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You are here: Home Page > Health and Social Care > Bedford Borough JSNA > Wider determinants > Food environment improvement

Food environment improvement

Introduction

Food consumption, how we consume it and how much we consume is recognised as a key public health priority. 

The foods which people consume as part of their daily diets has a direct impact on the health of the individual and / or population.  Poor food handling practices can lead to food poisoning, with poor diet choices possibly leading to increased risks of nutritional lifestyle issues such as obesity, heart disease, diabetes and some cancers.

It is therefore paramount to ensure that all consumers have food which is wholesome, healthy and nutritious.  This can be achieved through the adherence of strict food legal frameworks and guidelines which all food producers, caterers and retailing businesses have a duty to comply with.  It is similarly vital that the public has the knowledge of what their food contains, how it should be prepared and the effects food has upon their overall health.

The Regulatory Services team, through interventions via environmental health and trading standards, significantly contributes to this agenda by ensuring that all food businesses meet stringent food hygiene and safety legal requirements.  The team also endeavours to work with consumers and other agencies to promote safe preparation of food and healthy eating practices.

What do we know?

Locall

1) The Regulatory Services team regularly inspects approximately 1500 food premises within the Borough of Bedford, with over three quarters (80%) being classified as restaurants and other caterers.  Food retailers make up the second most significant group, with producers, distributors, importers and manufacturers accounting for the remaining premises. The team’s food service plan can be viewed at  http://www.bedford.gov.uk/environment_and_planning/env_health__trading_standards/food_safety__standards.aspx

2) 94% of food businesses in Bedford are defined as meeting minimum food safety standards under the food hygiene rating scheme (defined as broadly compliant or above). This compares to the national average of 91%, however 6% of food businesses in Bedford still fall below the acceptable standard (an FHRS score below 3) as defined  in the Food Hygiene Rating Scheme (FHRS) Brand Standard.

3) Between April 2010 and March 2015 Bedford Borough Council received and investigated 298 confirmed food borne notifications.  It is estimated that this is only a fraction of overall levels of food poisoning as these figures are often unreported (Food Standards Agency,  2011).

4) An estimated 21.2% of adults in Bedford were classed as obese in 2012 (PHE 2015).   Nationally, the cost to the NHS for treating obesity related conditions exceeds £5 billion a year. If levels of obesity continue to rise at their present rate, it is estimated this cost will double to £10 billion per year by 2050 (Faculty of Public Health, 2013).

5) Premature deaths (before a person reaches an expected age, e.g. 75 years) from heart disease and stroke from 2011-2013 was 73.1 per 100,000, compared to the national average of 78.2 per 100,000 (PHE 2015).

Nationally

1) Estimates suggest there are around one million cases of food borne illness in the UK each year, resulting in 20,000 hospital admissions and 500 deaths (DEFRA, 2013)

2) Campylobacter is the most common pathogen associated with food poisoning. Listeria Monocytogenes accounts for the greatest proportion of deaths at 33% of cases (DEFRA, 2013)

3) In an FSA research report on food attitudes and behaviours in the home, it was found that men and older respondents (particularly 75 and older) were more likely not to follow good food hygiene practices (FSA 2013).

4) Just over a quarter of adults (26% of both men and women aged 16 or over) were classified as obese in 2010 (HSCIC, 2013).

5) People are eating outside the home more than ever.  On average one in every six meals in the UK is consumed outside the home.  With 75% of people having eaten out in the previous seven days at the time of research (FSA 2013),

6) In 2011 eating out contributed to 10% of energy intake (excluding alcohol).  Food consumed outside of the home can represent up to 20-25% of calories eaten.  The ‘eating out’ diet is higher in fat and protein (DEFRA, 2012).

7) Age is the major factor with regards to those who eat out the most, with younger people being more likely to eat out (90% of 16-34 year olds eat out each week).  For other age groups the proportion eating out declines steadily, decreasing to 49% of those aged 75 and over (FSA 2013).

8) Childhood obesity in the UK is amongst the highest in the World.  Extrapolating data from the National Child Measurement programme (NCMP) data 2011/2013 (HSCIC, 2013), there are approximately 12,330 overweight and obese children In Bedford Borough between the ages of 0 and 19.

Current activity and services

Food Hygiene / Standards and Safety

1) Bedford Borough Council, through its Regulatory Services team has the core responsibility to ensure that all food businesses comply and meet the necessary national food safety and food standards legislation.  It does this through a range of interventions including routine inspection and audit programmes.

2) The Regulatory Services team operate the Food Hygiene Rating Scheme (FHRS).  This scheme helps the public choose where to eat or shop for food by giving information about their hygiene standards.  The scheme also encourages businesses to raise their hygiene standards to obtain high scores so they will have competitive advantage over other traders.  Generally food businesses which are rated 3 are considered to be broadly compliant with food safety legislation and therefore classified as satisfactory.  Ratings of 4 and 5 demonstrate that the businesses are good and very good respectively at meeting food safety standards.  To date approximately 1100 businesses have a food hygiene rating score and a further 500 food businesses will receive a score over the next 12-18 months.

3) The Regulatory Services team investigates all food poisoning notifications and outbreaks with an aim to identify the source, control and prevent further cases developing from the source and prevent spread from primary cases.

4) The Regulatory Services team investigates all complaints relating to food safety, including poor hygiene, foreign objects in food (e.g. metal, glass, and insects), unfit food,  food alleged to have caused food poisoning and food standards complaints (e.g. labelling, descriptions, claims).

5) The Regulatory Services team carries out a risk based sampling programme and samples foodstuffs for microbiological examination, labelling information, nutritional claims and pictorial representations.

6) The Regulatory Services team maintains the database of food premises in the Borough and takes steps to ensure that the information is accurate and up to date.

7) The Regulatory Services team regularly inspects feed premises e.g. farms, to check compliance with compositional, labelling and feed hygiene requirements.

Wider Initiatives 

The Regulatory Services team, through the environmental health and trading standards team, implement several joint food related initiatives with other public health partners, although some of these are in various stages of development.

1) A breast feeding project between the food safety team and local health providers has been established and is currently being progressed successfully by promoting breast feeding-friendly food establishments, thus helping to increase the rates of breastfeeding mothers.  Environmental Health Officers as part of their normal food safety inspections promote, assess and offer businesses the award which encourages breastfeeding-friendly establishments.  This scheme is also attractive to businesses as it encourages new custom from new mothers.  To date there are 25 establishments who have the award in Bedford.

2) The Regulatory Services team participates in Bedford Borough Council’s Excess Weight Partnership Strategy development process. The team contributes to the objectives on Priority 1 which includes a strategy to create environments that promote healthier lifestyles. 

3) The Regulatory Services team contributes to the national Food Safety Week initiative which is held every year in June/July and promotes good hygiene practices in the home, thus helping to reduce food poisoning levels.

National & Local Strategies

Local

1) The Regulatory Services team prepare a detailed annual Food & Feed Service Plan which is approved and ratified by the Executive and Full Council.  This plan sets out the departmental aims for the following year which include:

a)    Ensuring all food / feed establishments comply with food and feed legal requirements in terms of hygiene and standards through various intervention methods including inspection and sampling.

b)    Ensuring that all outbreaks of infectious disease are investigated in line with Public Health England guidelines.

c)    Promoting awareness of good food safety practices through a programme of food hygiene training and health education and advice initiatives.

Other local documents include:

2) The Bedford Health Profile 2015 (PHOF, 2015) which has identified obesity  as a priority in Bedford, both adults and children.

3) Bedford Borough Health and Wellbeing Strategy, 2014-2017

4)  Bedford Borough Excess Weight Strategy, 2015-2019

5) Bedford Borough Council Corporate Plan

National

1) The Food Standards Agency (FSA) Food Borne Diseases Strategy 2010 – 2015  identifies key aims to reduce food borne illness in coordination with various stakeholders including local authorities.  The FSA reiterates the efforts needed by environmental and trading standards teams in:

a)    Raising public awareness of good food handling practices

b)    Improved data sharing between agencies

c)    Increased publicity of the food hygiene rating scheme

d)    Increased support for businesses in achieving food hygiene compliance

e)    Introduction of pathogen specific programmes to help reduce levels of Campylobacter, Listeria and E coli 0157.

2) Healthy Lives Healthy people - Our Strategy for Public Health in England (Department of Health, 2010) and the subsequent document, Healthy Lives, Healthy People: A call to action on obesity in England (Department of Health, 2011) clearly identifies access to safe and wholesome food as one of the main factors to improving health and health inequalities.  The report identifies that the leading causes of death across all ages are circulatory diseases, cancers which can all be associated with poor food diet.  The strategies confirm that efforts need to be taken to reduce salt, increase the uptake of five a day portions, provide better information for consumers about food, and ensure more healthier choices are available. 

This same document refers to participation of the ‘Responsibility Deal’ programme.  The Public Health Responsibility Deal aims to tap into the potential for businesses and other influential organisations to make a significant contribution to improving public health e.g. food businesses offering healthy food choices and healthier preparation methods.  The Responsibility Deal embodies the Government’s ambition for a more collaborative approach to tackling the challenges caused by our lifestyle choices.

What is this telling us?

The local and national statistics, together with the local and national strategies which cover the wide spectrum of food issues demonstrate that a large amount of effort is still needed in order to tackle the issues of food poisoning, obesity and food related health concerns.  Bedford Borough Council is not immune to the serious issues that are evident across the country and sustained effort needs to be made in the following areas:

a)    Further measures are required in order to reduce the levels of food poisoning, especially in terms of Campylobacter, Listeria and E coli 0157, through initiatives which inform, educate and encourage positive behaviour change to both business and the public.  A continued and concerted effort is needed to ensure food establishments’ FHRS ratings are improved.

b)    Continued joint effort is required to assist other departments / agencies to help reduce obesity and other nutritional lifestyle issues such as heart disease, diabetes and some cancers, through targeted strategies.  This is particularly the case with regard to food establishments who now contribute a sizeable proportion of the population’s food intake.

c)    As ‘eating out’ diets significantly contribute to an individual’s overall calorie intake, focussed initiatives to improve food safety and nutritional standards within food establishments should be considered.  As younger people tend to eat out at an increased frequency compared to older demographics any interventions should be targeted at establishments where these age groups eat out.

d)    Initiatives should tap into the potential offered by business in promoting public health messages and agendas using ‘responsibility deal’ style initiatives, in line with government advice / guidance.

What are the key inequalities?

1) In terms of overall food poisoning levels, no local correlation exists regarding food poisoning prevalence and associated socio-demographic or socially disadvantaged groups.  Men and older persons are however less likely to carry out FSA approved food hygiene practices in the home.

2) While everyone is susceptible to obesity, levels are disproportionately higher in the lower socio-demographic, socially disadvantaged groups and some ethnic groups.

3) Young persons are more likely to eat out than older demographics.  As food eaten outside the home comprises a higher proportion of calorie content young persons are therefore at an increased risk to gaining weight.

What are the unmet needs/ service gaps?

1) Insufficient data exists to demonstrate any link between food poisoning levels and the socio-demographic or socially disadvantaged groups.  As such this area of work should be considered nationally in order to determine whether such a correlation exists.

 

2) The proportion of food businesses not meeting standards identified through the Food Hygiene Rating Scheme demonstrates a continual need to promote good hygiene practices in businesses.

3) Existing joint initiatives to promote healthy food choices and tackle poor nutritional preparation methodologies in food eateries are currently very limited in scope and insensitive to health inequalities.

Recommendations

1) To continue to roll out the Food Hygiene Rating scheme from 1100 premises to approximately 1500 within 12-18 months.

2) To contribute to the Excess Weight Partnership Strategy by engaging with food businesses to support the development and provision of healthier food choices to the public.

3) To continue to evaluate health inequalities of Bedford in the areas of food poisoning and home food hygiene education.  Devise appropriate and focused initiatives to reduce the risk of food poisoning in the home targeting high risk groups.

This chapter links to the following chapters in the JSNA:

  1. Excess Weight (Children and Young People)
  2. Excess Weight (Adults)
  3. Cardiovascular Disease
  4. Cancer
  5. Diabetes

 

References

1.    Data taken from Food Standards Website - available at   http://www.food.gov.uk/[Accessed 18/11/15]

2.    The Food Hygiene and Rating Scheme: Guidance for local authorities on implementation and operation – the ‘Brand Standard’ Rev3, Food Standards Agency 2014 - Available at http://www.food.gov.uk/[Accessed 18/11/15]

3.    Food borne Diseases Strategy 2010 – 2015 An  FSA programme for the reduction of Foodborne disease in the UK Version 1.0 Published May 2011 - Available at http://food.gov.uk/multimedia/pdfs/fds2015.pdf [Accessed 18/11/15]

4.    Bedford Unitary Authority Health Profile 2015 (Public Health Observatory) Public Health England 2015 - Available at:  http://www.apho.org.uk/resource/view.aspx?RID=50215&SEARCH=bedford&SPEAR[Accessed 18/11/15]

5.    Obesity: A Position Statement, Faculty of Public Health 2013

6.    Healthy Weight, Healthy Lives toolkit for developing local strategies, Faculty of Public Health 2010

7.    Exploring food attitudes and behaviours in the UK: Findings from the Food and You Survey 2012, TNS BMRB, Policy Studies Institute and University of Westminster, Social Science Research Unit, Unit Report 20, Food Standards Agency  2013 - Available at http://www.food.gov.uk/multimedia/pdfs/committee/foodandyou2012.pdf[Accessed 18/11/15]

8.    Food Statistics Pocketbook 2013, Department for Environment, Food and Rural Affairs - Available at: https://www.gov.uk/government/statistics/food-statistics-pocketbook-2013 [Accessed 18/11/15]

9.    Statistics on obesity, physical activity and diet: England 2013

10. The Health and Social Care Information Centre 2013, Bates et al, 2010; Department for Environment Food and Rural Affairs, 2007.

11. National Child Measurement programme (NCMP) data 2011/2013 - Available at: http://www.hscic.gov.uk/ncmp [Accessed 18/11/15]

12. Healthy Lives Healthy people - Our Strategy for Public Health in England (2010), Department of Health, November 2010 - Available at: https://www.gov.uk/government/organisations/public-health-england [Accessed 18/11/15]

13. Healthy Lives, Healthy People: A call to action on obesity in England, Department of Health, 2011.  Available at: https://www.gov.uk/government/publications/healthy-lives-healthy-people-a-call-to-action-on-obesity-in-england[Accessed 18/11/15]

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