An evaluation of the effectiveness of E. coli cross-contamination guidance

Background

E. coli O157 cross-contamination guidance was developed in response to an outbreak of E. coli O157 in South Wales in September 2005.

The findings of a public inquiry, undertaken by Professor Hugh Penningto were published in 2009. The enquiry investigated the circumstances that led to the E. coli O157 outbreak and how it was handled. This identified the cause as cross-contamination between raw and ready-to-eat foods, in particular a failure to ensure that critical procedures, such as cleaning and the separation of raw and cooked meats, were carried out effectively.

The first version of guidance was based on findings from public inquiries and independent scientific studies. A formal evaluation of the guidance in 2012 identified concerns, and a new version was produced in December 2014. This aimed to make the guidance clearer and easier to follow, and allowed a degree of flexibility for businesses to undertake a risk-based approach, while still maintaining public health protection.

Research approach 

The broad aim of this research was to undertake a post-implementation evaluation of the revised guidance. We wanted to ensure it had achieved its objectives, explore awareness of the guidance and gather feedback from food businesses and local authorities on their understanding and implementation of the guidance. We were particularly interested in what could discourage or prevent businesses from applying the principles of the guidance.  

The following strands of research were undertaken:

• 10-minute Computer Aided Telephone Interview (CATI) with the person responsible for food safety in 501 food businesses across England, Wales and Northern Ireland
• 10-minute CATI survey with 104 Environmental Health Officers (EHOs) across England, Wales and Northern Ireland
• an online focus group which lasted 90 minutes with eight EHOs who agreed during the telephone survey to participate in further research
• five on-site visits with food businesses which agreed during the telephone survey to participate in further research

Results

The findings showed an increase in businesses awareness and understanding of the advice:

• 91% of businesses (cf. 65% in 2012) are aware of the guidance
• 73% of businesses reported that the guidance was easy to understand
• 40% of businesses said they had made changes to working practices as a result of the FSA’s guidance on cross-contamination, with 91% of those that had not made any changes saying that this was because they were already meeting the guidelines  

The research also highlighted some potential opportunities to enhance the effectiveness and awareness of the guidance. These include continuing to raise awareness directly with businesses and knowledge sharing between environmental health officers.

In addition, the need to simplify the existing guidance is recommended with pictures, videos or other visuals.