FSA 22-06-07 Annex H – Improving our understanding of the extent of FHS reactions

Between August 2021 and March 2022 work took place to investigate the feasibility and design of a food allergic reaction reporting mechanism (FARRM) to enable consumers with a FHS to report incidences of allergic reactions. We wanted to understand whether consumers would be willing to report reactions and near-misses for the purposes of informing policy making and if so, what information they would be willing to give. 

The work also sought to understand the feasible number of questions, appropriate question wording and, through a FARRM Proof of Concept (PoC), gather consumer feedback.  

Promotion of the PoC focused on engagement with key charity and consumer organisations, and targeted social media activity.  The following charities and organisations provided front doors (or sign-posts) to the tools on their website to help raise awareness and support their members to report a FHS occurrence or a near miss: 

• Natasha Allergy Research Foundation 
• Anaphylaxis Campaign 
• Coeliac UK 
• Allergy Action 
• The Allergy Team 
• Allergy UK 

During the 4-month testing period, 498 reports were received (371 reactions and 127 near-misses).   

While the work demonstrated that consumers were willing to use the tool and report their reactions and near-misses to FSA for the purpose of informing policy development it did highlight a number of potential barriers to the introduction of a FARRM tool:  

Achieving and maintaining consumer awareness 

The communications and media campaign for the PoC was effective, but its impact was temporary – while there were spikes in reports following promotion on social media channels – engagement did drop over 4-month period.  

A review of the campaign suggests that solely relying on online promotion, particularly using social media, does not effectively reach those who do not spend considerable time online, or do not engage with FSA or FHS focused accounts.  

The work concluded that achieving and maintaining the high levels of awareness for FARRM would require significant and ongoing investment of resources.  

Data validity 

The work found that the self-reporting nature of the tool would reduce the “value” of the data that FARRM would provide as: 

A count of reactions without a count of the total population of people with FHS may be of limited value. 

There is a risk of an unquantifiable self-reporting bias. 

The data collected would need to cover a relatively long time-period to establish a baseline and allow the effect of policy changes to become apparent.  

Consumer motivations and expectations 

Usability testing and feedback from the PoC suggests that while consumers are motivated to report reactions, strategies for sustaining this motivation would need to be explored as there is no immediate tangible outcome or behavioural reward for consumers who use the tool that would reinforce reporting behaviour.  

Conclusions 

The user engagement work delivered as part of the PoC provided valuable insight into consumer expectations which has applications for the wider work of the FSA.  The use of user personas proved to be effective way to segment users and this work will be carried forward.  We plan to review the personas on a regular basis. 
 
The design of the questionnaire was successful with users reporting that the questions were clear, and the form was about the right length. 

The work with the charities and organisations to promote the FARRM through social media and links on their website was effective and we are considering how it could be applied to FSA work on food hypersensitive in the future. 
 
The work concluded that the barriers highlighted above mean that FARRM does not   offer good value for money and alternative methods of collecting data on the nature and number of FHS reactions and near misses should be explored.  

Next steps 

The outputs of the work will be used by the policy team to consider alternative approaches to collecting the required information including assessing the potential for a regular FHS survey to provide a more effective way to capture information on the nature and extent of FHS reactions.