Evidence Review on

Regulation Culture and

Behaviours

Institute for Employment Studies and

Cardiff Work Environment Research

Centre

Social Science Research Unit

Food Standards Agency

September 2010

Unit Report 12

Evidence Review on Regulation Culture

and Behaviours

Prepared by the Institute for Employment Studies and Cardiff Work Environment Research Centre for the Food Standards Agency

Sally Wilson

Claire Tyers

Emma Wadsworth

Institute for Employment Studies Sovereign House Church Street Brighton BN1 1UJ UK

Telephone: +44 (0)1273 763400 Email: askies@employment-studies.co.uk Website: www.employment-studies.co.uk

Copyright © 2010 Institute for Employment Studies

IES project code: 1933

Cardiff Work Environment Research Centre Cardiff Work Environment Research Centre Cardiff University 59 Park Place Cardiff CF10 3AS Telephone: +44 (0) 29 2087 0246 Email: cwerc@cardiff.ac.uk Website: http://www.cardiff.ac.uk/cwerc/ Copyright © 2010 Cardiff Work Environment Research Centre

Institute for Employment Studies

IES is an independent, apolitical, international centre of research and consultancy in HR issues. It works closely with employers in all sectors, government departments, agencies, professional bodies and associations. IES is a focus of knowledge and practical experience in employment and training policy, the operation of labour markets, and HR planning and development. IES is a not-for-profit organisation.

Cardiff Work Environment Research Centre

CWERC is a Cardiff University Research Centre which undertakes research to understand the relationship between health, safety and well-being in the working environment. It is supported jointly by the Schools of Psychology and Social Sciences and is sponsored externally by the Institution of Occupational Health and Safety (IOSH).

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Acknowledgements

The authors wish to thank Annette Cox, Rosie Gloster, Tom Higgins and Jenny Savage at IES and Katie Marsh at CWERC for their work in reviewing the literature, and also wish to thank Helen Atkinson, Joanna Disson and Julian Blackburn at the FSA for their advice and guidance. We would also like to acknowledge David Lock at LACORS, Conor McGurk at BRE, Andrew Moore at HSE, Jenny Morris at CIEH, David Walters at CWERC and Stephen Palmer at the University of Cardiff for their expert input and James Walker-Hebborn for assistance in preparing the final report.

© Crown Copyright 2010

This report has been produced by the Institute for Employment Studies and Cardiff Work Environment Research Centre under a contract placed by the Food Standards Agency (the Agency). The views expressed herein are not necessarily those of the Agency. The Institute for Employment Studies and Cardiff Work Environment Research Centre warrants that all reasonable skill and care has been used in preparing this report. Notwithstanding this warranty, the Institute for Employment Studies and Cardiff Work Environment Research Centre shall not be under any liability for loss of profit, business, revenues or any special indirect or consequential damage of any nature whatsoever or loss of anticipated saving or for any increased costs sustained by the client or his or her servants or agents arising in any way whether directly or indirectly as a result of reliance on this report or of any error or defect in this report.

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Contents

Glossary vii

Executive Summary x

Influence of organisational characteristics of the dutyholder x Organisational culture xi Culture within the regulator xii Interactions between the regulator and dutyholder xiii Recommendations xiv

1 Introduction 1

1.1 The Pennington Inquiry 1 1.2 Aims of the review 2 1.3 Research questions addressed by the review 3

2 Methodology 4

2.1 Scope of the review 4 2.2 Sources of evidence – academic literature and grey literature 5 2.3 Search terms and search strategy 5 2.4 Details of the search process 6

3 Organisational Characteristics and Behaviours 10

3.1 Introduction 11 3.2 Organisational characteristics 11 3.3 Ability to self-regulate 17 3.4 Behaviours 19

4 Organisational Culture 26

4.1 Introduction 27 4.2 The role of culture 27 4.3 Attitudes and perceptions 29 4.4 Motivating compliance 35

5 Characteristics of the Enforcing Organisation and Interactions with Dutyholders 38

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5.1 Introduction 39 5.2 Enforcement approach 39 5.3 Cultural and behavioural factors within the enforcing organisation 44 5.4 Interactions between the enforcement body and the dutyholder 46

6 Conclusions and Recommendations 57

6.1 Introduction 57 6.2 Main findings of the evidence reviewed 57 6.3 Limitations of the evidence base considered and research gaps 62 6.4 Recommendations for further research and other practical points

for the FSA to consider 63

7 Bibliography 67

Appendix 1: Search Engines Used in the Review 74

Appendix 2: Search Term Identification Process 76

Appendix 3: Search Terms Used and Results of Search Process 81

Appendix 4: Variations in Search Strategy 83

Appendix 5: Sift Pro-forma 85

Appendix 6: Review Pro-forma 87

Appendix 7: Documents Included and Excluded 91

Appendix 8: Categorisation of Included Documents 93

Appendix 8: Categorisation of Included Documents 93

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Glossary

BRE The Better Regulation Executive, part of the Department for Business, Innovation and Skills tasked with leading the regulatory reform agenda across government.

CIEH Chartered Institute of Environmental Health: an independent organisation representing the interests of the environmental health profession.

CWERC Cardiff Work Environment Research Centre: co-authors of the current review.

Dutyholder The individual or corporate body with the primary responsibility for meeting the legal requirements in the area under consideration.

E.coli O157 The abbreviated name of Escherichia coli O157:H7, a strain of the bacterium Escherichia coli and a cause of foodborne illness.

EHO Environmental health officer: an individual employed by a local government to advise on and enforce public health legislation and standards. They may be generalist or may specialise in specific areas, such as housing, occupational health and safety, food safety and food standards, environmental protection, waste management and pollution control.

EHP Environmental health practitioner: see EHO definition.

FBO Food business operator: a dutyholder whose activities fall under the jurisdiction of the FSA.

FSA The Food Standards Agency: an independent government department set up by an Act of Parliament in 2000 to protect the public's health and consumer interests in relation to food.

HACCP

Hazard Analysis Critical Control Points: an internationally recognised system of managing and identifying food safety hazards and protecting consumers. Procedures based on HACCP are a requirement of EU food hygiene legislation that applies to all

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food business operators except farmers and growers.

HSE The Health and Safety Executive: a non-departmental public body responsible for the encouragement, regulation and enforcement of workplace health and safety and welfare in England, Wales and Scotland.

IES The Institute for Employment Studies: co-authors of the current review.

LA Local authority: the local government bodies in the UK that have responsibility for official controls and enforcement of the main body of food law.

LA officers Local authority officers: see EHO definition.

LACORS Local Authorities Coordinators of Regulatory Services1: the local government central body responsible for overseeing local authority regulatory and related services in the UK.

LAEMS The Local Authority Enforcement Monitoring System: a web-based system to which local authorities are able to upload data generated from the local system(s) on which they record data on food law enforcement activities and outcomes.

LRS Law on individual rent subsidies: a form of housing benefit paid in the Netherlands when rent exceeds a certain proportion of taxable income.

MRSA A commonly used abbreviation for methicillin-resistant Staphylococcus aureus (S. aureus) bacteria. MRSA. S. aureus is sometimes termed a ‟superbug„ because of its ability to become resistant to several antibiotics.

The Pennington Inquiry

The Public Inquiry chaired by Professor Hugh Pennington which inquired into the circumstances leading to the outbreak of E.coli O157 infection in South Wales in September 2005.

PPE Personal Protective Equipment: all equipment and clothing which is intended to be worn or held by a person at work and which offers protection against one or more risks to health and safety.

REA Rapid Evidence Assessment: a tool for reviewing available research evidence as comprehensively as possible, within the constraints of a given timetable.

SFBB Safer food, better business: a food safety model which has been produced by the FSA in England, to assist small businesses with the implementation of suitable management arrangements to control food safety within their business.

1 Now called Local Government Regulation

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SHADs Safety and Health Awareness Days: sector-specific events held by HSE which consist of practical demonstrations covering common hazards.

SME Small or medium-size enterprise: defined by the European Commission as an organisation with fewer than 250 employees.

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Executive Summary

The Public Inquiry into the September 2005 outbreak of E.coli O157 in South Wales, published in 2009, identified serious breaches of Food Hygiene Regulations as a key cause of the event. It also identified poor food safety culture and inadequate enforcement action as contributory factors to the outbreak. In response, the Food Standards Agency (FSA) recommended further investigation to fully understand the culture and behaviours in businesses and enforcement bodies, as well as the communication between these two groups that facilitate or inhibit compliance with regulation. To start this work off, the Institute for Employment Studies (IES) and Cardiff Work Environment Research Centre (CWERC) was commissioned by the FSA to conduct an evidence review in this area.

The review was conducted according to the principles of a rapid evidence assessment, and a broad range of evidence was reviewed across a range of regulatory areas (notably health and safety) with read-across for the food sector1. To supplement the literature from the main search, key UK experts were also consulted to ensure coverage of important literature. The overall aim of the review was to determine „what works‟ in terms of culture and behaviour in securing compliance. The review‟s findings fell under the following headings.

Influence of organisational characteristics of the dutyholder

Intrinsic organisational characteristics (eg size, nature of business activity) can be linked, directly or indirectly, with a business‟ willingness, or ability, to exhibit compliant behaviours. The evidence suggests:

1 There was more limited literature available on food safety, with the result that the research has a

heavier focus on health and safety law enforcement.

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■ Size is a key determinant of many aspects of organisational culture, but is not the only important factor influencing who does/does not comply.

■ Some sectors are, by their nature, more hazardous, hindering cross-sector comparisons. Even within the food industry, different types of food business operators (FBOs) face diverse challenges.

■ Resource constraints can limit the extent to which staff are trained and monitored and time pressures negatively impact on the take-up of training. This can lead to workers taking „short-cuts‟, which compromise levels of risk control.

■ The costs of compliance are proportionately higher among small or medium-size enterprise (SMEs) than in larger businesses.

■ Larger businesses tend to have access to better information (eg through business networks or closer relationships with regulators), specialist internal resources and/or external support, and have more effective management structures. This means that they are more likely to be able to understand, and be aware of, compliance issues when compared with smaller businesses.

■ SMEs may lack technical expertise in product and service provision and their health and safety implications, resulting in poor understanding of food safety requirements. Within the food industry, compliance can also be compromised by the practice of recruiting inexperienced staff according to low or non-existent entry criteria (particularly where English is not a worker‟s first language). In these circumstances staff may not understand written or verbal instructions sufficiently to comply.

■ Compliant worker behaviour appears best reinforced via the use of multiple channels of feedback, including management communication combined with feedback on performance levels.

Organisational culture

Organisations which demonstrate features of an effective culture are likely to be more compliant. These features include manager commitment, peer group support, good staff communication and consultation, recognition of the fact that everyone has a role to play, and high quality training. The evidence shows:

■ Management approach is a key driver of compliant behaviour. Effective performance management has a positive impact on compliance and it is important for managers to lead by example. In catering organisations, the role of the chef has been highlighted as pivotal in promoting positive safety cultures.

■ Safety culture is important in the establishment of, and adherence to, effective safety management systems, and in the reduction of accidents.

■ SMEs often lack the management structures needed to drive through compliant behaviours, and may also have poorer documentation and policies.

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■ Peer group support, as well as supervision, serves to encourage best practice among staff, and the threat of „internal‟ sanctions (such as dismissal) can be effective in encouraging sustained compliance.

■ If workers agree with regulations, can see their fairness and legitimacy, and if they are involved in decisions about control measures, they are more likely to co-operate. Worker involvement can promote shared responsibility and is important in creating an effective health and safety culture which results in compliance and effective assessment of risks

■ Attitudes towards, and perceptions of, regulatory bodies and the regulations they enforce are also an important aspect of safety culture. Furthermore, a key finding is that food businesses tend to understand compliance as a more passive process than regulatory bodies, and are often reliant on inspectors to assess their degree of compliance, rather than undertaking self-assessment.

■ Risk perceptions are important, and often driven by knowledge of specific risks. Within the catering industry, major disease outbreaks are relatively rare, and even high-risk organisations can believe that there is a low risk of their products poisoning customers.

■ Self-regulation can be difficult for FBOs if they lack an understanding of specific legislation and how to comply with it. SMEs may operate what they believe to be compliant systems, for example, but only implement some aspects of what is required.

■ Dutyholders are more likely to comply when they perceive the regulatory regime as fair, trusted and co-operative, but fear of prosecution is a key driver of behaviour, with sanctions needed to back up more co-operative approaches.

■ Training alone does not necessarily result in compliance (businesses experiencing foodborne outbreaks are as likely as other businesses to have staff with formal food hygiene training). To be most effective, training must be perceived as important to management, be adopted on an ongoing basis, and supported by multiple channels of communication, including performance management.

■ The underlying motivations for businesses to comply are therefore complex. In broad terms these are driven by how the organisation is viewed (ie civic duty, industry and customer expectations), and how regulations are enforced (ie fear of negative consequences of non-compliance including reputational damage) but are tempered by the desire to minimise the burdens of compliance. The motivations driving SME behaviour are also likely to be different to those affecting larger businesses. Specific, targeted, information which sets out explicitly and concisely how to comply is welcomed, particularly among SMEs.

Culture within the regulator

There is only limited evidence that directly assesses culture and behaviour within enforcing bodies. What is available shows:

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■ UK regulators tend to adopt a preventative, conciliatory, approach to enforcement, although the literature suggests a range of enforcement methods (eg inspections, sanctions, provision of advice) can be effective depending on the circumstances.

■ Sanctions, irrespective of the size of the penalty, can impact on dutyholder behaviour, as can „naming and shaming‟ non-compliant dutyholders, particularly among those for whom reputation is important.

■ Rigid enforcement offers only limited results within the food sector, although the enforcing body must be perceived as taking action in non-compliant cases.

■ Less formal approaches should be characterised by clarity and consistency so that dutyholders' understanding of, and confidence in, the rules is not undermined.

■ Comparisons between dutyholders suggest that the approach of local authority (LA) enforcement staff is generally viewed as more advisory, and less formal, than that of Health and Safety Executive (HSE) inspectors. LA staff have the advantage of local knowledge and closer stakeholder relationships, but their approach is viewed as less consistent, less informed, and potentially susceptible to local political interference.

■ Resources can be an issue for LA inspectors and this can have practical implications for the comprehensiveness of record keeping and the quality of inspections.

Interactions between the regulator and dutyholder

A wide range of intervention strategies can be used with dutyholders, although there is insufficient evidence on the utility of many of these approaches to suggest that UK regulators should change their current position. The evidence shows:

■ Inspections offer the opportunity to share and disseminate information on how to comply as well as issue penalties, but there can be tensions for inspectors in operating a dual role of educator and enforcer. There is also debate on whether inspectors should focus firmly on enforcement, or operate flexibly, applying discretion.

■ Many businesses interact with a number of regulators, and multiple inspections can be seen as a business burden.

■ Dutyholders value, and respond to, personal, face-to-face contact, which is regarded as the single most effective form of communication. However, this works best in terms of promoting better understanding of, and adherence to, regulations, when reinforced by other methods (eg written communication, the involvement of intermediaries).

■ Written communications need to be clear and „user-friendly‟ and regulators should be aware that there can be confusion among SMEs about the difference

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in status between formal notices and other, more routine, written correspondence.

■ Enforcement bodies are seen to have a key role in training provision, particularly where resource constraints limit uptake of training from other sources. This is particularly true in relation to Hazard Analysis Critical Control Points (HACCP) implementation, which can be problematic for some businesses, especially SMEs.

■ There is limited evidence directly addressing the effect of formal incentives on compliance although some studies indicate that food hygiene ratings schemes can motivate businesses to comply. Employers who wish to retain their rating are required to maintain a high standard of hygiene and therefore schemes of this type may also motivate sustained compliance.

Recommendations

The review identified a number of gaps in the literature, including evidence on compliance as an outcome, cultures and behaviours within enforcing bodies, motivation to protect public health, reasons for compliance with one set of regulations over another, and sustained compliance. In order to address these gaps, the report suggests a number of areas for targeting future food safety research and policy development.

■ Establish the areas of regulation where lessons learned can most readily be applied to food safety. This would allow a more focused approach to be undertaken if, for example, a systematic literature review was conducted with the intention of building on present findings.

■ Gain further understanding of workplace cultures. The term culture has many meanings. Areas of the research literature not explicitly targeted by the current review, such as organisational psychology and systems analysis, could be helpful in further clarifying what kind of working culture is conducive to food safety compliance.

■ Examine first-hand experience of enforcers. Structured interviews with operational inspectors working „on the ground‟ may highlight issues specific to food safety enforcement that are not evident in the current research literature, such as how „microcultures‟ within LA inspection units operate.

■ Consider other sources of data. Such data could include court proceedings, case histories and reports of investigations, which would all consider, in detail, the precise actions and the types of non-compliant behaviours which have led to cases or outbreaks of foodborne infection. The Local Authority Enforcement Monitoring System (LAEMS) database could be used to provide detailed information on enforcement outcomes.

■ Ensure studies include compliance as an outcome measure. Independent assessments of compliance should be sought and longitudinal approaches should be taken to allow examination of sustained compliance.

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■ Design interventions with impact assessment in mind. This would entail considering the need and possibility for meaningful baseline data and a suitable control group from the outset.

■ Continue to develop targeted, prescriptive guidance. Audiences such as chefs, those for whom English is not their first language, those with poor literacy and employees new to the catering industry, could be considered. The guidance should explicitly address „what compliance is and what it is not‟. Guidance targeted at chefs or managers could emphasise principles of good hygiene and safety performance management, and strategies for remedying poor performance.

■ Provide specialised support for environmental health practitioners (EHPs) on communicating with SMEs. Training materials could be developed to facilitate EHPs‟ interactions in dealings with small food businesses with diverse needs.

■ Ensure pertinent research findings are disseminated. In particular, where there are lessons for EHPs, findings should be presented in a format that makes clear what its implications are for the way they undertake their duties.

■ Consider models adopted in other countries: the possibility of adopting alternative approaches could be explored further, although any contextual factors specific to the UK would need to be considered carefully before adopting an alternative enforcement model from another country.

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1 Introduction

This section of the report provides an overview of the policy background and circumstances which led to this review of evidence being undertaken for the FSA. It also sets out the review‟s aims and objectives and the research questions that it addresses.

1.1 The Pennington Inquiry

The Pennington Inquiry was published in 2009 and documents the circumstances surrounding the outbreak of E.coli O157 in South Wales in 2005. The Inquiry report identified serious and repeated breaches of Food Hygiene Regulations by the food business operator (FBO) involved (Tudors). A contributing factor to these breaches was considered to be the nature of the FBO‟s poor food safety culture.

„The culture that emerged [within Tudors (FBO)] was one of little regard for the importance of food safety but where making and saving money was the priority ... additional resources should be made available to ensure that all food businesses … have in place an effective, documented, food safety management system which is embedded in working culture and practice.‟

(Pennington Inquiry Report 2009)1

Inspection and auditing procedures also came under criticism; for example, the report concluded that the inspections did not assess or monitor the business‟ management of food safety as well as they could, or should, have done and that there was insufficient focus on identifying and assessing working practices and procedures to ensure that the HACCP plan was being applied in practice.

The Report made 24 recommendations, which included ensuring food businesses understand and implement the principles of HACCP1 adequately, putting in place

1 http://wales.gov.uk/ecolidocs/3008707/reporten.pdf?lang=en

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measures to ensure effective enforcement, and a review of FSA guidance for enforcement officers and businesses.

In July 2009 the FSA Board agreed that the Agency should take the lead in addressing the Report‟s findings and recommendations that lay within the Agency‟s remit2. Relevant to this review, the FSA Board recognised that, ‟the two main challenges presented by the Inquiry are to tackle businesses that share Tudors‟ attitude and to engender a proactive, inquisitorial approach by those who inspect and audit those operators‟ procedures – in other words a culture that is interested in achieving outcome rather than fulfilling a task. Factors that affect communication between FBOs and food enforcement officers need to be better understood.‟3 The FSA commissioned IES and CWERC to carry out this evidence review as part of it‟s response to these particular aims

1.2 Aims of the review

In broad terms the aim of the current review is:

„To investigate the culture and behaviours in businesses and enforcement bodies, and the communication between individuals in these two groups, to understand “what works” to secure regulatory compliance particularly, though not exclusively, in relation to food safety.‟4

The review is intended to:

■ illuminate the reasons behind poor food safety culture in some food businesses, which can result in serious food poisoning outbreaks

■ help the FSA to learn lessons from other regulatory bodies and industrial sectors, by drawing on literature about what works to secure regulatory compliance, in regulatory contexts both including, and wider than, food safety

■ draw out specific recommendations to enable the FSA to improve food safety behaviours and organisational culture, thereby increasing compliance with food safety legislation (and by implication, wider implementation of HACCP).

1 Hazard Analysis and Critical Control Point (HACCP) is an internationally recognised way of

managing food safety and protecting consumers. It is a requirement of EU food hygiene legislation that applies to all food business operators except farmers and growers. It is a preventative approach to food safety based on seven principles that provide a systematic way of identifying food safety hazards and making sure that they are being controlled day-in, day-out.

2 The July 2009 board paper can be found at

www.food.gov.uk/multimedia/pdfs/board/fsa090707.pdf. Annex 1 of the paper provides an overview of FSA activity since 2005.

3 www.food.gov.uk/multimedia/pdfs/board/fsa090707.pdf pages 8/9 (paragraphs 21-23)

4 www.food.gov.uk/multimedia/pdfs/committee/ssrc0923.pdf

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1.3 Research questions addressed by the review

A number of specific questions are of interest to FSA:

■ Who does/does not comply and why?

■ What approaches/communications are more/less effective in securing regulatory compliance?

■ What encourages sustained compliance?

■ What deterrents and incentives have been shown to achieve and maintain compliant behaviour, and what more can business bodies and enforcement agencies do to increase compliance?

The review takes an approach from a dual perspective, examining both employers and enforcers, and communication between the two.

In line with the main aims of the review the research questions are addressed principally in terms of the behaviours and cultures1 which drive compliance, ie factors primarily concerned with demographic, behavioural and psychosocial features of employers and organisations of interest.

At the time of commissioning this work, a series of stakeholder interviews were planned to explore the themes identified in the evidence review. However, as a result of the volume of relevant literature captured by the search (and associated time/resource implications), this research component was dropped. This allowed sufficient attention to be focused on the review itself. The report recommendations highlight the utility of conducting structured interviews with particular stakeholder groups at a future date.

1 A manifestation of the values and beliefs and attitudes within a workforce. Its formation is

dependent upon the knowledge, standards, motivation and leadership of the person in charge, and how they communicate with, and are trusted by, the staff.

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2 Methodology

This section of the report outlines the scope of the review, its approach and the details of the evidence base used. We also set out the main stages of the review process in detail.

2.1 Scope of the review

An important aim was to extend the review to areas outside food safety regulation to enable the FSA to learn „what works‟. In principle, no industrial sector, enforcement body or legislative framework was deemed to lie outside the focus of the review as long as it dealt with compliance issues among employers. This principle guided the search of the academic literature, and the FSA provided suitable specialist references to ensure that key evidence from the food safety literature was included in the review.

Outside the FSA‟s own literature base, the health and safety literature was considered to contain the most relevant findings for this review bearing in mind (i) the similarity (and partial cross over) of sectors receiving food safety and health and safety inspections, and (ii) the fact that local authority enforcement officers are involved in enforcement of health and safety alongside enforcement of food safety. The HSE‟s database of research reports was therefore examined as a key resource for the literature search.

A range of other specific expert sources were identified by the FSA and IES to ensure that other business activities covered by regulations and enforced by local authorities were included in the review. These included experts from the Chartered Institute of Environmental Health (CIEH), Local Authorities Coordinators of Regulatory Services (LACORS)1 and the Better Regulation Executive (BRE).

1 Since completion of the evidence review, the Local Authorities Coordinators of Regulatory

Services changed its name to Local Government Regulation. However, for the purpose of this report the organisation will be referred to as LACORS.

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The search for evidence covered documents published within the last ten years and primarily focused on evidence from the United Kingdom. However, some papers originating from other nations were identified and no documents were excluded on the basis of their country of origin.

2.2 Sources of evidence – academic literature and grey literature

This evidence review considered two main types of evidence: academic literature and „grey literature‟ (the latter is defined below). In total, 14 search engines were used to capture suitable academic literature. These search engines are listed in Appendix 1.

Grey literature was accessed mainly via the FSA, the HSE and expert sources (see below). In the context of the current review, grey literature covered relevant material not published in academic journals, including research reports, technical reports, commissioned literature reviews, investigation reports, dissertations and conference proceedings. In the main, the grey literature reviewed in this study originated from UK sources (largely as a consequence of the search strategy).

2.3 Search terms and search strategy

Due to the time and resources available for this work, a systematic review was not possible and a „Rapid Evidence Assessment‟ (REA) approach was adopted. As mentioned, an important requirement was to extend the review to areas beyond food safety regulation. However, this had the potential to yield an evidence base of an unmanageable size, and so it was essential to choose search parameters to limit the volume of literature generated.

Two key search engines were selected in order to determine the feasibility of initial search strategies. The scoping phase involved systematically trialling different combinations of search terms and recording the outcomes in terms of documents captured. Different definitions of the search field (the part of the document which should contain the specified search terms), namely, „title‟, „abstract‟ and „full text‟ were also trialled. A document is included in Appendix 2 which illustrates this systematic process and demonstrates the volumes of documents captured using various combinations of search terms and search fields.

Following consultation with the FSA it was agreed that „document title‟ would be used as the main search field in order to restrict the volume of captured documents to a manageable size. Scoping work confirmed that a similar review approach with different search fields would capture many thousands more papers within the academic literature. The chosen approach allowed the review to take a broad approach while adopting the principles of systematic inquiry and remaining replicable.

Drawing upon the review‟s main research questions, seven main areas were identified for the search, namely ‘enforcement’, ‘compliance’, ‘communication’, ‘support’, ‘behaviour’ and ‘culture’. Key words and corresponding search terms

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were identified for each of these areas: these are set out in Appendix 3, alongside the combinations of these terms which were used in the academic search process.

2.4 Details of the search process

The search process consisted of a series of distinct stages. A flow chart illustrating the volume of documents processed and rejected at the various stages is included in Appendix 7.

2.4.1 Search

Once the scope of the review and review strategy was agreed with the FSA, searching of the available literature was undertaken using electronic databases and other sources. Some adaptations to the initial strategy were necessary to accommodate various anomalies in the function of some search engines/databases, which we explain below in relation to each type of source.

Academic search engines

The full, agreed search was used for 11 of the 14 sources listed in Appendix 1. However, for the remaining three it was not possible to carry out the full search because the number of terms was too long for their search engines. Rather than not include these databases at all, a „short‟ search was developed for use in these cases, which entailed substituting „key area‟ words (see Appendix 3) for search terms.

HSE evidence

HSE has a searchable database of research reports allowing input of different combinations of search terms. However, this database did not allow the complexity of search term combinations used in the search of academic papers. In addition, using just the document‟s title as the search field was too restrictive and resulted in capturing only a handful of documents. In order to improve the chances of capturing relevant HSE research reports, the full text was used as a search field. This variant of the general search strategy is shown in Appendix 4.

In agreement with the FSA, references were also drawn from the relevant „What works‟ review (Cox et al., 2009) that was carried out by IES on behalf of the HSE.1 HSE references from this report were treated in the same way as other references identified during the search process.

1 This involved a review of all HSE research reports looking at the impact of HSE activities in the

preceding ten years

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Local Authorities Co-ordinators of Regulatory Services (LACORS) evidence

The LACORS database allowed only a limited number of search terms to be combined in any given search so the search strategy applied to this resource was adapted to accommodate these limitations (as described in Appendix 4). In addition, using „title‟ as a search field did not result in any documents being captured, so searches using full text were undertaken. A further adaptation to target documents with research content was made on the basis of the absence of high-quality evidence yielded in initial searches..

2.4.2 Contribution of experts

One of the risks of conducting a rapid evidence review is that key documents are missed. Therefore, the review team sent a standard letter to experts from a range of specialisms requesting references from their own field of expertise, to supplement the literature from the main search. Key individuals were consulted as follows:

■ HSE: senior personnel within the HSE‟s Social Science Unit (known to IES, through a previous research project addressing factors influencing health and safety compliance1) were approached to ensure all relevant HSE documents had been included in the review process, including very recent work and, at FSA‟s request, relevant work „in the pipeline‟. Since environmental health officers (EHOs) are often responsible for enforcing health and safety as well as food safety regulations, it was felt that most read-across literature would originate from HSE. Also the majority of literature to be considered for the review was expected to come from HSE sources.

■ LACORS: a named contact provided by the FSA was consulted to verify that the LACORS search had captured all relevant documents. LACORS were included to ensure that the review included LA input, and to ensure relevant food-related literature circulated at LA level was included.

■ CIEH: this organisation‟s Principal Policy Officer was approached to help ensure that recent publications pertinent to local authority enforcement activity were captured. It was felt that some key, food-related literature would be known to this organisation.

■ BRE, operating within the Department for Business, Innovation and Skills: a named contact provided by the FSA was consulted, with the intention of capturing pertinent literature across a range of business regulation areas. It was felt that BRE‟s participation would assist in identifying relevant literature on business regulation beyond the remit of food safety and health and safety.

1 Cox A et al., (2008. What Works in Delivering Improved Health and Safety Outcomes A Review

of the Existing Evidence, HSE Research Report 654. See www.employment-studies.co.uk/pubs/report.php?id=hse654

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■ Cardiff University: Professor Stephen Palmer, Professor of Epidemiology & Public Health, was consulted in order to help ensure that key food safety papers had not been missed by the formal search process.

Documents identified via experts were subject to the same sift and review process as documents obtained through more formal search methods.

2.4.3 Sift

Following the search process and prior to proceeding with the formal review stage, each document was subjected to a sift process. The sift criteria were devised with the primary aim of excluding (i) sources of poor quality evidence and (ii) documents not containing evidence relevant to any of the research questions. The sift pro-forma is included in Appendix 5, which sets out the applied criteria in detail.

In order to manage the process efficiently, an initial sift was conducted on the basis of title and/or abstract. For academic papers, this removed the need to acquire the full-text version and the time/expense involved. Grey literature tended to contain executive summaries, which could be used at this stage in place of abstracts.

Full-text versions of documents were obtained for all references not excluded at the initial sift stage. At this stage (ie on the basis of reading entire documents), it became clear that some documents did not contain findings pertinent to the review, although they may have contained relevant themes. Some further documents were excluded at this point. This is referred to in Appendix 7 as „sift phase two‟ although in practice in did not constitute a separate methodological stage: the same proforma was retained and identical criteria were applied in making a judgement regarding each document‟s suitability for review.

In general, on the basis of the title, abstract or full text, it was clearly apparent whether a document should be excluded at the sift stage. Where this was not the case, the decision was reached by two researchers.

All remaining documents were subjected to the review process, and details such as author, title and other identifiers were entered into an Endnote database.

2.4.4 Review and extraction of findings

For each document remaining after the sift process, a comprehensive review pro-forma was completed. The intention was that the pro-forma would serve a number of purposes:

■ allow articles to be classified according to type (academic, grey literature)

■ provide a check on methodological quality

■ enable classification of findings according to subject area

■ facilitate compilation of a summary of findings to be included in the review.

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A copy of the final pro-forma is included in Appendix 6. Following consultation with the FSA a decision was made not to grade or weight documents according to methodological quality; due to the applied nature of the research, many studies were not suited to the application of established scales (such as Maryland Scale of Scientific Methods1). Instead the pro-forma served primarily to eliminate low quality evidence and to check that there were no major methodological shortcomings which rendered findings from individual papers unsuitable for inclusion in the final report.

The final part of this process was the extraction of relevant findings for inclusion in the report. For each document remaining a summary was compiled listing main features of the methodology (expanding on boxes checked in the pro-forma), pertinent findings and a comment on the generalisability of findings to the current review. The summaries provided a basis for reporting the findings in the next chapters and also informed the tables presented in Appendix 8, which categorise the documents referenced in this review by document type, subject area and methodology.

In considering these findings, it is important to note that, as a rapid evidence review, this piece of work is susceptible to some degree of bias (in particular with regard to its emphasis on HSE and FSA activities) and limitations in terms of content. The conclusions presented here, therefore, should be interpreted with some degree of caution.

1 Maryland Scale of Scientific Methods (MSSM).

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3 Organisational Characteristics and Behaviours

Chapter summary

This first chapter focuses on organisational characteristics of dutyholders and the

behaviours they exhibit which can impact on compliance.

■ Within the food sector, size alone does not always act as a useful predictor of

compliance.

■ Hotels and restaurants account for most cases of food poisoning outbreaks, a sector

which is dominated by SMEs.

■ Larger organisations are better connected and more proactive in seeking support,

potentially leaving them better placed than SMEs to meet their legal obligations.

■ Large firms have specialist internal resources and/or can afford to pay for external

support, meaning that they are more likely to be able to understand, and be aware

of, compliance issues. The costs of compliance for SMEs can also be substantially

higher than in larger businesses.

■ Time pressures impact negatively on the priority given to health and safety and the

take-up of training. Performance pressures can also lead workers to perceive the

need for „short-cut‟ behaviours within their job.

■ Within the food industry, inexperienced staff recruited according to low or non-

existent entry criteria can exacerbate the problems, particularly where English is not

their first language and when food hygiene training is not provided.

■ Businesses may not always understand how to comply, and have low awareness of

specific pieces of legislation. Within the food sector, if regulations are not

understood, there appears to be a tendency to ignore them.

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■ Management approach is a key driver of compliant behaviour. In catering

organisations, the role of the chef has been highlighted as pivotal in promoting

positive safety cultures.

■ Although the provision of training should improve levels of food hygiene, the

literature is inconclusive on this question and businesses which had experienced

foodborne outbreaks were as likely to have staff with formal food hygiene training as

other businesses.

■ Compliant worker behaviour appears best reinforced via the use of multiple

channels of feedback, including management communication combined with

feedback on performance levels. Hand hygiene in particular is viewed as a

complicated behaviour and appears to benefit from a multifaceted approach to

feedback provision.

3.1 Introduction

The primary focus of this review is on organisational cultures and behaviours and the extent to which these influence compliance or (take-up of best practice). However, the literature identifies a number of intrinsic or „fixed‟ characteristics that are also important when considering compliance such as organisational size and sector. These characteristics are summarised first to provide some context to the cultural and behavioural issues presented in subsequent chapters.

3.2 Organisational characteristics

3.2.1 Organisational size

In the UK‟s food industry, 99.8 per cent of the hotel and restaurant sector consists of SMEs1 and 87.7 per cent of businesses in this sector are micro businesses, ie businesses employing fewer than ten staff (DTI, 20032). There has been limited assessment of SME compliance relative to the evidence available about larger organisations because of difficulties in engaging them in compliance processes and research (Chenoweth, 1995; Stokols et al., 2001a; Wilson et al., 19993). However, much of the literature reviewed suggests that SMEs are typically less

1 The European Commission‟s definition of SMEs as organisations with fewer than 250

employees (broken down into medium enterprises with 50-249 employees, small enterprises with 10-49 staff and micro enterprises with fewer than ten staff) is most commonly used. However, in some instances papers used alternative definitions, though SMEs will be defined as per the papers referenced.

2 Cited in Yapp and Fairman, 2006a.

3 Chenoweth, 1995; Stokols et al., 2001a; Wilson et al., 1999 all cited in Stokols et al., 2001.

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compliant than larger firms: FSA data show that the majority of premises with breaches of food safety regulations are SMEs (Food Standards Agency, 2001, cited in Yapp and Fairman, 2004). Also larger firms appear to be better placed to undertake compliance processes more effectively, when considering many of the points summarised below.

Authors urge caution in drawing generalisations in regard to company size and compliance with legislation (see, for example Amodu, 2008). Size alone does not always act as a useful predictor of compliance and there are a range of other, often linked, characteristics, which need to be considered, and which are discussed separately in the remainder of this chapter.

3.2.2 Organisational sector and sub-sector

It is evident from the health and safety literature that it is easier for some sectors and sub-sectors to control risk than others, usually depending on the level of activities that are hazardous in nature. For example, a study of worker behaviour with respect to manual handling regulations, found significant variation in compliance across different sectors. This variation appeared to stem from the business attitudes and culture within the sector and the extent of more general regulation in the sector (Lancaster et al., 2001). For example, in terms of culture, where health and safety risks are seen as „part of the job‟, compliance is less likely, while firms in sectors which are more heavily regulated are more likely to comply.

Within food retailing, 89 per cent of food poisoning outbreaks can be attributed to the hotel and restaurant sub-sector (FSA, 2001, cited in Yapp and Fairman, 2004). Findings presented in a paper by Jones et al. (2008b) found that businesses associated with foodborne disease outbreaks were more likely to operate as a hotel, to serve Chinese cuisine, dinner and snacks and be open continuously for ten hours or more. Catering and retail butchers in particular have low levels of food hygiene management training and high staff turnover (Worsfold and Griffith, 2003a) which are likely to increase risk of non-compliance.

The reasons for the differential level of risk within different sectors appear to lie in the food hygiene risks faced, for example greater risk is faced by hotel and catering establishments due to the type of service they provide, compounded by organisational size. Food manufacturing businesses often produce only one food product/ a limited range of products, and have designated staff at particular stages of the process which arguably make it easier to comply with HACCP (Yapp and Fairman, 2004). In contrast, catering establishments offer a choice of menus, and staff often handle raw as well as cooked foods, which creates greater hygiene risks. Lastly, caterers are more likely to be SMEs (Yapp and Fairman, 2004) which find compliance more challenging than larger organisations (see Section 3.2.1).

3.2.3 Access to information

The context and size of the firm are influential in shaping how compliance is addressed (Marlow, 2003) because they affect the levels of resources and

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information used to ensure compliance. It is generally accepted that larger organisations, particularly those operating within safety critical industries (such as construction and heavy engineering), tend to make more use of advice from the HSE and present less of a challenge for this regulator in establishing and maintaining contact as they seek out, require and welcome HSE advice (Lancaster et al., 2001).

There is a proliferation of health and safety literature which specifically addresses the challenges of communicating with SMEs; it appears to be generally accepted that these organisations are „harder to reach‟. Within the food sector, large businesses are likely to have a number of characteristics associated with compliant behaviour which relate to their access to information (Yapp and Fairman, 2004; Lancaster et al., 2001).

Larger dutyholders are more likely to:

■ be represented in working groups tasked with reviewing policies (eg Confederation of British Industries)

■ be members of trade bodies

■ employ specialists in food safety or health and safety

■ have self-assessment and self-regulatory approaches.

Although the literature available to this review does not directly establish a link between the above factors and compliance, there appears to be a widely held assumption that compliance is facilitated by access to appropriate expertise and advice from a range of sources.

In the food sector, the volume of literature received can be an important influence on the compliance among SMEs (Yapp and Fairman, 2004). Over-provision of information can lead to uncertainty and confusion about its applicability, and SMEs also perceive sources of information and support as too generic and aimed at larger organisations.

There is mixed evidence on the role of supply chains as sources of information and influences on safety. Supply chains can exert external influences on organisational health and safety, particularly via the requirements of large contractors (Vickers et al., 2003; Lancaster et al., 2001), and this may relate to the relative power of supply chains in different sectors. Within the food sector, supply chain pressure is argued to be helpful in achieving food safety compliance (Fairman and Yapp, 2005). For example, when clients make health and safety a precondition for their suppliers, this can have a significant impact on the suppliers. Others are less definitive about whether such pressure is actually exerted by large organisations and have raised the possibility (in the context of health and safety in the construction industry) that clients can have an adverse impact on safety by creating cost and schedule based pressures on suppliers (Wright et al., 2004).

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3.2.4 Availability of time and resources

Time

Time constraints are important to consider in gaining an understanding of why businesses do and do not comply (Vickers et al., 2003). A study about the food sector showed that 54 per cent of SME business proprietor participants identified a lack of time as a barrier to food safety compliance (Yapp and Fairman, 2006a). Another study, involving managers from the retail and catering sectors, showed that conditions in the workplace which place an emphasis on getting the job done quickly may contribute to poor hygiene performance (Worsfold and Griffith, 2003a). This is consistent with recent work from non-food related sectors including manufacturing (Gerstenfeld and Roberts, 2000; HSE, 2000; FSA, 2001;1 Stokols, 2001; PACEC, 20042).

SMEs tend to have less available time, and allocate much less time to health and safety than medium enterprises, usually less than one hour a week (Lansdown et al., 2007)3. A recent study of SMEs in the UK retail sector suggests that many proprietors find their existing workloads overwhelming and have difficulty keeping up with paperwork, making it hard to stay up to date with legislative developments (Schmidt et al., 2007). Time pressures also impact negatively on take-up of training through difficulty of releasing staff due to problems finding employees to cover their work (Worsfold and Griffith, 2003a). Time pressures can be an even greater deterrent to compliance than the direct costs of training, particularly where the apparent risk of injury in the workplace is low (Winton, 2003).

A project commissioned by the FSA to identify the main barriers to effective communication with SMEs confirmed that owner/managers found that time pressures were a major issue specifically for small FBO operators (Benson, 2003).

Resources

Evidence suggests that compliance costs SMEs a proportionally greater amount of their income than larger companies, resulting in a disproportionate impact of regulations on their business (Yapp and Fairman, 2004). SMEs may be paying almost six times more (on a per-employee basis) than larger ones on risk assessment (BRE, 2008). This is consistent with findings from a range of areas such as data security and environmental regulation, suggesting that lack of money is one of the main barriers to regulatory compliance among SMEs (Kyobe 2009;

1 Gerstenfeld and Roberts, 2000; HSE, 2000; and FSA, 2001 cited in Yapp and Fairman, 2006a.

2 Cited in Schmidt et al., 2007.

3 This may even overstate SME concern since the sample in this study was biased toward

companies attending a trade event, who are likely to be more knowledgeable, and engaged, through participation in this kind of networking activity.

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Hillary, 1995;1 Yapp and Fairman, 2006a). A study by Yapp and Fairman showed that 20 per cent of SME proprietors identified financial considerations as barriers to compliance (Yapp and Fairman, 2006a).

The cost of newer, safer technologies can be prohibitive and can make it difficult for SMEs to operate some processes, and they may be less likely to operate out of newer premises adequately in terms of health and safety (Vickers et al., 2003). Larger firms benefit from economies of scale: a large HSE survey covering five sectors found that large organisations with more than 5,000 employees spent less per employee on health and safety than smaller organisations (Lancaster et al., 2003). Those firms that do comply are likely to experience proportionate costs or ways of avoiding them. These include situations where firms are able to pass on costs to others, where costs are small relative to benefits and where costs are limited relative to production (Amodu, 2008).This means that SMEs are at a significant financial disadvantage when trying to comply with newly implemented or recently changed legislation (Hillary, 1995;2 Schmidt et al., 2007): and it has been argued that this tends to be designed with larger, more formally structured enterprises in mind (Schmidt et al., ibid).

Financial costs, in terms of investment in monitoring, interpreting and conforming to regulations (Hillary, 19953), are important influences on regulatory compliance among small firms, in addition to costs of equipment and training discussed earlier. Recent work looking at factors influencing SMEs‟ compliance with IT regulations in South Africa found that rural SMEs were more likely to incur high compliance costs (Kyobe, 2009), suggesting certain sub-groups of SMEs may find it more difficult to comply with regulations than others. Problems complying can be exacerbated for SMEs in remote locations due to the geographical challenge of providing these businesses with access to e-products and services (Choudrie et al., 20054).

Management of time and resources

Some form of management or leadership intervention is often cited as key to counteracting the impact that time pressures have on worker behaviour. A study which was carried out to understand the organisational and human factors influencing the health and safety of workers in the construction industry (BOMEL, 2004) concluded that most workers are prone to take short cuts in order to get the work done more quickly and easily, either through „human nature‟ or „management pressures‟. An evidence review examining the role of managerial leadership in determining workplace safety outcomes (across sectors) concluded that performance pressures can lead workers to believe that short-cut behaviour is an

1 Cited in Yapp and Fairman, 2006a.

2 Cited in Yapp and Fairman, 2006a.

3 Cited in Yapp and Fairman, 2006a.

4 Cited in Kyobe, 2009.

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expected or required part of their job (O‟Dea and Flin, 2003), while BOMEL (2004) concluded that in construction, supervision is key in ensuring compliance among workers. BOMEL (2003) drew similar conclusions regarding supervision and its impact on safety culture generally. Without supervision it is believed that many workers will take short cuts, particularly in industries with tough time constraints. This is viewed as detrimental to compliance with health and safety legislation.

A committee inquiry into the Stanley Royd Hospital outbreak in 1984 (Department of Health and Social Security, 1986 cited in Jones et al., 2008a) found that an understaffed kitchen, lack of supervision, and a manager with responsibility, but no power, all contributed to the outbreak of foodborne disease. It was also recognised in the Richmond Report (1991, cited in Jones et al., 2008a) that the catering industry, which is characterised by high staff turnover and the use of casual and part-time staff, required strong management to ensure that staff adhered to food safety control. This is supported in the study by Jones et al. (2008a), who found that businesses associated with foodborne disease outbreaks were more likely to have two tiers of management between the site manager or owner and the kitchen manager, to employ casual staff and to have a relief manager on duty at the time of the outbreak. They were also significantly less likely to have the owner or manager working in the kitchen.

Size of business was also found to be related to likelihood of foodborne outbreaks: smaller SME size and the owner or manager working in the kitchen were both significantly associated with a reduced risk of foodborne disease outbreak.

3.2.5 Technical expertise

Several recent studies have shown a positive association between organisational size and knowledge of regulations (Stokols et al., 2001; Laeeque et al., 20071; Winter and May, 2001). SMEs, particularly shop-based micro businesses, often lack expertise in the technical aspects of product and service provision and associated health and safety implications. This is due to low barriers to entry, no or limited provision of training (Marlow, 2003) and high levels of turnover, which limit the development of knowledge within organisations. These businesses tend to rely on an informally organised network of part-time staff, and local and family support without following formal recruitment processes (Marlow, 2003). As a result, judgements of the competency of workers tend to be based on trust rather than formal assessment. One study showed that recruitment processes for food production and catering tended not to test applicants for knowledge of food hygiene (McKay et al., 2006). SMEs also frequently have high staff turnover (Worsfold and Griffith, 2003a).

As a result of lack of experience, SMEs frequently have a general lack of awareness of many food safety requirements (Yapp and Fairman, 2004; Fairman

1 Cited in Laeeque et al., 2007

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and Yapp, 2005a), and lack the expertise and knowledge to undertake either risk and hazard analysis and assessment (Taylor, 2001; Wright, 19981) or self-regulation (Fairman and Yapp, 2005b). Recent evidence has shown that proprietors in the food sector lack knowledge throughout the compliance decision process (Yapp and Fairman, 2006a) and this is consistent with previous work (FSA, 2001; Taylor, 20012). Furthermore, while a complete absence of expertise may create risks to safety, greater familiarity with, and understanding of, risks may not improve safety; evidence from other sectors suggests that greater length of service and expertise are contributory to risk-taking behaviours and non-compliance (Diaz and Resnick, 2000). This suggests that in some cases experience may result in complacency and assumptions about safety should not be made on this basis.

3.3 Ability to self-regulate

Lack of knowledge is said to have a knock-on effect on poor compliance (Laeeque et al., 20063; May and Wood, 2003) because of lack of understanding of links between poor implementation of regulations and adverse outcomes (Birch et al., 2008). Lack of regulatory knowledge is therefore evident in weak implementation. Based on a large, representative, survey of companies, SMEs were less likely to take action to comply with manual handling regulations than larger companies (Lancaster et al., 2001). Other research demonstrated that small businesses are less likely than large or medium sized businesses to approach risk assessment strategically (Neathey et al., 2006).

Several studies have shown lack of expertise concerning self-regulation in SMEs (Hillary, 2000; ICEAW, 20004).

Large organisations have the capacity both to implement a systems management approach to safety and to self-regulate, as they can put together specialised internal teams, which is seen as conducive to successful self-regulation (Hopkins, 2007). Two studies into the views of HSE inspectors showed that they had greater expectations of management processes and structures in larger businesses, leading to more sophisticated approaches to compliance (O‟Hara et al., 2005). For example, in the agricultural sector inspectors find large farms with management structures are more likely to take up and apply guidance from regulators (BOMEL, 2009).

Lack of management systems and structure is a barrier to compliance in smaller organisations (Palmer and van der Vorst, 1996; Environment Agency, 2000a1).

1 Taylor, 2001; Wright, 1998 cited in Yapp and Fairman, 2006a.

2 FSA, 2001; Taylor, 2001 cited in Yapp and Fairman, 2006a.

3 Cited in Laeeque et al., 2007.

4 Hillary, 2000; ICEAW, 2000 cited in Yapp and Fairman, 2005.

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The absence of this expertise hampers small firms who cannot afford external support (Aalders and Wilthagen, 1997; Dawson et al., 1988; Genn, 19932), despite being subject to the same regime and mechanisms as larger organisations (Fairman and Yapp, 2005a). One study of SMEs in the UK food sector showed that just 16 per cent had effective management systems in place, and most of these employed 50 or more staff (Yapp and Fairman, 2006a). Having the ability to identify necessary systemic changes is key to compliance (Fairman and Yapp, 2005a). Compliant businesses are more likely to show clear lines of responsibility and accountability, the existence of managerial systems and their implementation, the employment of some mechanism of internal audit, and external accreditation.

3.3.1 Role of ethnicity/migrant workers

Ethnicity and nationality is important for food safety compliance in two ways: the ethnicity of owners/managers and the use of migrant workers.

The ethnicity of owners/managers has been identified as an important factor to consider with respect to safety compliance. Ethnic minority businesses were found to perform less well in health and safety management (Vickers et al., 2003), although the authors do not elaborate on the reasons for this. Other influences acknowledged as important by this author include previous management experience, education/skills levels, and gender, with women being more risk aware than men. Enforcement bodies must be conscious of religious and cultural norms, as a failure to understand these can lead to a breakdown of trust between the enforcing body and the business and may lead to a decrease in compliance among these businesses (Gervais, 2007).

The use of migrant workers has implications for health and safety performance. A large-scale qualitative study of the experiences of migrant workers reported a number of factors leading to inferior health and safety outcomes for workers (McKay et al., 2006). These included a limited knowledge of English, resulting in difficulties understanding health and safety training where it was offered; issues with the legality of work status; lack of clarity in perceived responsibilities for health and safety; and the economic motivations of migrants to earn as much money as possible in a short space of time, leading to long working hours with detrimental attention to risks. Further issues regarding training and ethnicity are presented in Section 3.4.4.

There are an increasingly large number of ethnic minority food businesses in the UK whose owners and employees do not have English as their first language. In

1 Palmer and van der Vorst, 1996; Environment Agency, 2000a cited in Yapp and Fairman, 2006.

2 Aalders and Wilthaden, 1997; Dawson et al., 1988; Genn, 1993 cited in Yapp and Fairman,

2005.

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addition to the interpretation issues this presents, many are not literate in their first language (Benson, 2003). These populations may miss out altogether on health and safety information, even when enforcing bodies provide translated versions. The overall impact of poor literacy on compliance is unknown but is likely to be negative.

3.4 Behaviours

A range of behaviours and activities have been identified in the literature as influencing compliance, although their impact is not generally quantified and more often discussed in relation to single, non food-related, sectors.

It is important to consider behaviours because there is direct evidence that demonstrating compliant behaviours is a major factor in controlling foodborne illnesses. Indeed food handlers‟ malpractice has been shown to contribute to 97 per cent of foodborne illness in the UK (Howes et al., 1996 cited in Worsfold and Griffith, 2003a). Guzewich and Ross (1999, cited in Gililand and Manning, 2002) state that the majority of recorded outbreaks could be prevented if restaurants complied with existing food safety regulations.

3.4.1 Management approach

The literature is clear that the approach of management is an important motivator of compliance behaviours. Senior management support for health and safety processes, for example, is vital for risk assessment to be taken seriously by staff (Neathey et al., 2006). An evidence review conducted for the HSE found that decisions made at senior level affect the priorities, attitudes and behaviours of managers and staff throughout the organisation, and in particular the emphasis that is placed on the competing values of safety and productivity (O‟Dea and Flin, 2003).

Mullen (2009) found that factors reported to influence the success of business management also generally influenced the success of health and safety management. Four factors have negative impacts on health and safety but positive impacts on business performance, although there were mixed views among experts on them. The factors were:

■ organisation operates in a market with intense competition from rivals

■ adoption of management philosophies such as lean production and just in time

■ organisation uses flexible employment practices to allow it to adjust staffing levels rapidly in response to fluctuations in demand

■ organisation gives rewards linked to individual productivity/profitability targets.

Managers do not always have the opportunity to reward appropriately or apply sanctions, and may, therefore, have limited ability to influence compliance directly. Willbourn (2009) found that sanctions were difficult to apply in the construction industry due to difficulties recruiting other skilled staff, closeness of working

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relationships in small companies and the influence of peer pressure (both positive and negative) from co-workers/managers/supervisors. It is often, therefore, unlikely that managers will sack employees for minor health and safety infringements. The same study identified a typology of management styles with regard to health and safety within construction. These were:

■ „Duckers and Divers‟ who pay lip service towards health and safety rather than being compliant

■ „Confident Captains‟ whose interest in compliance is curtailed by time and cost. They believe they run a safe site and were strict about the regulations they deemed to matter. They comply in so far as they agree with the HSE or feel coerced

■ „Ex-Big Site Conformists‟ who discuss doing method statements and creating paper trails. They are conscious of a compensation culture and comply because they feel visible.

Supervisory-level intervention as well as senior management can help to promote compliance behaviours. Hughson et al. (2002) identified the importance of supervision in ensuring compliance in a study focusing on use of hearing protection among individuals working in high-noise-level workplaces. Construction site managers are reported to pay most attention to rules which are enforced with strict (internal) sanctions (Willbourn, 2009). However, supervision needs to be accurate to have a positive effect. For example, a study of cleaners‟ roles in preventing slip accidents found that they simply followed instructions even when these led to ineffective cleaning (Hallas and Shaw, 2005). There was a lack of understanding of effective cleaning processes among cleaning staff, who could not identify most suitable cleaning products for different situations.

As a result of his/her constant presence and decision-making role, the chef is pivotal in establishing the climate and culture of safety in the hospitality industry according to a qualitative study (Howard and Galbraith, 2004a). In organisations where the chef had a positive attitude to safety, safety culture was good. Where the chef‟s attitude to safety was poor, safety culture was poor, even where more senior managers had a positive attitude. In organisations where safety culture was found to be excellent, although this came from senior managers, it was only passed down by appointing and retaining chefs who themselves shared a positive safety attitude. If enforcement agencies are to maximise concordance with hospitality businesses, it was suggested they must appreciate and recognise the special role of the chef in kitchen workplaces, especially in determining the safety climate. The authors concluded from this that the hospitality sector may require a tailored approach to enforcement if compliance strategies are to be optimised.

Safety is also, however, the result of more complex interactions between strong management and the application of systems and procedures which they introduce. An HSE evidence review (Bell and Healey, 2006) concluded that the majority of major accidents stem from „a complex chain of events, including organisational policies and decisions, individual behaviours and mechanical or technological failures that, when combined, resulted in the incident‟. Hazard analysis therefore

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requires a systems management approach (Fairman and Yapp, 2005a) which may not be present within some businesses.

In general, SMEs seem less well placed to promote positive safety behaviours due to a range of specific characteristics. Vickers et al., 2003 found that SMEs‟ organisational culture involves less formal approaches to management and close employer/employee relationships, which make it more difficult for managers to discipline or sack staff for not complying with health and safety regulations. They also found that some small business managers found it difficult to persuade their employees to observe safe practice and could find it impossible to provide a constant supervisory presence on all sites. Given the preponderance of SMEs in the food industry, these limitations are important to note.

3.4.2 Understanding how to comply

Whether managers and staff comply with legislation is also related to the extent to which they understand and respond to the requirements that the legislation places on them. Several studies (Coleman et al., 2000 cited in Worsfold et al, 2004; Worsfold and Griffiths, 2003a) have reported that food managers generally hold positive attitudes toward food safety, but the authors raise doubts about the ability of managers to implement adequate food safety controls.

Vickers et al. (2003) reported that HSE Inspectors described health and safety awareness and practices in small businesses ranging from excellent to very poor with the smallest businesses tending to be the poorest, notably with respect to systems, policies and documentation. SMEs also tended to have a low awareness of specific pieces of health and safety legislation, but this did not necessarily mean that they did not comply. There was a relationship identified between the size of the business and the adoption of health and safety management and improvement measures, with smaller businesses less likely to do so.

In their study of SMEs in the food sector, Fairman and Yapp (2005a) found that though very few organisations deliberately and knowingly chose to violate regulations, the most common response to requirements they did not understand (see Section 3.2.5 on technical expertise) was to ignore them. This was exacerbated by two factors: first, some of the requirements were perceived as irrelevant, excessive or not being aimed at the prevention of foodborne illness; and second, none of the participating SMEs were proactive in seeking, identifying, interpreting or applying information about food safety regulations, though they were more proactive about meeting requirements specifically required of them as the result of an inspection. A study examining small businesses‟ compliance with manual handling operations regulations (Addison and Burgess, 2002) found that 30 of the 80 companies sampled claimed they had never heard of manual handling operations regulations, with most of the remaining businesses stating they had gained their knowledge of legislation via HSE publications.

This is consistent with findings from other countries. Kyobe (2009) found that SMEs in the IT sector in South Africa made limited efforts to develop compliance policies, while Fairman and Yapp (2005a) concluded that the prescriptive requirements of food safety law were comparatively easy for SMEs to understand

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and make sense of, but the self-regulatory requirement of implementing hazard analysis was difficult for them to understand. The latter point was often because they did not use or agree with the terminology. Many SMEs ignored requirements as they could not see how their businesses could be „high risk‟.

Even where businesses feel that they understand their legal requirements, they may not be able to take appropriate actions to ensure compliance without help. Research conducted before the introduction of FSA‟s „Safer food, better business‟ programme showed that while managers of small fast food businesses were confident of their hygiene management systems, many had a very incomplete picture of the requirements of a hygiene management system (Worsfold, 2006). Also a fully documented HACCP system was construed by most as the keeping of temperature control records. (It is important to note, however, that the legal requirement for documented HACCP for food businesses of this type did not take effect until 2006.) In addition, few had secured formal hygiene training for their staff and, while most claimed to have a very good knowledge of the rules of personal hygiene essential for staff, few provided written rules or maintained sickness records. This is consistent with earlier work from a study of caterers‟ perceptions of HACCP (Worsfold and Griffith, 2003a) which found that, while participants were not hostile to the adoption of HACCP, they were uncertain about whether the benefits would outweigh the costs, and were critical of information that was too generalised, wanting specifically targeted and tailored information for their businesses‟ needs which was prescriptive (ie telling them explicitly and concisely how to comply).

One study specifically examined HACCP and found that there were serious concerns around its implementation, mainly in the perceived differences in compliance between similar businesses and countries (Romano et al., 2005). This can be particularly problematic for those businesses that have multiple sites which are differentially assessed.

3.4.3 Shared responsibility/co-operation and communication

Management, or senior staff, attitudes to health and safety appear to play a major role in shaping the attitudes of more junior staff, but worker involvement in health and safety is also strongly advocated throughout the literature. In a series of case studies focusing on larger organisations with at least 150 employees, Poxon (2007) identified worker involvement to promote shared responsibility as key to creating an effective health and safety culture which resulted in compliance and effective assessment of risks. This is consistent with earlier work suggesting that greater efforts are needed to broaden employees‟ opportunities for direct participation in the design and implementation of programmes and policies to enhance compliance with health and safety regulations (Heaney et al., 1993 cited in Stokols, 2001). Fooks and Rigby (2007) also found strong evidence to suggest that genuine worker participation can have a significant impact on occupational health and safety. This leads to questions about the best forms of communication and involvement.

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Using multiple sources of communication about risk and compliance is important. Recent work from France, for example, has focused on compliance with barrier precautions to control MRSA and suggests that information campaigns (for example, flyers on payrolls (Robert et al., 2006 cited in Eveillard et al., 2007)) might improve compliance (Eveillard et al., 2007).

Use of „multimodal‟ feedback (ie multiple channels to provide performance feedback) in two intensive care units was assessed in one study (Assanasen et al., 2008). The authors conclude that the production of multimodal feedback significantly improved performance on a range of measures, including hand washing, in the intensive care units being studied. Feedback via local management was largely ineffective, but discussion of health care-associated infections data by local leaders in conjunction with process measure compliance and direct feedback via posters, underscored the importance of compliance with infection control process measures. The authors note that hand hygiene is a complicated behaviour with many barriers for non-compliance and as such, multilevel and/or multifaceted interventions may be more effective than a single approach to change behaviour.

The idea of multiple feedback is supported by another study examining compliance with infection control practices in intensive care units (Berhe et al., 2006). Administrative, system-level measures showed a significant improvement in compliance following measurement and feedback. However, they acknowledge that those measures which required behavioural interventions, such as hand hygiene, did not change.

3.4.4 Training provision within organisations

Several articles consider the role of training in compliance, but the findings are inconclusive, although training is an important issue for the food industry. In 100 reported food poisoning outbreaks in Ireland, for example, the vast majority were attributed to inadequately trained staff (Food Safety Authority of Ireland, 2001 cited in Worsfold and Griffith, 2003a). The FSA estimate that 45 per cent of food handlers have not yet been trained and that staff turnover in the catering sector may be as high as 50-100 per cent on a regular basis (Power, 2002 cited in Worsfold and Griffith, 2003a). This is consistent with a recent survey of manufacturing, retail and catering food businesses, suggesting that under 20 per cent of managers were trained to supervisory level. This might make it difficult for them to design and implement appropriate hazard analysis systems. Additionally, only 31 per cent of managers had received HACCP training and this training had not been extended to the workforce (Morlock et al., 2000 cited in Worsfold and Griffith, 2003a).

Conversely, another study found that businesses associated with foodborne outbreaks were as likely to have staff with formal food hygiene training as other businesses and that they were no less likely to use HACCP systems either formally or informally (Jones et al., 2008a). This study found that training was actually negatively associated with outbreaks in some analyses, although they note that it is unlikely that food hygiene itself is detrimental. This could indicate

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greater risks caused by complacency among trained staff. A number of studies echo the sentiment (Bower and Davies, 1976; Cook and Casey, 1979; Julian, 1984 all cited in Worsfold and Griffith, 2003a) that although training may bring about an increased knowledge of food safety, this does not necessarily result in a positive change in food safety behaviour.

A study undertaken in the US showed that there was no difference in the training offered to food handlers in outbreak compared to non-outbreak restaurants (Hedberg et al., 2006 cited in Jones et al., 2008a). An investigation into a large restaurant outbreak of salmonellosis (Luby et al., 1993 cited in Jones et al., 2008a), for example, showed that both managers and staff had recently undergone food hygiene training. This raises questions about the efficacy of training, and suggests other factors may be more important. The authors suggest that knowledge of food hygiene has less impact on food safety controls, and as a consequence on the risk of foodborne disease outbreaks, than do commercial pressures (Powell et al., 1997 cited in Jones et al., 2008a).

Food hygiene training appears ineffective in isolation, since it must be supported by commitment, motivation and management supervision (Committee on the Microbiological Safety of Food, 1991; Taylor, 1996; Worsfold et al., 2004 cited in Jones et al., 2008a). A study to improve compliance with health and safety practices in the solarium industry found that an industry-led self-education programme had mixed results. When part of their cross-sectional data was analysed it was evident that the programme had promoted increased compliance in some areas, but not in others (Paul et al., 2009). The authors suggest that higher levels of compliance in metropolitan areas may be related to the greater level of demand or competition in the metropolitan environment.

Studies of the impact of hygiene training specifically have shown that, before training, knowledge of risks, hazards and risk management systems is generally low (Worsfold and Griffith, 2003a; Worsfold, 2006). This research shows it is important to minimise jargon and confusing terms, particularly where English may not be the first language and where there is little previous experience of hygiene training, and to keep information concise, prescriptive and targeted to the business‟ needs (Worsfold and Griffith, 2003a; Worsfold, 2006). However, there is some evidence that, regardless of organisation size, training is associated with consequent improvements in knowledge levels, (Stokols et al., 2001) although the association with improved compliance is not stated.

Worsfold et al. (2004) suggest that trainees‟ beliefs regarding the opportunities to practice the skills or use the knowledge acquired in training programmes, and the extent to which they received reinforcement and feedback from supervisors and peers, are particularly important in influencing the impact of training on behaviours. If motivation to learn is low, then behaviour change and performance is less likely to occur, but if reinforcement is encouraged and rehearsal of skills is emphasised in on-the-job training, there is greater probability of behaviour change and improved performance. Support from supervisors or managers and the organisational climate have also been identified as key variables that may influence the transfer of training (Baldwin and Ford, 1988 cited in Worsfold et al., 2004).

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The duration for which training has an impact is uncertain and there is some suggestion that regular updates are needed to ensure compliance. A survey of food hygiene and safety training in the retail and catering industry suggested that training was generally seen as a one-off activity and in most businesses refresher training was neither planned nor implemented, while any induction training was largely unstructured, informal and conducted on-the-job, and often covered personal hygiene and dress but not personal health (Worsfold and Griffith, 2003a). Although managers appear to value training and believe that staff who have been trained have better attitudes to food hygiene (Coleman et al., 2000 cited in Worsfold and Griffith, 2003a), about one-third thought that this effect was short-lived (Worsfold and Griffith, 2003a).There was also recognition that senior staff could only encourage appropriate attitudes and behaviour in operational staff if they have been adequately trained themselves. A „general lack of satisfactory hygiene management systems‟ in the catering sector was linked to a „lack of appropriate training for senior staff‟ (Worsfold and Griffith, 2003a). It should be noted, however, that this research was undertaken before the legal requirement to implement documented food safety management procedures based on HACCP within small catering outlets took effect in 2006. It also pre-dates the introduction of the FSA‟s „Safer food, better business‟ initiative and accompanying training provided by local authorities.

Barriers to training included costs, particularly for small businesses (Worsfold and Griffith, 2003a; Worsfold et al., 2004; Yapp and Fairman, 2006a), high staff turnover and the perception that training was not integral to the business (Yapp and Fairman, 2006a; see also Worsfold and Griffith, 2003a).

Research findings suggest that the employees from an ethnic background experience additional barriers in terms of training. In a large-scale qualitative study for the HSE, more than one-third of migrant workers stated they had received no health and safety training (McKay et al., 2006). Because migrant workers may be entering jobs without previous experience, their knowledge of health and safety risks was often limited. The literature also shows there to be blurred lines of responsibility for health and safety between recruitment agencies and employers, with each feeling it was the other‟s responsibility. As a result, some workers were handling food products without an awareness of the steps they needed to take to avoid contamination. The authors recommended that the HSE should produce relevant written materials targeted at staff in organisations with large numbers of migrant workers. This suggestion, however, needs to be considered in the light of uncertainty regarding the level of literacy of some non-English speaking workers.

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4 Organisational Culture

Chapter summary

■ Safety culture is important in reducing non-compliant behaviour and ensuring that

relevant management systems are operationalised. Managers in particular and staff

at all levels have a role to play in promoting effective safety culture.

■ Dutyholders tend to understand compliance as a more passive process than

regulatory bodies, and are often reliant on inspectors to assess their degree of

compliance, rather than undertaking self-assessment.

■ A lack of proactive motivation may be linked to a perception, particularly related to

food safety, that legislative requirements are largely irrelevant and that compliance

will not actually improve safety standards.

■ Where risks are seen as „rare‟, or the consequences of exposure are not

immediately visible, this can also affect how seriously they are taken. Involving

workers in the design of risk control measures can be effective in encouraging their

co-operation.

■ Dutyholders are more likely to comply when they perceive the regulatory regime as

fair, trusted and co-operative, although sanctions are still needed to back up co-

operation. Fear of prosecution is a key driver of behaviour.

■ Self-regulation aspects of food safety law have been demonstrated as difficult for

SMEs. Furthermore, SMEs may operate what they believe to be compliant systems,

but only implement some aspects of what is required.

■ Specific, targeted, information which sets out explicitly and concisely how to comply

is welcomed, as exemplified by the approach of FSA‟s „Safer food, better business‟

programme of work.

■ The underlying motivations for businesses to comply are complex, but the evidence

suggests that views on the costs of compliance, the fears of deterrents, reputational

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damage caused by non-compliance, a sense of duty and acceptance/trust in the

system all play a role.

4.1 Introduction

The purpose of this review was to investigate food safety culture and behaviours in businesses and enforcement bodies. This chapter examines the available evidence on the role of organisational culture and attitudes in promoting compliant behaviours, and motivations to comply.

It is important to bear in mind that some of the characteristics discussed in the preceding chapter are linked with organisational culture. Company size is one example of this: the work culture of a large corporate organisation will generally be different to that of an SME as a consequence of its different size and organisational structure. Although this report presents the impact of the former and the latter on compliance separately, in practice it is difficult to separate the contribution of each.

4.2 The role of culture

Culture is formed from the collection of traditions, values, policies, beliefs and attitudes that prevail in an organisation (Worsfold and Griffith, 2003), with every group of people developing a culture comprising shared attitudes, beliefs and ways of behaving (HSE, 20091). Although there is still much debate about definitions of culture, HSE (2009) have defined „good‟ organisational safety culture as one where there are „shared, accurate perceptions of risks and everyone adopts the same positive attitudes to health and safety‟.

Culture is defined by the Pennington Inquiry report as:

„A manifestation of the values and beliefs and attitudes within a workforce. Its formation is dependent upon the knowledge, standards, motivation and leadership of the person in charge, how they communicate with, and are trusted by, the staff.‟

(Section 6.1.1.12)

Rather than explore these different definitions in detail or constraining the review process by a precise definition, this chapter simply focuses on the review literature (ie papers yielded by the search and sift process) where a link has been made between compliance and culture. Taking a lead from the above definition, we also explicitly address the role of beliefs and attitudes in compliance.

1 HSE, 2009. Reducing error and influencing behaviour (HSG48). HSE Books

2 www.food.gov.uk/multimedia/pdfs/committee/mhpf180503.pdf

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4.2.1 Safety culture

While safety cultures are acknowledged as important in the literature reviewed, there is little evidence on how they are cultivated and what they look like in practice. Good culture can sometimes serve to counteract the negative behaviours of individuals, and the development of a safety culture is now a requirement in certain industrial sectors such as the Norwegian petroleum sector (Hopkins, 2007). The importance of safety culture was highlighted in a number of studies (especially in the construction sector), but there was little evidence about what it means to have a safety culture and how one can best be cultivated, according to a review for the HSE (Cox et al., 2008). Another HSE literature review concluded that the underlying causes of accidents are similar across the major hazard industries and that many are symptomatic of a poor safety culture (Bell and Healey, 2006). Others have suggested that safety management systems are too often little more than „sets of manuals on shelves‟ (Reason, 2000, cited in Hopkins, 2007) and safety culture is needed to breathe life into such systems (Hopkins 2005, cited in Hopkins, 2007).

Managers have a pivotal role in promoting a positive safety culture, and leadership is considered to have a considerable impact on moulding the behaviour of employees. Without a „tangibly observable commitment to safety‟ from managers, employees are likely to view management support for health and safety as „perfunctory‟ and imply that non-compliance is acceptable (Howard and Galbraith, 2004a).

A study examining the impact of an intervention on compliance with infection control guidelines and practice in nursing homes found that the outcome variables, including hand hygiene, were more related to local management support than other features of the intervention (Gopal Rao et al., 2009). Similarly, Stokols et al. (2001) suggest that a lack of upper management commitment can reduce corporate compliance. In the food sector this can manifest as a difficulty transferring a generally positive attitude to specific food-handling procedures. For example, where managers value fast customer service or saving money more highly than hygiene, employees may regard good food safety practice as too time-consuming or inconvenient (Coleman et al., 2000, cited in Worsfold and Griffith, 2003a).

There is also evidence that other staff within the business have a role to play in building a strong safety culture. Board level involvement (Buchanan and Robertson, 2009) as well as peer support (Gezelius, 2002) have also been shown to maintain good standards and sustained compliance. Employees‟ perception of management commitment to safety is also reported to be influential in proffering a positive attitude to safety compliance (Diaz and Resnick, 2000). Qualitative and survey work with SME owners and managers and health and safety inspectors found organisational culture to be a major influence on health and safety performance (Vickers et al., 2003). One reason for this is that safety culture can also be important in limiting the risks from individuals who lack expertise. A large-scale survey of workers employed in diving and offshore industries concluded „where there is a worker with low competency…a good safety culture would

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ensure that the dangers associated with lower competency are minimised through communication and risk assessment‟ (Osman et al., 2003).

4.2.2 Other facets of culture

Cultural issues are extremely important in understanding what drives organisations to compliant behaviours, although these need not be limited to the safety culture of the organisation. This includes factors such as perceptions of fairness, legitimacy and moral norms which manifest through peer (dis)approval and this has implications for good practice by involving those subjected to legislation in its development.

Social factors such as morality, peer involvement and the threat of social disapproval are all influential in terms of compliance with the law (Friedland et al., 1973; Silberman, 1976; Meier and Johnson, 1977; Grasmich and Green, 1980; Paternoster et al., 1983; Tyler, 1990 cited in Gezelius 2002). These factors serve to bring about compliance where there is a desire to behave in a way that is socially or morally acceptable to others (although the authors do not specify the circumstances in which these factors are/are not applicable). A study of compliance in US fisheries (Randall, 2004) suggests influences affecting compliance behaviour can be understood as „normative‟.

„Fairness‟ or legitimacy (the extent to which workers view regulations positively or agree with them) is a particularly important concept in explaining compliance. People are more willing to co-operate when they believe that the underlying laws or values are legitimate, and this may be more likely to be achieved when people are involved in forming those principles. A HSE study recognised the importance of involving workers and their representatives in decisions about control measures (Buchanan and Robertson, 2009). Procedural justice is important for nurturing compliance when people questioned the legitimacy of the laws they were requested to uphold (Murphy et al., 2009). Procedural justice is inherently intertwined with people‟s moral and ethical values (Leventhal, 1980 cited in Murphy, 2009).

4.3 Attitudes and perceptions

Behaviour is governed by a number of variables as well as the law itself, including attitudes towards regulation (and those who enforce it). From the definition provided by the Pennington Inquiry (see Section 4.2), it is clear that attitudes and perceptions drive both organisational culture and behaviours. It is important, therefore, to consider the literature relating to attitudes and perceptions before behaviours themselves are discussed.

4.3.1 Attitudes to risk

Risk perception is regarded as an important determinant of safety behaviour and as a major influence on compliance. Knowledge about risks is an important factor in risk perception and is therefore a consideration when understanding the potential causes of non-compliance.

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The known history of incidents within a given industry, or within a particular organisation, is likely to impact on risk perception. In the catering industry, where major disease outbreaks are relatively rare, there is a documented tendency for high-risk organisations to believe that there is a low risk of their products poisoning customers (Worsfold and Griffith, 2003a). Indeed, some in the industry see hygiene as significant only when things go wrong, and view issues of food hygiene, such as cleanliness and temperature control of food, in terms of aesthetics rather than food safety (Guierrier et al., 1992 cited in Worsfold and Griffith, 2003a)

The concept of risk perception is important across industry more generally. For example, work carried out to examine use of personal protective equipment (PPE) in the nuclear industry suggests that uninformed or inappropriate attitudes to physiological risks can result in lesser weight being given to their importance (Frost and Mogridge, 2008). Work with the construction industry has shown that lack of knowledge of a physiological risk is likely to result in less weight being given to its importance, and immediacy of risk heightens its salience. When consequences are remote in time (eg respiratory problems in later life compared with an imminent fall from height), workers are less likely to comply with regulations (Greenstreet Berman, 2009). Degree of prominence of risk also affects the extent to which dutyholders attempt to control risks. Generally, dutyholders seem to focus on the „obvious‟ risks that will have some kind of major impact, particularly to customers or the general public (eg in kitchens there is more concern about food safety which could affect customers than about occupational health and safety) (Howard and Galbraith, 2004a). Hairdressers were also found to focus more on the potential for slips and trips affecting customers (wet floors, trailing wires etc.) than the occupational health risks to their staff (Elgood et al., 2004).

Attitudes to risk vary even within the same workplace and are shaped by personal characteristics. In an interview study to explore attitudes towards working with asbestos safely among maintenance workers (O„Regan et al., 2007), a range of attitudes were found to influence behaviour in relation to risk control. Some workers felt that taking a stand about safe behaviour was not worth losing their job over, and some could feel pressurised into taking a job that had risk because of the economic returns of doing so. Others reported that the attitude of their employer to risk shaped their own behaviour. A „macho culture‟, (a stereotypical concept which tends to be applied to employers and employees working in male-dominated heavy industries) is widely reported to have a negative effect on safe behaviour and applies to situations such as working at height in construction where attitudes are described as „deeply ingrained‟ (Oliver et al., 2007). Hughson et al. (2002) also found that the understanding of the attitudes and behaviour of workers towards hearing protection was affected by culture, gender stereotypes, and peer pressure and that these influences may counteract management influence (either positively or negatively). For example, if an individual employee‟s peers use hearing protection, he/she is more inclined to use similar protection, even when managers fail to adequately promote good health and safety practices. On the other hand, if there is peer pressure not to use hearing protection, this might undermine even well-designed management health and safety interventions.

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The implications of these findings are that messages concerning risk need careful tailoring to specific sectors, in order to take account of the prevailing culture, and demographic characteristics of workers, in order to ensure the most salient and pressing arguments to change behaviours are used. This supports FSA‟s use of social marketing techniques in the development of specific hygiene messages and health education interventions for particular audiences.1

4.3.2 Attitudes towards compliance

SME passivity in compliance

There is an important distinction which emerges from the literature which highlights differences in the perceptions of what compliance means among businesses and within regulatory bodies.

The enforcing agency‟s concept of compliance is a „continual, evaluative process of business operation‟ (Yapp and Fairman, 2006a) but this is different from organisational understanding. Fairman and Yapp (2005b) found that SMEs within the food industry conceptualise compliance as:

■ „the negotiated outcome of the regulatory encounter‟ which leads to „heavily reactive decision making in which the enforcer is the predominant driver‟

■ „doing everything that had been asked of them at the previous inspection and that once this was done they were compliant‟

■ „negotiated with the inspector at a particular point in time‟

■ a process of negotiation with the inspector in which knowledge of the regulations was unimportant

■ a way to protect their business and reputation, rather than as a moral issue.

They conclude that this conceptualisation may „promote reliance on the inspector, with the responsibility for assessing compliance seen as the inspector‟s and not the SME‟s‟. This stance is arguably detrimental to sustained compliance which requires adherence to risk control procedures on a daily basis and aspects of compliance that require a proactive approach, such as conducting risk assessments independently from inspection advice. An earlier study concluded that one of the main barriers preventing food safety compliance in SMEs was a reactive attitude in dealing with food safety which led to a lack of motivation to comply (Yapp and Fairman, 2004).

Similar research identified that over two-thirds of SME food proprietors were totally dependent on external agencies in terms of identification, interpretation, and application of the legislation for their business, with visits from the enforcing body

1 For an example of this see: www.food.gov.uk/news/newsarchive/2009/may/enforcementcourse

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acting as their primary source of information, and responsibility for identifying non-compliance seen as part of the role of the enforcing body (Yapp and Fairman, 2006a). The authors suggest that SMEs‟ reactive approach was in part a result of their perception that many of the requirements were irrelevant to food safety and that implementing them would not improve their organisation‟s safety levels. This was further reinforced by low levels of motivation, knowledge, trust and management systems. As a result, a minority of UK food sector SMEs in this study had implemented written self-regulation documentation, and all of those with their own documentation had received external help to prepare it, often from an inspector. The authors go on to point out that this help frequently took the form of re-packaging the HACCP plan in a prescriptive „checklist‟ form. This, they argue, changes the emphasis away from self-regulation and consequently increases SME reliance on the enforcing agency, with responsibility for hazard analysis lying with the inspector rather than the SME. Similarly, Kyobe (2009) reported that the majority of SMEs (in a study of compliance in the IT sector in South Africa) were not proactive with regard to compliance, with few planning systems, allocating sufficient resources, training staff regularly or developing policies. This is further evidence of the „reactive response to regulation‟ among many SMEs identified by Yapp and Fairman (2004).

Overall, there is limited evidence that SMEs can be encouraged to be proactive about health and safety, since they are most typically portrayed as entirely reactive to inspections. In some cases SMEs might also come under pressure to comply from bodies that are not regulators, eg supply chain pressure, insurance requirements or from other public bodies such as training colleges. These external influences can serve as additional drivers for compliance (Fairman & Yapp 2005b).

Management attitude to risk

McMahon et al. (2006) conducted a series of case studies concerning factors that motivate Boards of Directors to give strong leadership on health and safety policy at board level. The motivating factors include:

■ a wish to be socially responsible

■ the perception of health and safety as a significant corporate risk

■ the need to respond to health and safety legislation

■ improved productivity from better health and safety.

For the food sector, motivations appear to derive from avoidance of penalties rather than gaining positive benefits. A quarter of caterers agreed the main reason for complying with the legislation was fear of prosecution, although 96 per cent of respondents believed that compliance with legislation would also make them feel more confident about food safety (Coleman et al., 2000 cited in Worsfold and Griffith, 2003b). However, research conducted by Guerrier et al., 1992 (cited in Worsfold and Griffith, 2003b) showed that managers and supervisors from the catering industry believe that food hygiene is significant only when something goes wrong. Similarly, and more broadly across industry, fear of adverse publicity can

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encourage compliance because in some cases businesses fear bad publicity more than they fear the law (Amodu, 2008).

Managers are found to make variable interpretations of the value of compliance, linked to calculated assessments of costs and benefits. Wilbourn (2009) studied construction managers, examining reasons for compliance, and found that participants often resented and rejected compliance because they believed that it was insufficiently context sensitive, and could be impractical. Managers were therefore felt to „make a deliberate choice about their degree of compliance based on their own assessment of risk and of the benefits and dis-benefits of compliance‟. Managers identified instances when non-compliance was acceptable, making a judgement of the specific situation based on the costs, time taken, proximity to job completion, the degree of inconvenience of mitigation, and the availability of PPE and other risk protection measures.

Findings from the UK retail sector suggest that SMEs did not always understand the point of rules, so that applying them was seen as creating more inconvenience than benefit (Schmidt et al., 2007). A recent small-scale study from France, which focused on compliance with barrier precautions to control MRSA found that the materials necessary for compliance (alcohol-based solutions, and disposable gloves and gowns) were not always available (Eveillard et al., 2007). The presence or absence of the physical means of compliance may be important determining factors.

This variability in interpretation of, and attitudes to, compliance can lead to misunderstanding of what constitutes compliance. Many organisations believe they are already compliant regardless of whether they are (in the eyes of the regulator) or not (Fairman and Yapp, 2005b). Worryingly, SMEs believed that their own businesses complied even where the researcher identified extensive breaches of food safety law (Yapp and Fairman, 2005b). Where non-compliance had been identified, SMEs generally did not feel that these were serious issues warranting formal enforcement action, leading to a lack of motivation to take action. Winton‟s (2003) survey of employers addressing compliance with First Aid Regulations noted that many employers achieved only partial compliance despite „the wide appreciation of the value of first aid‟.

Coincidence of interests between regulator and regulated organisations can help compliance. Where employers see an alignment of interests between business and the public interest, compliance is more likely and voluntary compliance is a possibility (Amodu, 2008). For example, where a business believes that causing environmental damage might harm its reputation, it is more likely to comply with environmental regulation. Where there is a convergence of interests between several businesses, there is also the possibility of developing collective interest and self-regulation. This may happen if a) customers choose between companies in an industry on the basis of their compliance record, eg within a national food hygiene rating scheme, or b) if non-compliance of one business in an industry has negative knock-on effects for the whole industry (Amodu, ibid.).

Lastly, a study of (individual) compliance with two different laws in the Netherlands found that the particular determinants of non-compliance for a given law were, in

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part, law-dependent, suggesting that different approaches to encouraging compliance may be needed in different contexts (Elffers et al., 2003). The study compares non-compliance with two different laws: the law on individual rent subsidies (LRS – a form of housing benefit paid when rent exceeds a certain proportion of taxable income) and the law on agricultural chemicals (a law covering what chemicals farmers can use and when and how they can use them). In the former case increasing the likelihood of being caught and reducing the benefits of non-compliance are likely to reduce non-compliance; however, in the latter case non-compliance could be reduced both by increasing the social stigma associated with non-compliance and reducing the benefits of non-compliance.

4.3.3 Attitude towards the regulator

The evidence suggests that perceptions of, and attitudes towards, regulatory bodies are also important considerations in understanding compliance. Literature reviewed by Amodu (2008) suggests compliance may vary across different regulatory regimes where perceived immediate and significant risks take precedence over long-term ones. For example, firms may comply with safety regulations to prevent accidents but may be less concerned about occupational health.

The „visibility and tangibility‟ of hazards which might cause accidents is often higher than hazards which may result in a risk to public health – it is fairly easy to spot a trailing wire or a slippery floor. Also the „visibility of default‟ is higher – when someone trips at work, the cause tends to be clear (ie a health and safety failure). Occupational diseases may be acquired over time, without the individual or their employer realising that the cause arises from a work context. So for example, many hairdressers contract dermatitis but do not make the connection with exposure to chemicals at work (Fairman & Yapp, 2005b).

Perceptions of regulators can vary and, with these, the likelihood of compliance. An evidence review focusing on standards in the UK waste industry found that the two main regulators, HSE and the Environment Agency, were viewed differently (BOMEL, 2004). The HSE was considered to be promoting improvements in culture and providing good advice. In contrast, some of the requirements of the Environment Agency were regarded as potentially detrimental to health and safety. Similarly, Yapp and Fairman (2004) concluded that one of the main barriers preventing food safety compliance in SMEs was a lack of trust in the EHPs and their requirements. However, making these conclusions must be treated with caution because companies experience confusion in distinguishing between different regulators (BRE, 2008).

Trust and confidence are used as ways of framing and expressing attitudes to regulators, but may conceal fundamentally different understandings of compliance. A study of construction site managers found they believed that HSE did not apply judgement or common sense, but applied fixed rules to every situation regardless of context or the relationship between the workers doing the task. This led to black and white judgement of practice being either right if compliant with rules or wrong if not compliant (Willbourn, 2009). In contrast, respondents‟ perceptions of safe

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and unsafe practice covered a wide range of categories, ranging from unsafe, taking caution, safe, to excessive. This meant that they might judge both compliant and non-compliant behaviours as safe. One study of the effect of differing enforcement styles on compliance in the US construction sector found that 68 per cent of respondents cited inconsistencies in inspectors‟ behaviours as „somewhat‟ to „very‟, constraining their ability to comply (May and Wood, 2003). The authors noted that the dutyholders generally preferred to have a single inspector assigned for the course of a construction project. This is understandable as it could potentially lead to greater perceived consistency in decisions and the opportunity to build up trust between the inspector and the managers.

In a qualitative study of health and safety behaviour within the hospitality industry (Howard and Galbraith, 2004a) the authors found that the approach taken by enforcement bodies (in this case the HSE and local authorities) during inspections was an important factor. Parallels were drawn between views on inspecting bodies and shared views among kitchen staff, namely the prime importance of food quality and its production above any other objective, including health and safety. Indeed, it was suggested that the bias towards emphasising food safety over more general health and safety matters was informally institutionalised within the guidelines for inspecting food-producing premises.

Lastly, fear of the regulator may carry an important symbolic function, even if this does not actually result in uniform and widespread compliance. SMEs in the food sector displayed a generalised fear of formal enforcement action (Yapp and Fairman, 2004). Although this unfocused fear did not motivate SMEs to carry out action needed to remedy areas of non-compliance, the authors argue that formal enforcement was a vital component of the compliance process. This is because it formed a last resort action for the enforcer and maintained the general fear of enforcement present in SMEs, so without it the enforcement process would become „ineffectual‟. The Environment Agency (2000) cited in Yapp and Fairman (2006a) suggests that legislation and effective enforcement are key drivers for investment in pollution prevention and control. Wright et al., 2006 notes that hearing about enforcement in other organisations serves to motivate business to improve health and safety.

4.4 Motivating compliance

Several articles focus on ways of motivating compliance and a number of factors appear important, including civic duty and compliance with industry and customer expectations, avoidance of negative consequence of non-compliance, style of enforcement, and minimising burdens of compliance. For example, Hutchinson and Hutchinson (1995, cited in Yapp and Fairman, 2006a) identify legislative requirement, industrial standards, environmental protection, insurance requirements, customer pressure, improving business efficiency, employee pressure and investor pressure (in descending order of priority) as ways of motivating improvements to SME environmental performance. A study of the costs and benefits of complying with HACCP in the meat and dairy sectors showed that perceived benefits to compliance were higher value market shares, improvements in staff skills, and reduced costs of failures (Romano et al., 2005). Communicating

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these benefits to dutyholders, therefore, could be a useful way to promote compliance.

Others have also pointed to the role of civic duty in motivating compliance. This is part of a combination of other motivators including good public relations, market differentiation and a fear of more stringent regulation (Arora and Carson, 1996; Prakash, 2000; Segerson and Miceli, 1998 cited in May, 2005). Loss of corporate credibility and a duty to comply are motivators for the initiation of health and safety improvement among both SMEs and large organisations (Wright, 1998 cited in Yapp and Fairman, 2006a). This is consistent with findings from a study of SMEs in the UK food sector suggesting that two-thirds were motivated to take action to comply with food safety requirements in order to „protect their reputation and their business from legal action, from adverse publicity or because of consumer demand‟ and 75 per cent were motivated because they felt a duty to comply, often irrespective of whether or not they agreed with the requirements (Yapp and Fairman, 2006a). This study also suggested that an additional motivator among these SMEs was to keep the inspector happy and to ensure minimal contact with the enforcing body.

Some authors have suggested, however, that motivations for compliance differ according to organisational size. SMEs are more motivated by the deterrent fear of negative publicity, social motivations, their ability to comply and maintaining a competitive edge, while larger firms are motivated by the deterrent fear of prosecution and a sense of duty, with larger firms better able to comply because of their resources (including staff) (Laeeque et al., 2007). This is similar to findings from the chemical and electroplating industries where SMEs were more responsive to deterrence compared with large firms that were concerned about maintaining the trust of the public (Gunningham et al., 2005 cited in Laeeque, 2007). While reputation is a major driver for compliance with food safety regulation for larger organisations, it is far less influential for SMEs (Birch et al., 2008). This study points to Fairman and Yapp‟s (2005b) finding that SMEs comply because they fear that their legal duty would make them responsible for an accident, which could damage their reputation or make them financially liable, rather than from any sense of moral duty.

Elsewhere it has been suggested that motivation is inextricably linked to regulation as the form of regulation is predicated on firms‟ willingness to act, which is affected by the form of regulation (May, 2005). This is consistent with recent work suggesting that food hygiene award schemes can motivate businesses in this sector because they regard awards as a way to encourage staff to maintain the required standards of hygiene necessary to retain them (Birch et al., 2008). Similarly, a study of the impact of different enforcement styles on compliance in the US construction sector found that dutyholders‟ motivations, including market demands and their firm‟s reputation with enforcement officials, were the most important influences for increasing their knowledge of the regulations (May and Wood, 2003), although cost was also found to be important. This study suggested that co-operative relationships between duty-holders and enforcing bodies enhanced compliance for more knowledgeable dutyholders but not necessarily for less knowledgeable ones. The two main motivations for compliance are deterrent fears May (2005); and a sense of duty based on a combination of moral obligation,

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acceptance of the rules and trust in the system (ie that the enforcing body and other dutyholders are all also playing their part) (Bardach and Kagan, 1982; Kagan and Skolnick, 1993; Levi, 1988; Scholz and Lubell, 1998; Tyler, 1990 cited in May, 2005).

In the food industry, punitive measures appear not to be productive in terms of commitment to enforced self-regulation because SMEs in this sector believe their systems are already safe, question the practicality and efficacy of the legislation for their own situation, and see enforcement as being remote (Gilling et al., 2001; Taylor, 2001 cited in Birch et al., 2008). However, they may be responsive to both punitive and incentive measures for implementing requirements made by enforcing agency officials, ie employers may need „carrots‟ as well as „sticks‟ to encourage them to comply (May, 2004 cited in Birch et al., 2008). Efforts to understand why and how individuals and organisations comply must acknowledge the multitude of factors underlying the decision to comply and should consider a range of cultural factors (Birch et al., 2008). These authors cite earlier work suggesting that compliance is a product of dutyholders‟ understanding of the regulatory expectations, an acceptance of the values behind those regulations and the internalisation of these values (Silverman, 1971 cited in Birch et al., 2008).

Reducing the business burdens associated with compliance is a continuing goal among governments, eg the rationale for BRE, and may help compliance. This could be implemented through fewer regulations, a reduction in complexity and paperwork, enhanced consultation prior to the introduction of new regulations, greater flexibility in compliance, and a one-stop-shop for information and support (PACEC, 2004 cited in Schmidt et al., 2007). Additional advice and support mechanisms aimed specifically at SMEs and delivered through channels they traditionally use and trust would help compliance (Schmidt et al., 2007). In the food sector, many of the caterers participating in a recent study believed that targeted licensing of high-risk premises, linked to an understanding of HACCP, would be the most effective approach (Worsfold and Griffith, 2003a) to motivating improved compliance.

Another way of reducing business burden would be to encourage industry self-regulation. The evidence, however, suggests that there can be problems with this approach. A study by Ashby et al. (2004) describes the practice of industry self-regulation and voluntary compliance. Though self-regulation is posited as a favourable alternative to government-led initiatives to correct market failure, successful self-regulation within an industry could potentially be jeopardised by „free-riding‟ within the industry. Widespread compliance may afford collective gains to the industry, but individual firm incentives to gain an advantage over others through non-compliance may also exist and reduce overall compliance.

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5 Characteristics of the Enforcing Organisation and Interactions with Dutyholders

Chapter summary

■ Enforcement strategies can secure compliance by detecting and penalising

violations, or by more preventative, conciliatory approaches, or a mixture of both.

UK regulators tend to adopt the latter. Employing a variety of enforcement methods,

according to the circumstances and behaviour of firms, is likely to be most effective.

■ When sanctions are applied during an inspection, this can impact on dutyholder

behaviour irrespective of the size of the penalty. UK enforcement agencies

commonly „name and shame‟ dutyholders that are not compliant (by publishing

inspection results, serving notices or pursuing high-profile prosecutions).

■ Rigid enforcement has been shown to offer only limited results within the food

sector, although it is important that the enforcing body is believed to take action in

non-compliant cases.

■ Accreditation/award schemes offer businesses good publicity and if applied without

overzealous enforcement, can increase awareness and good practice within

businesses. There is no evidence, however, that registration (eg through

licences/approvals) is a successful enforcement approach.

■ LA enforcement has the advantage of local knowledge and stakeholder

relationships, but can lack sufficient specialist or technical support. Other potential

issues include inconsistency, resourcing and political interference.

■ Resourcing problems can lead to poorer record keeping, less verification of

dutyholder systems, and reduced challenge of dutyholders or raising of breaches of

regulation.

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■ While there are a wide range of intervention strategies available which regulators

can use in their interactions with dutyholders, there is not enough evidence to

suggest the UK should move away from its current position.

■ There can be tensions for inspectors in operating a dual role of educator and

enforcer, and there is debate on whether inspectors should firmly focus on

enforcement or operate flexibly, applying discretion.

■ Communication is most effective when multiple methods (including written materials,

face-to-face communication and use of intermediaries) are employed. Written

communications used in isolation are not generally effective.

■ The use of suitable language is an important consideration when communicating

with dutyholders. Guidance should be short, easy to follow and should focus on the

benefits of compliant behaviour

5.1 Introduction

This chapter considers one of the key research questions of this review concerning the role of enforcing organisations with respect to compliance, following on from previous chapters which have focused on dutyholders.

Research addressing the operation of enforcing organisations typically focuses on formal aspects of enforcement; „softer‟ aspects including their behaviours and cultures have received relatively little attention. This largely reflects a tendency for regulatory organisations to look outward and focus on the characteristics of those they enforce, rather than examine their own beliefs and practices. There is a considerable amount of evidence on communicating and interacting with dutyholders and this forms the main body of this chapter.

The chapter starts with an overview of formal aspects of approaches to enforcement, and then summarises the available evidence regarding behaviours and cultural factors within enforcement bodies. It then moves on to consider aspects of the inspection process and various communication issues that arise when enforcers and employers interact. The role of other interventions such as awareness-raising campaigns and other educational activities are also discussed.

5.2 Enforcement approach

There is a significant body of literature dealing with the principles and philosophies underlying enforcement approaches. It is beyond the remit of the current review to discuss the merits of these various approaches in depth but we provide an overview of some general themes that emerge. We cannot draw firm conclusions about the direct effect of these various approaches on compliance within a particular regulatory area.

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5.2.1 Enforcement strategy

Many authors distinguish between „compliance‟ and „deterrence‟ strategies, in which the former aims to secure compliance by prevention without the necessity for detection and penalty, while the latter aims to secure compliance by detecting and penalising violations (Reiss, 19841). The former involves a more flexible, conciliatory approach (Bradach and Kagan, 1982; Hawkins, 1984; Hutter, 19992; Pires, 2008), while the latter is seen as involving more formal enforcement action, particularly prosecution and business closure (Yapp and Fairman, 2006a).

Most enforcement strategies adopt a mixture of these approaches (Birch et al., 2008), with compliance strategy the predominant approach among UK environmental regulators (Hawkins, 19843), including food safety regulation. The mixed approach results from a range of factors, including the complexity of detecting violations and the unclear links between cause and effect (Reiss, 19844), the attitudes of inspectors (Aalders and Wilthagen, 19975), the characteristics of businesses (Hawkins, 19846), and the need for inspectors and businesses to have a continuing relationship (Yapp and Fairman, 2006a). The preferred methods to achieve these ends are „co-operative and conciliatory‟ and the use of formal legal methods, especially prosecution, is regarded as a last resort (Hutter and Amodu, 2008).

Well designed responsive regulation which mixes a variety of enforcement methods according to the circumstance and behaviour of firms has the potential to encourage firms to go beyond compliance, and take positive actions not required of them by law (Amodu, 2008). Enforced self-regulation can be a starting point for „responsive regulation‟. For example, rather than using uniform enforcement techniques, a „hierarchy‟ of enforcement methods is developed, with lighter touch enforcement being applied to compliant companies and harsher forms of enforcement being used against non-compliant firms (Amodu, 2008). Elsewhere in the world regulatory approaches rely on a combination of prescriptive and enforced self-regulatory approaches (Yapp and Fairman, 2004).

In the Netherlands, policy is shifting away from direct intervention and towards indirect inducement to simulate closer co-operation in the supply chain (Dinsdale and Hutchinson, 2008). The final responsibility for enforcement and control will still rest with the government, but where industry develops its own chain-wide quality assurance scheme, the government can shift its focus from direct supervision to

1 Cited in Yapp and Fairman, 2006a.

2 Bradach and Kagan, 1982; Hawkins, 1984; Hutter, 1999 cited in Yapp and Fairman, 2006a.

3 Cited in Yapp and Fairman, 2006a.

4 Cited in Yapp and Fairman, 2006a.

5 Cited in Fairman and Yapp, 2005.

6 Cited in Yapp and Fairman, 2006a.

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supervising the control scheme. The success of plans for „supervising the supervisor‟ will depend on the industry taking up the responsibility for setting up an approved control system which needs to be recognised by the government. The Netherlands scheme could therefore be a particularly useful model in assessing the scope for introducing earned recognition or extending alternative enforcement strategies to compliant categories in the UK and fits well with Hampton‟s (20051) recommendations on reducing the regulatory burden on „low-risk‟ business.

5.2.2 Effect of sanctions and penalties

Enforcement regimes typically use a hierarchy of sanctions, operating under the general principal that the more intrusive the sanction, the less it is used (Yapp and Fairman, 2006a). Sanctions serve as a „reminder‟ and provide „implicit deterrence‟, and there is evidence that imposition of a sanction or penalty during an inspection can impact on dutyholder behaviour irrespective of the size of the penalty (Amodu, 2008). Dramatic increases in penalties have been linked to decreased numbers of violations, but the reduction in violations may be small. Reductions of 10 to 20 per cent were measured in relation to penalties which increased ten-fold for non-compliance with US regulations in the hazardous waste industry (Stafford, 2002).

The use of administrative penalties, such as on-the-spot fines, is actively being considered by the Cabinet Office as part of the implementation of the Hampton Review (Hampton, 20052). These measures aim to increase the costs of non-compliance, and/or increase the perception that non-compliance is actively being detected (Fairman and Yapp, 2005a). Imposing fines, however, can diminish the impact of public censure as individuals come to view such sanctions as the „cost of doing business‟ (Turner, 2005).

In the context of health and safety, enforcement measures differ considerably between different nations, as highlighted by one study (Fooks and Rigby, 2007). In Germany and Sweden dutyholders are provided with an opportunity to rectify problems before formal enforcement is considered. Inspections in the Netherlands and Italy, by comparison, are primarily seen as vehicles for the identification of violations that can result in enforcement action. The same study found no firm evidence regarding whether these approaches had differential effects upon compliance, but concluded that sanctions producing moral, as well as deterrent, effects are likely to have a greater impact on organisational decision-making. because firms do not make decisions purely on operational grounds. Where company reputation is unlikely to be greatly damaged by conviction and sentence, sanctioning policy should focus on increasing the moralising effect of court-based sanctions (ibid.).

1 Cited in Dinsdale and Hutchinson, 2008.

2 Cited in Dinsdale and Hutchinson, 2008.

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Schemes such as „naming and shaming‟, by publishing the results of inspections, serving statutory notices or ensuring high-profile prosecutions, have either been adopted or seriously considered by all the centralised enforcement agencies (HSE, Environment Agency and FSA, as identified by Fairman and Yapp, 2005a). The Financial Services Authority, for example, use public censure to highlight expected standards of conduct, and view issuing public statements as a serious sanction (Turner, 2005).

5.2.3 Informal or „responsive‟ approaches

Enforcement regimes can adopt a formal approach of rigid enforcement or an informal approach based on provision of advice (social instruction). The evidence suggests that there may be problems in converting a more formal approach into compliant behaviours (Gillard and Manning, 2002), particularly in the longer term (Braithwaite and Makkai, 19911). Formal control may in fact motivate businesses opportunistically to try and avoid detection of violations (Gilliland and Manning, 2002). Specific research on the food sector is consistent with this, and suggests that a more formal enforcement approach such as an immediate response to non-compliance is unlikely to improve compliance among food sector SMEs (Yapp and Fairman, 2005). However, for SMEs to respond to, and remedy, non-compliance there needs to be a perception that the enforcing body will act if they do not (Yapp and Fairman, 2006a). The effectiveness of different types of approaches therefore would seem to be dependent upon characteristics of the dutyholder, suggesting that enforcement should be flexible depending upon the context in which it is applied.

Several authors have pointed to drawbacks to a responsive (ie a less formal) approach, including the perception by businesses that enforcement is inconsistent (Ayres and Braithwaite, 19922), which was a view shared by food sector SMEs in the UK (Yapp and Fairman, 2006a). On the other hand, inspectors may be unprepared or ill-equipped to adopt a more instructive (formal) approach, according to a study on labour inspection in Brazil (Pires, 2008).

A review of enforcement styles among inspectors in the US construction industry (May and Wood, 2003), makes a series of points about the downside of „responsive regulation‟. These are that:

■ inconsistencies in inspection undermine dutyholders‟ understanding of rules and shared expectations about compliance

■ facilitative inspection styles had a positive influence in fostering co-operation, whereas a formal inspection style had a negative influence

1 Cited in Fairman and Yapp, 2005.

2 Cited in Fairman and Yapp, 2005.

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■ dutyholders value clarity, consistency and being given the benefit of the doubt when deficiencies are found

■ inspectors must strike a proper balance to encourage co-operation without allowing themselves to be manipulated into ignoring substantial violations.

The authors conclude that their findings „raise challenges in thinking about ways to achieve the benefits of formalism without undermining co-operative relationships and the benefits of facilitation without introducing counterproductive inconsistencies over rule interpretation‟ (ibid).

5.2.4 Accreditation schemes

In addition to inspection, another means by which the regulator can influence compliance discussed in the literature reviewed is via accreditation and award schemes. While there is evidence that these approaches can influence decision making about compliance by offering a way for businesses to enhance their reputation (Yapp and Fairman, 2004), there are also concerns that they encourage overzealous enforcement or „regulatory creep‟ among the business community (BRE‟s Davidson Review, 2006). One issue is that they often require businesses to exceed the industry standards. These can be more prescriptive than current hygiene regulations and go beyond legal compliance (Lyne et al., 2008). The local „Scores on the Doors‟ schemes were highlighted as an example of this (BRE‟s Davidson Review, 2006). Regulators may therefore need to be cautious in their use of information gathered during certification and „not use the certification standards as minimum legal requirements‟ (Lyne et al., 2008). It is important to note, however, that the FSA‟s national hygiene rating scheme to be introduced in 2010 has legal compliance as the top band to avoid any regulatory creep.

Reward schemes may be a useful tool to promote good health and safety practices in firms. Local food safety award schemes, for example, „may encourage best practice on the part of the industry and improve transparency for local consumers‟ (BRE‟s Davidson Review, 2006). Such schemes are seen to offer a number of business benefits as marketing tools to generate good publicity and generate staff pride in the organisation, even though businesses tend not to be able to identify tangible benefits (Hopkinson and Gervais, 2006). Indirect benefits of food hygiene award schemes have been identified as increasing awareness and adoption of a food safety management system (FSMS) by food businesses through attendance at council-run courses on HACCP, SFBB (Safer food, better business), Cooksafe and Safe Catering. Together with onsite evaluation, these cause businesses to seek guidance on compliance (Birch et al., 2008). A limitation of these schemes, however, is that they may target food businesses that already have a good record of compliance, and may seem unobtainable to firms with poorer compliance levels (ibid.).

5.2.5 Licensing

There is a common assumption that the enforcement of licences/approvals is easier than enforcing other forms of legislation, even though this is not supported

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by empirical research (Yapp and Fairman, 2006b). The cost of these schemes, particularly in the light of current staffing and financial difficulties in LAs, is a challenge, and this type of approach may not be consistent with the Hampton recommendations (20051) for risk-based targeted inspection activity (ibid.). As alternatives, LAs could introduce formal early warning alert systems, develop more proactive approaches to business registration, undertake pre-opening visits to all new businesses, and investigate the use of civil penalties for non-registration (Yapp and Fairman, 2006b).

Registration in its current form has been described as a „weak tool which is not enforced by local authorities‟, and as an approach that requires empirical testing to determine whether registration actually misdirects enforcement activities to lower risk premises or is a cost-effective intervention in terms of encouraging more holistic and sustained compliance from businesses (Yapp and Fairman, 2006b).

5.3 Cultural and behavioural factors within the enforcing organisation

The evidence base addressing the significance of behaviours and cultures within regulators is limited compared to the extent of evidence available regarding these factors within dutyholding organisations. Only a handful of studies address this directly and these do not allow firm conclusions to be drawn regarding the impact of these factors upon compliance.

5.3.1 Attitudes and perceptions within the enforcing organisation

There is a limited amount of evidence available which compares the characteristics of UK enforcers within the HSE and an LA. These findings are particularly relevant to the current review as LA inspectors enforcing health and safety are also responsible for food safety. One study (Mellor et al., 2006) contrasts the approaches of these two organisations in some detail. LA officers‟ main strengths were their local intelligence and enhanced opportunities to build relationships with stakeholders. Their main weaknesses were identified as a lack of available resources relative to HSE staff, limited legal and specialist support, lack of consistency, and the pressures of conflicting demands. External factors, such as local political interference and negative public perceptions, can also impact negatively on the LA officer role (ibid.). In a series of focus groups involving HSE and LA inspectors, respondents identified the approach of LA officers as advisory, whereas that of HSE inspectors was focused on enforcement (O‟Hara et al., 2005). Mutukumira and Capper (2006) identified that many of the LA staff they surveyed felt that they would benefit from a better understanding of the industry they were inspecting. However, they argued that it would be virtually impossible for

1 Cited in Dinsdale and Hutchinson, 2008.

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an individual enforcement officer to be an expert in all matters pertaining to the industry.

LA enforcers felt that the LA Environmental Health function is more commonly associated with food safety rather than workplace health and safety (ibid.). Moreover, LA inspectors felt that health and safety enforcement was generally given a lower priority compared with other topics, in part due to a lack of resources or competence of officers, and the emphasis was placed on food safety. The role of the FSA in setting national performance targets for food safety and its requirement for findings of LA audits to be published accounted for its higher priority as no similar system for health and safety exists (Mellor et al., 2006).

There is recognition within the literature that inspectors‟ behaviours are guided by their own subjective perceptions of risk, which are in turn influenced by a range of factors such as guidance notes and codes of practice, industry practice, previous accidents or incidents they have investigated, and knowledge of readily available risk reduction remedies (Hutter, 19971). HSE guidance (HSE, 20002) designed to assist inspectors with the problem of judging risk advises them to determine the „risk gap‟ between where the dutyholder is and where they should be. The concept of the risk gap is fundamental to the decision-making process both in terms of assessing what enforcement is necessary to secure compliance with the law and determining whether prosecution should be considered.

There are similar decision processes in the context of food hygiene training (Worsfold et al., 2004). EHOs‟ judgements of risk have to take into account the possibility of „on-the-spot‟ performance modification by food handlers when visited by an inspector and the likelihood that behaviour at peak periods may differ to those demonstrated when there is adequate time for hygiene routines. This means that any observation needs to take into account the attitude of managers and/or supervisors towards hygiene standards as well as whether the individual is aware of relevant procedures.

5.3.2 Behaviours within the enforcing body

Availability of resources within the enforcing body may determine the enforcement approach adopted. A national shortage of EHPs means that, for each authority, meeting inspection targets is difficult, leading to businesses reporting that an increasing amount of time is being spent by officers examining paperwork rather than making observations (Worsfold et al., 2004). Pressures on inspectors brought about by high workloads and broad mandates of responsibility, in terms of industrial sectors covered, have also been identified as important in relation to enforcement approach (Pires, 2008). Enforcement regimes have been described

1 Cited in Hopkins, 2007.

2 Cited in Hopkins, 2007.

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as enforcing a myriad of complex and frequently changing regulations with limited resources in a study of US federal fisheries (Randall, 2004).

The consequences of resourcing difficulties within enforcement bodies have been observed in practical terms as problems with inaccurate, incomplete or out-of-date paperwork; low levels of assessment in terms of the extent to which dutyholder systems were verified, gaps assessed and problems challenged; and inspections where clear breaches of regulations were not raised, according to an audit (FSA Scotland, 2009).

In order to overcome these problems, involvement of the enforcement agency in the design of regulations and agency guidelines could be beneficial, offering those closest to their implementation the opportunity to provide feedback. This was according to comments on the role of planning officials in Northern Ireland (McKay, 2007). There is evidence that where checklists for recording inspection details had been developed by individual LAs in consultation with enforcement officers, these were generally comprehensive and fully completed, whereas others were regarded by officers as cumbersome and not user friendly, and were often only partially completed (FSA Scotland, 2009). Sharing examples of good processes between inspectors can also be a useful way of sharing best practice, but this requires raising self-confidence and developing a culture of knowledge transfer among LA officers who may not believe that their work is good enough to share or that others would reciprocate (Ford and Williams, 2005).

5.4 Interactions between the enforcement body and the dutyholder

The range of intervention strategies available to regulators is considerable and growing, but new approaches have generally been developed in the absence of strong evaluative evidence of their utility (Fooks and Rigby, 2007). In particular, there is a lack of „robust studies that explicitly explore the impact of techniques on health and safety outcomes‟, with the conclusion that it is unclear whether any of the international evidence on new approaches is strong enough for the UK to justify shifting away from existing intervention strategies (ibid.).

5.4.1 Inspections

While there are a range of functions for inspections, the main focus is on whether inspection activities result in enforcement action. This review did not find any literature which directly links the way inspections are carried out with rates of compliance, although different styles of inspections were discussed.

Function of inspections

The extent to which inspection is used as the primary means of providing advice and information to dutyholders differs in different countries, and in some nations this type of interaction has a consultative role (Fooks and Rigby, 2007). In the UK, the majority of non-compliance with food safety regulations is detected during

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inspections (Yapp and Fairman, 2006a). Inspections are therefore a key part of enforcement, especially when coupled with penalties, and are also a medium for disseminating information and knowledge about how to comply.

Sweden appears to be the only jurisdiction that the literature identified as having an explicit policy of informing premises of an impending inspection (Fooks and Rigby, 2007). There is evidence that the styles of individual inspectors, for example whether they take a collaborative or combative approach to inspection, may have differing impacts on compliance, but the overall approach of the agency is still more significant (Amodu, 2008).

Impact of inspection activity

Findings suggest that inspections themselves deter future violations but that this effect is small. The regulator may use inspections to educate dutyholders about the regulations, making reductions in violations possible even in the absence of punishment, according to a study of Canadian petroleum storage sites (Eckert, 2004). These findings are consistent with work from other sectors of industry such as steel and paper-pulping, suggesting that increasing inspections can reduce non-compliance (Laplante and Rilstone, 1996; Gray and Deily, 1996; Nadeau, 19971) and promote self-regulation (Laplante and Rilstone, 19962).

Enforcement activity may serve to remind dutyholders of their duties and reassure them that other businesses are subject to the same controls (Yapp and Fairman, 2004). Formal enforcement activity has been found to have a significant effect upon inspection rating scores of catering premises; however, formal enforcement activity did not significantly affect the level of compliance when the effects of education and local deprivation were removed (Yapp and Fairman, 2004).

The inspector’s role

Within broad parameters established by agency guidelines and routines, inspectors typically have a good deal of autonomy and discretion in how they go about enforcing regulations, including discretion over the thoroughness of inspections and the nature of their interactions with dutyholders (May and Wood, 2003). Their decisions about the best approach (which might be informative, cajoling, educating or punitive etc.) are often taken in-situ (ibid). The approach inspectors take depends on a number of factors including their perception of the wilfulness of the violation and the likelihood of recurrence of this behaviour in the future, and past behaviour (Hawkins, 19843). The influence of differences in inspectors‟ styles of behaviours is dependent, at least to some extent, on the

1 Laplante and Rilstone, 1996; Gray and Deily, 1996; Nadeau, 1997 cited in Stafford, 2002.

2 Cited in Stafford, 2002.

3 Cited in Yapp and Fairman, 2006a.

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situation, with repeated interactions between the inspector and the dutyholder needed for consistency (May and Winter, 19991).

Both LA officers and HSE inspectors aim to help organisations to understand their responsibilities, to encourage a proactive approach to safety management and promote sustained compliance rather than simply discussing and reacting to the messages or issues raised during an inspection (O‟Hara et al., 2005). Some employers are also keen to forge relationships with inspectors, to check that they were complying to regulations, and believe that more opportunities to meet with HSE inspectors face-to-face would be useful, according to a construction industry consultation (Oliver et al., 2007). Variations in inspectors‟ behaviours have been depicted in two dimensions of formalism concerning the rigidity with which rules are interpreted and applied and facilitation in the willingness of inspectors to help and be forgiving (May and Burby, 1998; May and Winter, 1999, 2000; Winter and May, 20012), although the authors do not specify which of the cited approaches are most conducive to compliance.

Focus group work with HSE inspectors showed that they felt an important part of their role is to demystify legislation and guidance, particularly for smaller companies (O‟Hara et al., 2005). Another study discussed the inspector role with both managers and inspectors (Vickers et al., 2003). This found that managers wanted inspectors to be prepared to discuss issues and negotiate actions for improvement, and that some wanted help and advice about health and safety to be separate from any threat of enforcement action. Some businesses, however, preferred to gain advice from alternative (ie non-HSE) sources, as they mistrusted authority and feared prosecution; this led them to avoid use of official sources of information, such as that produced by the HSE.

The HSE encourages inspectors to be a „critical friend‟ to SMEs, which involves inspecting but also providing advice and support (King et al., 2004). It is acknowledged that there might be some tension between the two roles. There is some debate about whether inspectors should be firmly focused on enforcement (Davis, 2004) or should be more flexible and use discretion in applying regulations (Amodu, 2008). Inspectors seem aware of the tensions that this type of dual role can create (ibid.). Within the agricultural sector, HSE inspectors felt that it would be useful to de-couple access to information from the threat of enforcement (BOMEL, 2009). Elsewhere it has been suggested that inspectors may experience a conflict of interest if required to act as both consultant and enforcer (Wheelock, 20023). However, there is also some evidence in the health and safety literature that advice and information is less effective in the absence of the possibility of

1 Cited in May and Wood, 2003.

2 May and Burby, 1998; May and Winter, 1999, 2000; Winter and May, 2001 cited in May and

Wood, 2003.

3 Cited in Worsfold and Griffith, 2003b

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enforcement; some firms may need the threat of enforcement to act on the advice they have received (Wright et al., 2004).

5.4.2 Other forms of intervention

Inspections constitute only one aspect of regulator-dutyholder interaction. Other forms of interaction include the production of written guidance and documentation for the use of dutyholders, as well as face-to-face interactions not involving inspections such as awareness raising and training events.

Education/training interventions provided by regulators

Education and training interventions run by regulators for dutyholders are commonly used to promote compliant behaviours. However, most studies which address training assess comprehension or acceptability of the various training courses and materials to employers, rather than the behaviour of trainees after training. There is also a lack of evidence on the basis of the literature examined in this review which indicates the extent to which knowledge gained by an individual who has been trained is shared with other workers in their organisation. In addition, training or awareness interventions are not targeted or designed in a way that enables evaluation of their effectiveness across different types of dutyholders. Despite these issues, training is generally seen as crucial to gain commitment from the workforce and to raise awareness (eg Lancaster et al., 2001), even though it cannot be assumed that awareness is always translated into action (Hillage, 2001).

Using EHPs to deliver educational messages and best practice is considered the most effective and reliable channel of communication primarily because they have direct access to SMEs (Benson, 2003). Enforcement agencies have a very valuable role in providing advice, assistance and support to small food businesses (Mutukumira and Capper, 2006).

The regulator can be involved in training without directly delivering it, for example through partners, and this can offer certain benefits. For example, organisations could work with their existing health and safety consultants who would offer individually tailored training (Sinclair et al., 2007). LA education activities have been found to affect inspection rating scores, and compliance levels, of SMEs significantly (Yapp and Fairman, 2005). Interventions that increased specific food safety knowledge within businesses were judged to be the most effective at improving conditions. These included advisory visits, formal inspections and subject-specific seminars. These were found to be effective throughout the compliance process, and the effects of education remained even when the effects of formal enforcement activity and regional economic deprivation were removed (ibid.).

Research has been specifically conducted on the effectiveness of training in promoting hygienic behaviour. Training tends to be administered under the assumption that an individual‟s behaviour or practice is dependent on their knowledge, and that the mere provision of information will lead to changes in

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behaviour (Worsfold et al., 2004). Some dissatisfaction has been reported among EHPs in relation to the examinations of awarding bodies such as the Royal Society for the Promotion of Health, the Chartered Institute of Environmental Health and the Royal Institute of Public Health (MacAuslan, 2001, cited in Worsfold et al., 2004).

This has led to calls for the syllabi of foundation/basic food hygiene courses to be radically overhauled so that elementary hygiene courses are shortened, are more industry specific, and are more focused to provide greater emphasis to personal hygiene and non-technical hazards (MacAuslan, ibid1). Findings from a FSA survey (20022) showed that of over 1,000 caterers in small independent businesses, 59 per cent of whom had basic food hygiene certificates, more than one-third (39 per cent) neglected to wash their hands after visits to the lavatory while at work, and 53 per cent did not wash their hands before preparing food. While education in the form of advisory visits and training may be vital to help SMEs understand what is required of them and incorporate requirements into their business (Fairman and Yapp, 2005), education alone is unlikely to be enough to achieve compliance. It seems likely that in some circumstances close supervision may be needed in order to ensure that employees translate knowledge about hygienic behaviours into action.

Possible alternative approaches

The Hampton Review (20053) highlighted complaints that businesses have about regulation, including multiple inspections requiring similar information, the inconsistency of regulators, and the cumulative burden of paperwork. It made recommendations which highlighted the reasons behind an alternative enforcement strategy, including:

1. entrenching the principle of risk assessment throughout the regulatory system so that the burden of enforcement falls most on highest-risk businesses and least on those with the best records of compliance

2. ensuring that inspection activity is better focused, reduced where possible but, if necessary, enhanced where there is good cause

3. making much more use of advice, again applying the principle of risk assessment

4. substantially reducing the need for form filling – in practice businesses‟ most frequent and direct experience of regulatory enforcement – and other regulatory information requirements

1 Cited in Worsfold and Griffith, 2004.

2 Cited in Worsfold and Griffith, 2004.

3 Cited in Dinsdale and Hutchinson, 2008.

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5. applying tougher and more consistent penalties where these are deserved.

The most popular alternative enforcement methods that have been implemented by LAs are self-completion questionnaires, consumer complaints (as an inspection trigger), and significant changes in activities and management changes (as inspection triggers). Most LAs were satisfied with their new approach because it gave them more time to spend on high risk premises, more efficient use of resources, better use of admin/support staff and capacity to keep databases up to date (Lyne et al, 2008). Other interventions, such as partnerships, use of intermediaries, use of supply chains and working with those at risk, have been considered, but there have been concerns raised that these alternative approaches are not appropriate to the kinds of firms, predominantly SMEs, that LAs monitor (Howard and Galbraith, 2004b). For example, SMEs are thought to lack the necessary resources to engage in partnership work. These would be most effective if they were led at a national level, with LAs working on implementation at a local level.

It has been suggested that interactions with the FSA make LAs more conservative in their choice of interventions. Howard and Galbraith (ibid.) observe that the FSA is much more prescriptive in its directions to LAs than the HSE, emphasising formal inspections above all else. This is a potential explanation for findings that suggest an unwillingness of some LAs to consider other forms of intervention, but conditions among local businesses could also cause a particular approach to be adopted by the LA (Yapp and Fairman, 2004). Subsequently a new Food Law Code of Practice has been introduced which replaces the inspection-focused approach to food law enforcement with a more flexible one enabling LAs to use a wider range of interventions1.

There are a number of other ways in which regulators have attempted to work differently with employers:

■ Using supply chains – evidence from the construction industry indicates that practice on large sites can influence practice on smaller sites over time, with compliance filtering down when workers and managers work together repeatedly (Willbourn, 2009).

■ Intermediaries – Benson (2003) found that one of the most effective ways of getting information across to SMEs was to use intermediary groups (such as trade associations, community groups, etc.). Intermediaries have a vital role to play in disseminating information to those SMEs that do not have regular interaction with EHOs and in encouraging SMEs to go to their local EHP for advice.

■ Safety Awareness Days and mobile inspection units – these can be useful for marketing and delivering support as well as linking with networks of professionals for providing specialist support (BOMEL, 2005), although a direct

1 www.food.gov.uk/news/newsarchive/2008/jun/code

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relationship between attendance and subsequent compliance has yet to be established.

■ Health and Safety Roadshows – have been found to be an effective way for the HSE to communicate messages about slips, trips and falls to their target audience, with resulting changes in practice. There is generally a „trade-off‟, however, between the depth of the intervention versus the reach. Communication campaigns – such as Watch Your Step – were felt to reach more people for example; an evaluation of the latter was inconclusive on how much actual change in workplace practice was achieved (Powell, 2007).

■ Operating telephone help or advice-lines – have been viewed as demonstrating that „guidance on achieving compliance is often bypassed in favour of receiving direct authoritative advice‟ (Winton, 2003, commenting on compliance with First Aid Regulations and a high level of enquiries to HSE Infoline about this issue).

■ Workshops with employers – although there is some evidence that prescriptive guidelines are preferred over (more generic) goal-setting approaches (see BOMEL, 2009, discussing workshops run for farmers by the HSE).

5.4.3 Communication between the enforcing body and the dutyholder

There is a large body of work within the HSE literature that explores effective means of communicating with dutyholders. However, the extent to which the FSA can extrapolate from the HSE literature is not clear, and there is a need to explore what works with different groups and the need to evaluate this formally (Gervais, 2007). The effectiveness of communication tends not to be measured in terms of compliance, with the focus of the literature, instead, on comprehension and awareness of materials.

Modes of communication

Mutukumira and Capper (2006) found that support provided to food companies on a one-to-one basis, either by an enforcement officer or independent adviser, was key in assisting small food enterprises. According to Benson (2003), face-to-face meetings should ideally take place on-site and should be advisory and non-confrontational.

Some businesses use the Internet extensively to communicate and receive communications but for others, barriers to using this technology remain. SMEs do not use the Internet for food hygiene law (Yapp and Fairman, 2004). This means that regulators need to be aware that over reliance on the Internet for providing information could miss certain sub-sections of dutyholders. Similarly, dutyholders prefer to have health and safety messages sent to them through channels which they are already using to keep up to date with different issues (BOMEL, 2009, commenting on the preference of farmers for communications via industry magazines).

A multiple methods approach to promoting LA health and safety interventions, including written materials, face-to-face communication, and use of intermediaries,

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has been found to be most effective (Howard and Galbraith, 2004b). Written communications used in isolation appear ineffective. Many SMEs, for example, were found not to understand the difference in status between formal notices and other, routine, letters sent by Environmental Health Officers, and leaflets have been found to be ineffective in communicating regulatory requirements to individual businesses (Yapp and Fairman, 2004).

A recent study (Gervais, 2007) examined business response to different communication methods and found that:

■ all businesses, especially small businesses, indicated a high preference for postal communication while large and medium businesses also listed fairly equal preferences for email and face-to-face communication

■ ethnic minority businesses were more receptive to face-to-face communication

■ businesses tend to be most receptive to communications which emphasise the business benefits of health and safety compliance.

Findings that SMEs prefer postal communication should be treated with caution in view of the findings reported earlier that they may misunderstand the messages contained and written communications are ineffective in communicating regulatory requirements. This could simply be indicative of fear of direct contact with a regulator and hostility to third parties which is documented in the wider literature on SMEs.

Benson (2003) identified the three key barriers to effective communication with SMEs as:

■ cultural and attitudinal – where good food hygiene is seen as an unnecessary hindrance by businesses

■ regulatory – where regulation is overly complex or inappropriate

■ comprehension and implementation – where businesses do not understand regulations or are unwilling to implement them.

There are also claims from SMEs that there is a lack of supporting material and advice that adequately transfers the food hygiene legislation into practical steps and measures (ibid.). However, these claims are made in reference to the situation in the early 2000s so it is likely that recent FSA initiatives to communicate more effectively with SMEs have impacted on this situation since then.

Working with large employers appears to require a bespoke approach, due to the variations in operation and working practices among this group, according to a study of the HSE‟s Large Organisations Partnership Pilot (Buchanan and Roberston, 2009). A single point of contact managing the regulatory interface was felt to simplify lines of communication and facilitate better access to technical and regulatory expertise in the regulator. Resistance at board level within the dutyholding organisation was felt to limit the success of relationships with the regulator. However, even when these mechanisms were in place. Specific communications about health and safety that are directly aimed at directors may

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be useful as they have been shown to stimulate action among this group (King et al., 2009).

Style and acceptability

Different business types often prefer different forms of communication and using an appropriate style and emphasis may enhance responsiveness of the recipient. The use of suitable language is another consideration.

Clear and common language should be used throughout, and acronyms kept to a minimum regardless of the method of communication (Bates and Greaves, 2009). Written guidance needs to be as short and easy to follow as possible for time restricted SMEs (Gadd and Balmforth, 2003; Ferguson, et al., 2003). Printed materials need to be simple, industry-specific, practical, and make good use of examples. It also helps if they use visual explanations and are consistent in terms of terminology, tone and style (Benson, 2003).

There is evidence that „road-testing‟ guidance with end-users is worthwhile (Bates and Greaves, 2009). For example the use of pictures and visual imagery has been trialled within the construction industry. Pictures have been used to illustrate good and poor practice on construction sites, with workers finding them clear and easy to understand, as well as gaining their attention better than text (Willbourn, 2009). However, some workers can find pictures patronising, particularly if there is a perception that they have been used because of an assumption that real targets could not be read (ibid.). Pictures have also been used to deliver safety messages which are printed directly on to equipment used in construction work: these messages were found to cause minimal interference with work and produced high levels of awareness and information uptake with regards to the safety recommendations (Chinien and Cheyne, 2006, reporting on the HSE‟s „Trojan Horse‟ campaign).

The effectiveness of distributing generic guidance is potentially limited where employers lack understanding of key concepts. There is evidence that some employers, particularly small employers, find the term risk assessment meaningless (BRE, 2008). Neathey et al. (2006) used a telephone survey of 1,002 employers to evaluate the impact of the HSE‟s „five steps to risk assessment‟ leaflet. There appeared to be confusion among employers about what to do once a risk is identified, particularly in relation to what constitutes a reasonable and appropriate method of risk control.

For communications to be most effective, it is also important that dutyholders perceive the message as credible. There can be a gap between the „world view‟ of the enforcing body and that of respondents so that „language which talks about eliminating risk is not perceived as realistic‟ (Willbourn, 2009). The concept of „learned irrelevance‟ has been used to explain why some signs, such as those warning of slip and trip hazards, are frequently overlooked. Learned irrelevance occurs when individuals start to ignore information to which they have been over-exposed and has led them to conclude that the information is not directly relevant to them (Rossmore MCA, 2005). Positively framed risk communications which focus on the benefits of adopting safe working practices have been found to be

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generally more influential than negatively framed communications (Ferguson et al., 2003).

Specificity/level of prescriptiveness

Dutyholders often state that they prefer to receive communications which are prescriptive in nature. Regulation based on specific rule-following makes it easier to identify non-compliance, but it is difficult to draw up rules for lots of specific situations. It creates the risk of rules being applied to situations where they are not appropriate or some areas remaining unregulated (Amodu, 2008). Regulation based on broad principles is easier to apply in multiple situations so that dutyholders have a broad range of responsibilities which they have to fulfil by methods they choose. However, this approach can create uncertainty about what is specifically required in a certain situation (ibid).

Smaller organisations and the self-employed have been shown to prefer more prescriptive guidance and legislation (see BOMEL, 2009; Gaskell and Stephens, 2007; O‟Hara et al., 2005; Wright et al., 2004). In a study in the agricultural sector, farmers felt it was not possible to be up to date with all specific legislation and reported that some kind of „crib-sheet‟ covering all the legislation they needed to know would be useful, including health and safety and Farm Assurance (FA), which would require HSE and FA representatives to communicate with each other more. This would reduce the burden of compliance because farmers would not require two separate inspections from the two bodies (see BOMEL, 2009).

Within the food sector, Yapp and Fairman (2004) found that generic written information was frequently misinterpreted and misunderstood, thus limiting its effectiveness in improving food safety compliance within SMEs. They found evidence that SMEs prefer to be told exactly what to do to comply with legal requirements and that self-assessment can be daunting.

Worsfold and Griffith (2003b) conclude that if the FSA is to succeed with wider implementation of HACCP, guidance for the food industry and training is not sufficient and that businesses will need financial support to pay for training and assist with implementation of the system. However, these conclusions were formed before the introduction of the FSA‟s „Safer food, better business‟ initiative and related local campaigns to help small catering and small retail food businesses implement food safety management procedures. FSA Safer food, better business (SFBB) packs have been specifically praised by LA enforcers (Mellor et al., 2006).

5.4.4 Need for a multi-faceted approach

A number of interventions have been shown to be effective at some level in communicating with dutyholders (Cox et al., 2008). These were using face-to-face communication to educate and inform, regulation, Safety and Health awareness days (SHADs), worker involvement techniques (such as H&S representatives being used to cascade messages), and targeted initiatives (helpful to enable the setting of objectives and progress towards health and safety outcomes). Print-

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based messages were found to be good at raising awareness of an issue, but less effective at creating behavioural change. Personal contact, however, has been identified as possibly the most effective mode of communication, in particular through the use of inspections (Hillage et al., 2001) or other face-to-face contact (Gervais, 2007).

A comprehensive evidence review found that none of the research indicated that any one activity (education, incentives, reputational risk, supply chain pressure, inspection/enforcement) meets the needs of small firms, or is particularly effective in the context of small firms (Wright et al., 2004). A „multi-dimensional strategy‟ is suggested with an acknowledgement that activities may have a lower return for small firms when compared with large ones (eg fewer staff/consumers are impacted when dealing with small firms). This is due to heterogeneity within the small business sector which requires enforcing organisations to use multifaceted approaches to improving health and safety compliance (Vickers et al., 2003).

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6 Conclusions and Recommendations

6.1 Introduction

This final chapter returns to the original research questions and discusses how the evidence addresses these questions. We also consider the nature of the evidence identified and note some issues regarding its scope and research gaps which appear to be present. Finally, we present a number of recommendations for the FSA. These include suggestions for further research that could address gaps in the literature identified in the current review and some practical suggestions for future areas of research activity and policy development.

6.2 Main findings of the evidence reviewed

6.2.1 Research Question 1: Who does/does not comply and why?

The literature indicates that SMEs are less compliant than larger businesses across enforcement areas including food safety,1 although size alone is not always a useful predictor of compliance. The contribution of SMEs to food safety hazards in the wider population is difficult to quantify, and there is some evidence that sector may be a better predictor; hotels and restaurants appear to account for more food poisoning outbreaks relative to other areas of the industry.

Large businesses tend to be better networked (with regulators as well as with each other), and more proactive in seeking support, although it is not possible to distinguish a single factor that explains their greater compliance levels. There is general agreement within the reviewed literature that regulators need to target initiatives aimed at improving compliance at SMEs.

Resources are a key factor when considering ability to comply and there is evidence that the relative costs of compliance are greater in SMEs. SMEs may not

1 www.food.gov.uk/multimedia/pdfs/premisessurvey2007.pdf

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have access to equipment, structures, trained staff, or be able to monitor and comply with regulations in the same way as larger businesses do. Because larger organisations tend to be better resourced, there is greater potential for them to meet their legal obligations and they are more likely to have access to in-house expertise, or can afford to pay for external support. This means that larger dutyholders are more likely to be able to understand, and to be aware of, compliance issues.

Time is also an important resource, and a shortage can impact negatively on compliance. Performance pressures can lead workers to perceive the need for „short-cut‟ behaviours within their job. There is some evidence that effective supervision counters this tendency.

To fully understand why certain organisations and individuals are non-compliant, aspects of organisational culture, particularly whether an effective safety culture is in place, must be examined. Organisations which demonstrate features of an effective culture are likely to be more compliant. These features include manager commitment, peer group support, good staff communication and consultation, recognition of the fact that everyone has a role to play, and high-quality training.

Reputation is another cultural factor that has a positive influence on compliance. It is important to be aware, however, that concerns about reputation may not offset other factors which disincline companies to comply, such as lack of resource.

Within the food industry, inexperienced staff recruited to low or non-existent entry criteria can exacerbate any existing barriers to compliance, particularly where English is not their first language and when food hygiene training is not provided. Experience is not necessarily linked with improved compliance; some workers may become complacent if longstanding „bad habits‟ have not resulted in an adverse outcome to the business.

The availability of information and advice is a major influence on compliance, particularly in the context of changing regulations along with the presence or absence of in-house expertise. Also, on-the-job experience is not a substitute for formal training and instruction. Among employers in the food industry there is some evidence of improved compliance in areas where LAs are active in improving levels of knowledge.

Risk perception is regarded as an important determinant of safety behaviour and as a major influence on compliance. Knowledge about risks is an important factor in risk perception and is therefore a consideration when understanding the potential causes of non-compliance. The known history of incidents within a given industry, or within a particular organisation, is likely to impact on risk perception. In the catering industry, some see hygiene as significant only when things go wrong. However, attitudes to risk vary even within the same workplace and are shaped by personal characteristics.

If the regulatory regime is perceived as fair, trusted and co-operative, this is likely to lead to greater compliance, although sanctions are still needed to back up a co-operative approach. Fear of prosecution is a key driver of compliant behaviour. Within the food sector, if regulations are not understood, there appears to be a

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tendency to ignore them, so there is a need for clarity in any communications between the regulator and businesses.

What compliance actually means to dutyholders and regulators can differ. The enforcer‟s concept of compliance is that it is a „continual, evaluative process of business operation‟. Research suggests that SMEs may operate what they believe to be compliant systems, but only implement some aspects of what is required and may see compliance as a single event, such as the outcome of an inspection. They can therefore take a passive role, where the enforcer is seen as the predominant driver, with negative implications for compliance.

The underlying motivations for businesses to comply are complex, but the evidence suggests that views on the costs of compliance, the fears of deterrents, reputational damage caused by non-compliance, a sense of duty and acceptance/trust in the system all play a role. The literature is clear that the approach of management is an important motivator for compliant behaviour among employees.

6.2.2 Research Question 2: What approaches/communications are more/less effective in securing regulatory compliance?

There is little evidence about the types of organisational cultures within enforcing bodies that secure compliance, so the impact of different ways of working within regulatory units cannot be determined. Also, the minutiae of how inspectors go about doing their job and communicate with each other does not appear to have been a focus of research to date. As a consequence the current review only allows limited analysis of how compliance is affected by different ways of working within regulatory units.

The most substantive evidence regarding cultures within regulators comes from the HSE literature regarding the differences in approach between HSE and LA regulators which both enforce health and safety. There is some evidence that LA officers, when compared to HSE inspectors, feel compromised by a lack of resources, limited legal and specialist support, and the pressures of conflicting demands due to the breadth of their enforcement responsibilities. This may have adverse implications for the quality of inspections and associated paperwork.

It is clear that food safety is already a major priority for LA enforcers. There was an apparent emphasis on food safety (compared with other regulatory areas within the LA inspectors remit) which was attributed to the role of the FSA in setting national performance targets for food safety.

Some conclusions can be drawn regarding the effectiveness of various types of interactions and communications between employers and regulators. Among the health and safety as well as the food safety literature there is agreement on the effectiveness of inspections with respect to (i) actively securing compliance within inspected premises and (ii) serving as a deterrent against non-compliance. Visits also serve to promote the idea of a „level playing field‟ among dutyholders, reinforcing the message that compliance is mandatory and enforcement fair.

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The self-regulatory elements of food safety compliance can present particular problems for small businesses. Research suggests that some SMEs struggle with generic guidance, and find it difficult to apply broad principles to their own business activities. Where possible, businesses prefer prescriptive advice tailored to their own business, preferably delivered face-to-face. Leaflets have been found to be ineffective in communicating regulatory requirements to individual businesses and the effectiveness of distributing generic guidance is compromised where employers lack understanding of key concepts such as hazard analysis/risk assessment.

Training is an important issue for the food industry but findings regarding its influence on compliance are inconclusive. Some studies cite inadequately trained staff as a major causal factor in food poisoning outbreaks, while conversely some studies suggest that formal food hygiene training (or reported usage of HACCP systems) does not protect against foodborne outbreaks. Drawing firm conclusions about the impact of training and the relative merits of different formats is hindered by the lack of studies looking at behavioural outcomes of training over a sustained period.

Inconsistencies in inspection can undermine dutyholders‟ understanding of rules and shared expectations about compliance. Given the critical role of inspection in securing compliance in many food businesses, this is an important area for the FSA to address.

6.2.3 Research question 3: What encourages sustained compliance?

There is an evidence gap regarding the conditions for securing sustained compliance. The factors that encourage compliance are likely to be instrumental in securing sustained compliance, but given dutyholder views of compliance as a standalone event rather than a continual process, this may not be the case. It is important to bear in mind that many businesses have a „weak‟ concept of compliance that is essentially based on passing an inspection.

There is good evidence that sustained compliance is more likely to be achieved when driven internally (ie within the company) than externally (ie directly through regulation). Messages about safety and hygiene are most effective when provided from multiple sources (eg via posters as well as verbally) and it is important for managers to lead by example. In some industries, notably construction, supervision is key to ensuring that employees adhere to safety regimes. Fear of punitive measures applied by company management (eg dismissal) can also be an effective motivator. Effective performance management has a positive impact on compliance, and within the food industry the chef is seen as pivotal in promoting a positive safety culture.

Awarding schemes may have some value in driving sustained compliance, and are seen to have business benefits, but have a number of potential pitfalls. They can be seen to „over regulate‟, in that they encourage over-compliance and unnecessarily burden businesses. It is also unlikely that poorer performers will choose to participate. Caution must therefore be exercised when promoting voluntary awarding schemes because, by their very nature, they tend to attract

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more compliant, aspirational businesses and they will not, if used in isolation, impact on potentially poorer performers who effectively „opt out‟.

Ideally, risk control measures should be embedded in routine processes and systems so that they are perceived as an automatic part of the job rather than as a (time-consuming) add-on. The research literature indicates that, where possible, workers should be actively involved in the design and implementation of compliance systems for them to be maximally effective.

While evidence surrounding the effectiveness of training is mixed, a general principle applies that the effects of training are difficult to sustain if employees do not have access to refresher training. It is also important to note that the evidence included in the current review applies to formal as opposed to on-the-job training. In addition, messages concerning risk need careful tailoring to specific sectors, in order to take account of the prevailing culture, and demographic characteristics of workers, in order to ensure the most salient and pressing arguments to change behaviours are used. This supports FSA‟s use of social marketing techniques in the development of specific hygiene messages and health education interventions for particular audiences.1

6.2.4 Research Question 4: What incentives and deterrents have been shown to achieve and maintain compliant behaviour, and what more can business bodies and enforcement agencies do to improve the position?

There is limited evidence directly addressing the effect of formal incentives on compliance, although some studies indicate that food hygiene ratings schemes can motivate businesses to comply. Employers who wish to retain their rating are required to maintain a high standard of hygiene and therefore schemes of this type may also motivate sustained compliance.

There is evidence that imposition of a sanction or penalty during an inspection can impact on dutyholder behaviour, and do so irrespective of the size of the penalty. Sanctions serve as a „reminder‟ of the presence of the regulator.

Reputation is a driver for compliance with food safety regulations in both larger and small organisations. However, while being influenced by a sense of moral duty, smaller businesses are more motivated to comply because they fear that their legal duty would make them responsible for an accident, which could damage their reputation or make them financially liable.

1 For an example of this see: www.food.gov.uk/news/newsarchive/2009/may/enforcementcourse

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6.3 Limitations of the evidence base considered and research gaps

This section sets out some areas which did not appear to be well represented in the content of the literature captured and where more focused research may be useful. Due to limitations in the review‟s scope, the areas identified here may not necessarily reflect gaps in the broader research literature. But there do appear to be areas where less or little research is available when compared with others.

6.3.1 Compliance as an outcome

The current review has found very little hard evidence which makes a direct link between particular aspects of culture and behaviour within dutyholders and regulators, and compliance. The focus of research and evaluation has largely been on process issues (ie how things are done), and acceptability issues (ie how regulators and dutyholders view interventions), as well as views on what will support compliance, rather than hard evidence on what does. This arises, at least in part, from the difficulties inherent in measuring and observing compliance, and particularly sustained compliance, within a research context.

6.3.2 Cultures and behaviours within enforcing bodies

A major barrier to addressing several of the central research questions is the paucity of evidence detailing cultures and behaviours with regard to LA regulatory activity. The lack of material held within the LACORS database which can be described as research evidence is potentially a reflection of this. It is also unclear to what extent current LA approaches to enforcement (across the whole range of areas they enforce) are evidence-based. This limits the ability of the current review to draw firm conclusions about the impact of practices within the regulatory bodies on enforcement.

This gap in the literature appears to reflect a tendency for regulatory bodies to look ‟outward‟ rather than „inward‟ when commissioning research. In particular, „in-house‟ cultures of regulatory organisations are not well-documented, for instance internal decision-making processes and management approaches. As a result it is not possible for this review to form conclusions regarding some of the issues identified as significant factors in the Pennington Report, such as internal communications within LA units, access to records of inspections and the practice of giving advance notice of inspections. Staff turnover was also highlighted as a potentially important issue.

6.3.3 Public health concerns

There is a gap in the literature regarding a major feature of food safety legislation likely to drive compliance: its aim of protecting the public. A potential risk of looking to the health and safety literature to provide further understanding of compliance is that health and safety legislation is principally in place to protect those within the workplace. It would seem feasible that behaviours to reduce risks to the employee

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him/herself (or to fellow colleagues) could be differently motivated from those to protect the wider public. This is an important area of research that is not explored in depth in any of the literature under review.

6.3.4 Reasons for compliance with one set of regulations over another

Related to the above area is the lack of literature detailing which particular sets of regulations food industry employers find it difficult to comply with and any explanation of differential rates of compliance within the same company. There are potential lessons that the FSA can learn if, for example, an employer deliberately prioritises health and safety considerations over food hygiene. As the literature stands it is difficult to ascertain whether such a scenario is common and the cultural and behavioural factors that may underlie it.

6.3.5 Sustained compliance

The apparent lack of literature addressing sustained compliance is an obvious barrier to understanding its behavioural and cultural drivers, although the likely reasons for this gap are fairly self-evident. Assessing sustained behaviour involves making repeated observations across the same employer sample over a moderately lengthy time period and longitudinal studies are, by their very nature, very resource intensive.

The level of expertise necessary to assess compliance in a consistent manner, as well as the (usual) requirement to assess control as well as treatment groups in most longitudinal intervention studies, are other factors which have resource implications. While there are isolated examples of studies which have overcome these barriers, the quantity of the literature sustaining compliance behaviour does not do justice to the obvious importance of this issue.

6.4 Recommendations for further research and other practical points for the FSA to consider

6.4.1 Establish the areas of regulation where lessons learned can most readily be applied to food safety

Examining which particular regulatory systems are/are not relevant to food safety regulation in advance of conducting future (possibly systematic) evidence reviews could allow a greater focus on the most useful literature, now that the current broader review has been undertaken.

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6.4.2 Gain further understanding of workplace cultures

The term culture has many meanings, and definitions of effective organisational cultures or even (food) safety cultures may differ across different industries and different research disciplines. There may be scope for looking at areas of the research literature not explicitly targeted by the current review, such as organisational psychology and systems analysis. This could be helpful in (i) further defining what kind of working culture is conducive to food safety compliance and (ii) identifing whether the ways of working characterised by this culture are consistent with an effective organisational culture in a more general sense.

6.4.3 Examine first-hand experience of enforcers

Fieldwork with operational inspectors working „on the ground‟ may highlight issues specific to food safety enforcement that are not evident in the current research literature. In particular, qualitative methods (eg through structured interviews) could be used to gain an understanding of how „microcultures‟ within LA inspection units operate (essentially how officers „do their job‟). A more detailed analysis of what prompts different decisions in the way that officers interact with businesses (eg to make an announced versus an unannounced inspection) and with each other (eg discussing premises where „things don‟t seem right‟ with other officers) could be useful.

This work could also be helpful in supplementing the limited research evidence available which describes (i) LA inspectors‟ requirement to „juggle‟ food safety enforcement responsibilities with their other enforcement duties and (ii) how inspectors balance their dual role of adviser and enforcer, and the implications of these issues for securing dutyholder compliance.

6.4.4 Consider other sources of data

A useful activity for the FSA in understanding the central questions of this review may be to determine whether a review of material which falls outside conventional research evidence bases could usefully supplement the current review. Such items could include details of court proceedings, case histories and reports of investigations, which would all consider, in detail, the precise actions which have led to cases or outbreaks of foodborne infection. Reviewing these materials in a specific and systematic way could be a particularly useful exercise in gaining a fuller understanding of cultures and behaviours within the enforcing body that do/do not promote compliance.

The FSA‟s recently introduced Local Authority Enforcement Monitoring System1 (LAEMS) database presents an important opportunity to look at enforcement outcomes in detail and could potentially be used to supplement future qualitative

1 www.food.gov.uk/enforcement/auditandmonitoring/laems/

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work with inspectors to obtain a fuller picture of how organisational culture within LAs has a bearing on food law enforcement activities.

6.4.5 Ensure studies include (sustained) compliance as an outcome measure

In order to properly investigate the cultures and behaviours which lead to compliance, future studies should include indicators of compliance as principal outcome measures. Independent judgements of compliance should be obtained for this purpose (ie not from employers‟ own assessment of their performance).

In order to identify factors that lead to sustained compliance, future studies would need to include a longitudinal component. This would necessitate monitoring compliance over a substantial time period and, although this is a resource-intensive approach, it would go some way to improving on the current evidence base.

6.4.6 Design interventions with impact assessment in mind

Full cost-benefit analysis of all interventions should be carried out where possible and future interventions, which are intended to increase compliance with food safety regulations, should take impact assessment into consideration from their inception.

Baseline data (indicating compliance levels before the intervention) and/or control group (indicating compliance levels in those not receiving the intervention) are essential for meaningful evaluation.

In particular, training and safety awareness initiatives should be delivered in such a way that allows some assessment of their behavioural consequences. Where acceptability and knowledge can be indicators of success, behavioural outcomes are more important to measure where compliance is a desired outcome.

6.4.7 Continue to develop targeted guidance

The evidence reviewed suggests there is a demand for simple, user-friendly, guidance which is as prescriptive as possible and tailored to particular types of premises (or individual). We understand that the FSA have achieved some degree of success in this area , and that guidance such as the „Safer food, better business‟ pack has been received well across many sectors of the food industry.

There may also be some merit in considering other target audiences such as chefs, those for whom English is not their first language, those with poor literacy and employees new to the catering industry. Guidance targeted at managers could emphasise the importance of providing feedback to employees and setting a good example. There may be scope to work with chefs and managers to establish principles of good hygiene and safety performance management, and strategies for remedying poor performance.

66

6.4.8 Provide specialised support for EHPs on communicating with SMEs

SMEs have diverse communication requirements and preferences, and a training package or „toolkit‟ that recognises this may enable EHPs to be more flexible and reactive in their dealings with small food businesses. Also, an important consideration when communicating with food businesses, particularly SMES, is a potential tendency for them to view compliance as satisfying an inspector, rather than a set of ongoing processes or systems. It may be worthwhile if EHPs explicitly address this misunderstanding with dutyholders. Guidance materials stating „what compliance is and what it is not‟ could be used to reinforce this.

6.4.9 Ensure pertinent research findings are disseminated

The applicability of all research findings to the food industry and enforcement bodies should be assessed at the time of publication and disseminated to appropriate parties. In particular, where lessons for EHPs are generated by research findings, these should be presented in a format that makes clear what its implications are for the way they undertake their duties. When circulating guidance and updates to EHPs, the material should make clear whether it is evidence based or not and the source it derives from.

FSA may wish to consider disseminating new evidence among relevant internal staff and its research partners, particularly those involved in Pennington Inquiry work streams. These could be condensed into bulletin format to minimise the paperwork involved.

6.4.10 Consider models adopted in other countries

The possibility of adopting alternative approaches could be explored further, for example in the Netherlands, where there is a shift away from direct intervention and towards indirect inducement to simulate closer co-operation in the supply chain. However, any contextual factors specific to the UK would need to be considered carefully before adopting an alternative enforcement model from another country.

67

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Appendix 1: Search Engines Used in the Review

Database Limits used Total

N

ABI/INFORM Global Title

2000 onwards

207

Applied Social Sciences Index and Abstracts (ASSIA) Title

2000 onwards

English

12

Econlit Title

2000 onwards

0

EMBASE Title

2000 onwards

English

Human

83

International Bibliography of the Social Sciences (IBSS) Title

2000 onwards

0

INGENTA* Title 184

JSTOR* Title

Article, review or editorial

2000 onwards

English

7

Medline Title

2000 onwards

English

Human

126

PsycInfo Title

2000 onwards

English

Human

16

75

Database Limits used Total

N

SCOPUS Title

2000 onwards

English

Journals

421

ScienceDirect* Title

2000 onwards

74

SocIndex (formerly Sociological Abstracts) Title

2000 onwards

English

5

Web of Science

Includes:

Science Citation Index Expanded (Sci-Expanded); Social Sciences Citation Index (SSCI); Arts and Humanities Citation Index (A&HCI); and Conference Proceedings Citation Index – Science (CPCI-S)

Title

2000 onwards

Articles, editorials, reviews

295

Wiley Interscience Title

2000 onwards

Journals

79

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Appendix 2: Search Term Identification Process

Note: This document was originally prepared as a discussion document as part of the process of developing the search strategy for the review.

Background

This document has been prepared by IES (in consultation with CWERC to directly addresses the following issues:

1. The necessity of keeping the search to a manageable size, given that the current review is insufficiently resourced to allow a wholly systematic approach.

2. Concern expressed by FSA that a search limited to documents containing „food‟ and/or „catering‟ would not capture a sufficiently wide evidence base.

3. The importance of ensuring that documents to be reviewed focus on „soft‟ influences on compliance such as culture, communication and behaviour (ie factors central to the main research question).

4. The need to ensure that the review captures sufficient material directly relevant to food safety regulation, in recognition that findings regarding some areas of business regulation (such as health and safety) are more likely to have implications for the FSA than others.

5. The acceptability of using „document title‟ as the main search field in order to constrain (in a replicable manner) the number of results yielded by selected search engines.

Discussion of specific issues

Here we set out the issues that we have considered in developing our methodology and our rationale.

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Keeping the search manageable: „Rapid‟ vs. systematic review

Some of the issues that arise when conducting a literature review within a limited budget and timeframe have been highlighted in recent research guidelines for civil servants1. These guidelines suggest circumstances where „Rapid Evidence Assessments‟ (REA) as opposed to systematic literature reviews may be appropriate and the potential pitfalls when a shorter review approach is adopted.

Due to its size, the current review will necessarily introduce some degree of bias and will also have limitations in its scope. We recognise the need to be aware of these potential pitfalls when designing and conducting the review and be explicit about these at the reporting stage.

Expansion of the search beyond food safety

In order to address FSA concerns that food safety-related searches would produce too narrow an evidence base, we have developed a new search strategy which removes this constraint and introduces others.

It is important to note that removing „food and/or catering‟ as a single step increases the number of returns by potentially tens/hundreds of thousands (this change produces output quantities in the realm of 100,000+ and renders the review unachievable).

Note that removing any term as criteria for a document search dramatically increases the number of documents returned.

In order to counter this, our proposed strategy focuses more directly on compliance and enforcement and includes, as suggested by the FSA, communication as a specific search area. Note that each „search area‟ is inclusive of several search terms, for example the area „communication‟ captures the terms „communication‟, „exchange‟, „interaction‟, „transmission‟, „discussion‟ etc.

Note also that our proposed search strategy does not exclude documents from the search which contain food, safety, health, „culture‟, and/or „behaviour‟ in any part of its title/key words/ abstract or full text.

This new strategy was trialled with key search engines (which together capture a significant proportion of peer-reviewed literature, government research reports and grey literature). The results of an initial search are shown in Table A2.1.

1 www.civilservice.gov.uk/my-civil-service/networks/professional/gsr/resources/REA-how-to-

search-strategy-how-rapid-will-it-be.aspx

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Table A2.1: (CWERC document sent to IES 25/11/09, Table 4)

psycINFO & EMBASE

Limits: Title, English, Human, 2000 onwards

ABI/INFORM Global

Limits: Title, 2000 onwards

Compliance 60,550 16,255

Communication 75,305 114,189

Business 109,743 399,851

Enforcement 99,700 137,333

Support 50,486 97,345

Compliance & Enforcement 1,798 1,177

Communication OR Business OR Support

229,222 594,009

(Compliance & Enforcement) & (Communication OR Business OR Support)

99 207 – of which 60 were journal or report publications

Note from CWERC: These publications (just the journal or report ones from ABI/INFORM) were downloaded and duplicates removed giving 154 publications altogether. Scanning the titles suggested that, of these, 37% (57) might be relevant.

This initial search (carried out purely for scoping purposes) produces a „manageable‟ number of documents to sift (154) and an estimated 57 which may be suitable for use in our review. We anticipate that the use of additional search engines will yield further documents for the sift.

In addition, consultation with experts and the use of searchable website indices (such as HSE‟s) will yield further documents for the review. We discuss how we propose to utilise expert input more fully later in this document.

Ensuring documents address culture and behaviour

We agree that these issues (and related terms) are key to the central research questions addressed by this review. Therefore we propose to address this issue explicitly in our sift strategy (we have already circulated this in an earlier document).

As noted above, the proposed search strategy is very broad and does not prevent „culture‟ and „behaviour‟ appearing as key themes in the documents that it captures.

The aim of the proposed search strategy is principally to cast a net which allows a wide range of themes to be captured, in anticipation that we can target papers/reports of specific interest (and exclude those which are not) at the sift and the later review stages.

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Capturing review material that has a bearing on food safety regulation

We acknowledge that safety is a key theme and we will use the sift process as a means of identifying documents which (as well as satisfying other criteria) are focused on safety/health and safety. Again as noted above, the proposed search strategy does not prevent „food‟ or „food safety„ or „health and safety‟ appearing as key themes in the documents that it captures.

Also, as discussed with FSA we intend to take a strategic approach to supplement our initial literature review by consulting with other experts and agencies.

Note that expert consultation as a means of supplementing more formal literature search methods is an established research approach which has been used by organisations such as NICE1 and the World Health Organization2.

Capturing relevant review material which focuses on food safety regulation

As set out in our proposal, we will utilise available food safety expertise to ensure that we do not overlook key documents in this area. FSA have already provided us with some key references (mostly „grey literature‟) and we would wish to utilise their in-house expertise to ensure that other, key, documents pertaining to food safety are included in our review. If, for example, FSA has a searchable library of published research, we would suggest that this is included in our search phase as a potential further source of literature.

Capturing relevant review material which focuses on health and safety

The Health and Safety Executive (HSE) has a searchable database of research reports which we intend to make use of in this review. In addition we plan to draw from the findings of a recent, relevant IES review that was carried out for HSE3 and consult with HSE Social Sciences Unit to ensure we cover material published since the review was undertaken.

As already agreed with FSA, we will also be consulting with experts from the following organisations to obtain material to supplement our search:

■ LACORS (Local Authorities Co-ordinators of Regulatory Services).

■ CIEHO (Chartered Institute of Environmental Health Officers).

1 www.nice.org.uk/nicemedia/pdf/Smokingreview.pdf

2 www.unece.org/thepep/en/workplan/candw/documents/Guidance_

document_summary.pdf

3 What Works in Delivering Improved Health and Safety Outcomes: A Review of the Existing

Evidence. Cox A, O‟Regan S, Denvir A, Broughton A, Pearmain D, Tyers C, Hillage J; Research Report RR654, Health and Safety Executive, September 2008.

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Capturing relevant review material which focuses on business regulation

In order to ensure we obtain relevant literature regarding business compliance within a range of enforcement areas, we propose to supplement the documents uncovered during our search by consulting with experts from the following agencies:

■ LACORS (Local Authorities Co-ordinators of Regulatory Services)

■ BRE (Better Regulation Executive, operating within the Department for Business, Innovation and Skills): we are aware of recent publications which may be relevant1,2.

Using title vs. key words

Our suggestion that we use „title‟ as a search field stems from the broad nature of the research question being addressed by this review, coupled with the time/resource pressure which limit its scope.

In order to contain the output, we need to impose some sort of limit that is (a) replicable and (b) maximises the chances that the documents we access are representative of the literature as a whole (in terms of subject matter and publication type).

The alternative of using „title‟ AND „key words‟ as search fields captures approximately one thousand times the number of documents obtained from using „title‟ alone.

Comparable reviews for NICE3 and the HSE (previously cited) have drawn on evidence bases of between 50-70: our current scoping work has already identified 50+ relevant documents, and this figure is not inclusive of the documents the FSA has sent us, nor the literature we expect to obtain after consulting with the expert sources cited above.

We recognise that this may introduce some bias (possibly towards document titles that are formal/substantive rather than informal/eye-catching). However, we feel that there has to be some level of compromise in a review of this scope and size and that the measures we are taking to supplement the evidence captured by search engines (ie expert consultation) will serve to mitigate the risks.

1 http://www.berr.gov.uk/files/file47324.pdf

2 http://www.berr.gov.uk/files/file53252.pdf

3 Review of the Effectiveness and Cost Effectiveness of Interventions, Strategies, Programmes

and Policies to reduce the number of employees who take long-term sickness absence on a recurring basis. Rick J, Carroll C, Hillage J, Pilgrim H, Jagger N; Document 6, National Institute for Health and Clinical Excellence; May 2008. http://www.nice.org.uk/guidance/index.jsp?action=folder&o=40624

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Appendix 3: Search Terms Used and Results of Search Process

Table A3.1: Search areas used and associated key words and search terms

Area Key words Search terms

Business Business, organisation, establishment, employment, work, operator, SME, small to medium size enterprise, producer, industry, sector, supply, process

Business OR organisation OR establishment OR employ* OR work OR operator OR SME OR enterprise OR produc* OR industry OR sector OR suppl* OR process*

Enforcement Enforcement, regulation, control, legislation, officer, Environmental health officer, EHO, local authority, LA, inspection, standard

Enforce* OR regulat* OR control OR legislation OR officer OR EHO OR authority OR LA OR inspect* OR standard

Compliance Compliance, fulfilment, conform, obey, agree, resist, ignore, flout

Comply OR complies OR complian* OR fulfil* OR conform* OR obe* OR resist* OR ignore* OR flout

Communication Communication, exchange, interaction, transfer, transmission, discussion, talk

Communicat* OR exchange* OR interact* OR transfer* OR transmit* OR discuss* OR talk*

Support Barriers, drivers, sustain, reward, incentive, persuade, support, effective, economic, encourage, discourage, maintain, motivate

Barrier OR driver OR sustain OR reward OR incentive OR persuade OR support OR effective OR economic OR encourage OR discourage OR maintain OR motivat*

82

Table A3.2: Demonstration of results obtained using key search engines

psycINFO & EMBASE

Limits: Title, English, Human, 2000 onwards

ABI/INFORM Global

Limits: Title, 2000 onwards

Compliance 60,550 16,255

Communication 75,305 114,189

Business 109,743 399,851

Enforcement 99,700 137,333

Support 50,486 97,345

Compliance & Enforcement 1,798 1,177

Communication OR Business OR Support

229,222 594,009

(Compliance & Enforcement) & (Communication OR Business OR Support)

99 207 – of which 60 were journal or report publications

These publications (just the journal or report ones from ABI/INFORM) were downloaded and duplicates removed giving 154 publications altogether. Scanning the titles suggested that, of these, 37% (57) might be relevant.

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Appendix 4: Variations in Search Strategy

Table A4.1: Results obtained from HSE database

All HSE websites. Anywhere on page

All HSE websites. Limited to title only

Refined to: Publications

database.

Anywhere on page

Refined to: Publications

database.

Limited to title only

Refined to:

Research database.

Anywhere on page*

Refined to:

Research database. Limited to title only

Compliance 377 40 7 0 402 10

Communication 400 22 10 0 440 8

Business 436 237 489 1 272 19

Enforcement 275 199 14 0 219 11

Support 477 139 6 0 572 29

Culture 297 23 7 0 330 14

Compliance AND Enforcement

299 1 0 0 151 0

Communication OR Business OR Support

470 252 489 1 352 55

(Compliance AND Enforcement) & (Communication OR Business OR Support OR Culture)*

257 0 0 0 124 * 0

* Bold denotes the variant of the main (academic) search strategy that was used in the review.

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Table A4.2: Results obtained from LACORS database

Anywhere on

page Limited to

title/abstract only

Complian* 490 33

Communic* 323 21

Business 623 52

Enforc* 1243 173

Support 626 17

Cultur* 136 7

Complian* AND Enforc* 92 5

Communic* OR Business OR Support 1629 131

Complian* AND Enforc* AND Communic* 5* 0*

Complian* AND Enforc* AND Business 9* 0*

Complian* AND Enforc* AND Support 7* 0*

Complian* AND Enforc* AND Cultur* 1* 0*

* Bold denotes the variant of the main (academic) search strategy that was used in the review.

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Appendix 5: Sift Pro-forma

Basic requirements for studies to be reviewed.

Academic articles

Sift of documents identified through literature search should elicit a positive response to criteria 1 and 2 AND to at least one of criteria 3 and 4.

1. a) Is the research publication date 2000 onwards?

b) Is the document text in English?

2. Is the article reporting on research?

Exclude comment and opinion items.

Exclude case studies which are purely descriptive or exploratory; consider inclusion of case studies only where they are explanatory in nature, ie where the study presents data having some bearing on cause-effect relationships.1

3. Does the article address factors influencing one or more of the following: regulatory compliance, the enforcement of legislation, safety culture, „regulation culture‟ and „regulation behaviour‟?

4. Are the issues that are discussed or investigated of relevance to the current review?

Papers of relevance would address:

■ Who does/does not comply and why?

■ What approaches are more/less effective in securing regulatory compliance?

1 Yin R (1993), Applications of case study research. Newbury Park, C A: Sage Publishing.

http://www.amazon.com/Applications-Research-Second-Applied-Methods/dp/0761925511#reader_0761925511

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■ What encourages sustained compliance?

Following our discussions with FSA, another useful indicator of relevance to this review is explicit mention of modes of communication which are effective in securing regulatory compliance; this could refer to communications:

■ within the dutyholding organisation (eg between managers and employees)

■ between the enforcing authority and the dutyholding organisation

■ within (ie between different elements of) the enforcing authority

■ across enforcement boundaries (ie between one enforcing authority and another).

Grey literature

Sift of grey literature sent by FSA or identified through literature search or designated experts1 should elicit a positive response to at least one of criteria 3 and 4 described above.

A similar approach should be taken to exclude case studies: ie exclude those which are purely descriptive or exploratory; consider inclusion of case studies only where they are explanatory in nature, ie where the study presents data having some bearing on cause-effect relationships2.

1 At this stage, 15/12/09, we envisage experts will include designated individuals from: University

of Cardiff; The Health and Safety Executive (HSE); Local Authorities Coordinators of Regulatory Services), Better Regulation Executive (LACORS); Better Regulation Executive (Department for Business, Innovation and Skills); CIEHO (Chartered Institute of Environmental Health Officers).

2 Yin R (1993), Applications of case study research. Newbury Park, CA: Sage Publishing.

http://www.amazon.com/Applications-Research-Second-Applied-Methods/dp/0761925511#reader_0761925511

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Appendix 6: Review Pro-forma

Document classification

Article type:

Please check box as appropriate

Academic article □ Grey literature □

Article sub-type:

Please check box as appropriate

Academic articles Grey literature

Quantitative research □ Report □

Qualitative research □ Case study □ Evidence/literature review □ Other – specify: □

Other – specify: □

*If „review‟, „case study‟, or „other‟, please go straight to Section 3. In all other cases (ie „quantitative research‟, „qualitative research‟, „reports‟), proceed to Section 2.

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Methodological quality

All studies:

Please check box as appropriate

Peer-reviewed journal article □

Approved by gov‟t body or NGO □

Neither (please state) * □

Quantitative studies only:

Please check box in right-hand column and elaborate, where relevant, in the article summary

Yes No NA 2.2.1 Is there evidence of:

selection bias? if “yes” please comment in summary whether this is explained □ □ □ performance bias? if “yes” please comment in summary whether this is explained □ □ □ attrition bias? if “yes” please comment in summary whether this is explained □ □ □

2.2.2 Have the following details of the study been reported:

design? □ □ □ methods? □ □ □ participants? □ □ □ interventions? □ □ □ outcomes? □ □ □

2.2.3 Are the experimental and control groups truly comparable? □ □ □ 2.2.4 Have appropriate statistics been used in the analysis of data? □ □ □ 2.2.5 Have the appropriate statistics been fully reported? □ □ □ 2.2.6 Are there any missing data that need to be gathered/followed-up? □ □ □ 2.2.7 Do the findings and analysis support the author‟s conclusions? □ □ □ 2.2.8 Are there any other concerns about the way the study was carried out? (Please highlight these in the article summary) □ □ □

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Qualitative studies only:

Please check box in right-hand column and comment, where appropriate, on „No‟ responses in the article summary

Yes No NA 2.3.1 Are the underlying assumptions of this study clear? □ □ □ 2.3.2 Has the research design of this study been justified? □ □ □ 2.3.3 Are the following presented in the study

sample design? □ □ □ case selection? □ □ □ analytical approach? □ □ □ attrition bias? □ □ □ documents used? □ □ □

2.3.4 Have any reasons for non-participation of subjects been made clear? □ □ □ 2.3.5 Have the data collection procedures been made explicit? □ □ □

Recording findings for inclusion in review

Please use table below to guide data extraction and aid completion of article summary sheet in Section 4 (topics in left-hand column are suitable for use as headings)

YES NO

3.1 Does the study address any of the following factors within the dutyholding organisation and their influence on compliance?

3.1.1 Size/nature of business/position in supply chain/ membership of trade association and/or accreditation schemes of the dutyholding organisation?

If “yes” please record details in article summary

□ □

3.1.2 Behaviours within the dutyholding organisation?

If “yes” please record details in article summary □ □ 3.1.3 Safety culture within the dutyholding organisation?

If “yes” please record details in article summary □ □ 3.1.4 Modes of communication within the dutyholding organisation?

If “yes” please record details in article summary □ □ 3.1.5 Other within organisation factors (please state)?

If “yes” please record details in article summary □ □

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YES NO

3.2 Does the study address any of the following factors within the enforcing body and their influence on compliance?

3.2.1 Organisational characteristics of the enforcing body?

If “yes” please record details in article summary □ □ 3.2.2 Behaviours within the enforcing body?

If “yes” please record details in article summary □ □ 3.2.3 Enforcement approach of the enforcing body?

If “yes” please record details in article summary □ □ 3.2.4 Organisational culture within the enforcing body?

If “yes” please record details in article summary □ □ 3.2.5 Modes of communication within the enforcing body?

If “yes” please record details in article summary □ □ 3.2.6 Other factors within the enforcing body (please state)?

If “yes” please record details in article summary □ □ 3.3 Does the study address any of the following factors with respect to interaction of the enforcing body with other parties? 3.3.1 Modes of communication between the enforcing body and the dutyholder?

If “yes” please record details in article summary □ □

3.3.2 Approach to working across enforcement boundaries and with other enforcing bodies?

If “yes” please record details in article summary

□ □

3.3.4 Other factors with respect to interaction of the enforcing body with other parties?

If “yes” please record details in article summary □ □ 3.4 Does the study address any other factors not covered above which have a bearing on the current review?

If “yes” please record details in article summary

□ □

Article summary

PLEASE RECORD/PASTE SUMMARY OF ARTICLE HERE

This should include:

■ brief description of research methodology, expanding on information in checked boxes in Section 2

■ brief description of relevant research findings, expanding on information in checked boxes in Section 3.

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Appendix 7: Documents Included and Excluded

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*168 articles were of relevant and of sufficient quality to be reviewed but were not cited in the text of this review. In these cases

there were other (more relevant) articles which better illustrated the arguments being made.

Search total

(N=1,728)

Excluded duplicates

(N=619)

Potentially relevant

(N=1,109)

Potentially relevant

(N=282)

Excluded scope

(N=827)

Excluded scope

(N=114)

Reviewed for potential

inclusion in report

(N=168)*

Relevant but not cited

in report (N=66)*

Included in report

(N=102)

Sift phase two

(on basis of reading full

document )

Sift phase one

(on basis of title, abstract)

Review phase

Search:

(initial exclusions due to

overlapping search engine

results)

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Appendix 8: Categorisation of Included Documents

Document type (number of documents)

Academic articles

35 Grey literature 67

Subject area (number of documents)

Food-related 17 Non food-related

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Methodology (number of documents)

Quantitative only

27 Qualitative only

14 Literature

review only 25

Mixed methods

36