiple places of exposure’ refers to national outbreaks where nationally distributed food vehicle has been consumed in more than one different setting. ‘Others’ include settings with less than 3 outbreaks reported including, hospital or medical settings, workplace canteens or other undisclosed settings. ↩

32. Gormley, F.J. and others, ‘A 17-year review of foodborne outbreaks: describing the continuing decline in England and Wales (1992-2008)’, Epidemiology and Infection 139 (5) (2011), pages 688 to 699. ↩

33. European Parliament and Council, ‘Regulation (EC) No 2160/2003 of the European Parliament and of the Council of the 17 November 2003 on the control of salmonella and other specified food-borne zoonotic agents (2003), https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX%3A02003R2160-20210421. ↩

34. European Centre for Disease Prevention and Control: ‘Re-emerging multi-country WGS-defined outbreak of Salmonella Enteritidis, MLVA type 2-12-7-3-2 and 2-14-7-3-2 (2017), https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/rapid-risk-assessment-WGS-defined-outbreak-Salmonella-Enteritidis-3-feb-2017.pdf;
    ‘European Food Safety Authority, 2021. Multi-country outbreak of Salmonella Enteritidis sequence type (ST)11 infections linked to poultry products in the EU/EEA and the United Kingdom’ (2021), https://www.ecdc.europa.eu/sites/default/files/documents/salmonella-enteritidis-rapid-outbreak-assessment-united-kingdom-poultry-2021.pdf;
    ‘European Food Safety Authority, 2020. Multi-country outbreak of Salmonella Enteritidis infections linked to eggs, third update’ (2020), https://www.ecdc.europa.eu/en/publications-data/multi-country-outbreak-salmonella-enteritidis-infections-linked-eggs. ↩

35. Pebody, R.G., M.J. Ryan and P.G. Wall, ‘Outbreaks of campylobacter infection: rare events for a common pathogen’, Communicable Disease Report Review 7 (1997). ↩

36. PHE, ‘Investigation into an outbreak of Listeria Monocytogenes infections associated with hospital-provided pre-prepared sandwiches, UK May to July’ (2019), https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/937907/2019-05-Listeria-CC8-Outbreak-Report.pdf. ↩

37. DHSC, ‘Report of the Independent Review of NHS Hospital Food’ (2020), https://www.gov.uk/government/publications/independent-review-of-nhs-hospital-food. ↩

38. FSS, ‘Food Crime Strategic Assessment’ (2020), https://www.foodstandards.gov.scot/publications-and-research/publications/food-crime-strategic-assessment-2020. ↩

39. Home Office, ‘Serious and Organised Crime Strategy’ (2018), https://www.gov.uk/government/publications/serious-and-organised-crime-strategy-2018. ↩

40. Scottish Government, ‘Serious and Organised Crime Strategy (2015), https://www.gov.scot/publications/scotlands-serious-organised-crime-strategy/documents/. ↩

41. Europol, ‘Operation Opson VII – Analysis Report’ (2019), https://www.europol.europa.eu/publications-events/publications/operation-opson-vii-analysis-report. ↩

42. Defra and FSA, ‘Elliot review into the integrity and assurance of the food supply networks: final report’ (2014), https://www.gov.uk/government/publications/elliott-review-into-the-integrity-and-assurance-of-food-supply-networks-final-report. ↩

43. FAN, ‘What we do’, https://www.foodauthenticity.global/FAN. ↩