Fix workforce problems in environmental health or risk further outbreaks of foodborne disease
- Mark Elliott, president
- Chartered Institute of Environmental Health
Environmental health has a critical role in safeguarding the public against foodborne diseases. The UK’s steady rise of foodborne illnesses in the past two years,1 including the recent outbreak of Escherichia coli, underscores the importance of environmental health teams in ensuring food safety and the urgent need to fix workforce shortages across the profession. Hospital admissions for salmonella, E coli, and campylobacter reached record highs in England in 2023.1 Without timely action to tackle staffing, training, and resourcing shortages in environmental health teams in local authorities, national outbreaks of foodborne disease will continue to rise.
Environmental health professionals are a core part of the public health workforce, but their contributions often go unrecognised, particularly as so much of their work is focused on prevention. They are tasked with ensuring that all the physical environments we work, live, and share with one another are safe—encompassing the air we breathe, the homes we live in, and, crucially, the food we eat.
Environmental health professionals often work directly in businesses to inform their food safety practices or in local authorities to advise, regulate, and enforce legislation—such as the 1990 Food Safety Act.2 They are our first line of defence against foodborne illness, conducting regular inspections of food establishments to assess compliance with hygiene and safety standards. Environmental health professionals regularly take food samples from manufacturers, businesses, and retailers for microbiological testing including tests for E coli bacteria.
Beyond preventing potential risks of foodborne illness, environmental health professionals also seek to investigate local food complaints and deliver enforcement action. This includes seizing products and issuing a formal notice to prevent localised problems from becoming a national or international threat. In the instance of an outbreak like E coli, environmental health professionals and the Food Standards Agency work together with other agencies to issue a food hazard warning and work to investigate and control the outbreak. Environmental health professionals will also identify future preventive measures that the food premises implicated in an outbreak should take and how they can mitigate the risks of future outbreaks.
It’s clear that environmental health professionals are crucial in identifying, preventing, and subsequently tackling outbreaks of foodborne illnesses. But the profession is grappling with a staffing and resourcing crisis that is severely compromising its ability to ensure public safety, resulting in what has been described as a “Russian roulette” of foodborne illnesses in the UK.3
Unsustainable shortages
The 2021 workforce survey by the Chartered Institute of Environmental Health (CIEH) found that over half of local authorities had vacancies in their environmental health teams that were left unfilled for six months or more.4 The vast majority—four of five local authorities—were using agency staff to deliver environmental health services. Supplementing permanent workforce shortages through agencies isn’t only financially unsustainable, costing £20.7m in the 2022-23 financial year,5 it’s also ineffective for delivering statutory environmental health duties that require trained environmental health professionals. A third of respondents to the 2021 survey thought that fundamental environmental health duties were at risk because of resourcing issues.
Beyond the struggle to recruit trained professionals, CIEH’s 2021 workforce survey also found that only half of local authorities had the capacity to train and support a new generation of environmental health professionals.4 These capacity problems are exacerbated by barriers to training and developing current environmental health professionals, with 69% of local authorities anticipating gaps in the skills or knowledge of their environmental health workforce.4
More needs to be done to train, attract, and retain skilled environmental health professionals so that the UK has a sustainable profession that can adequately protect public health. To that end, CIEH has established a Workforce Satellite Panel with representatives from across different sectors to investigate these problems and will report their recommendations later in the year. As president of the CIEH, I have also established a commission to inquire into the capacity and capability of environmental health.
But we can’t make environmental health fit for the future alone. CIEH is calling for wider legislative action to support local authorities’ efforts, such as the introduction of a Mandatory Food Hygiene Rating Scheme. This scheme, which forces premises to disclose their food hygiene practices to consumers, has been found to reduce foodborne related illness in both Wales and Northern Ireland.6 England should follow their lead and make this a legal requirement to encourage businesses to improve their food hygiene practices and to empower the public with knowledge.
The new government should protect public health by adequately funding local authorities’ environmental health teams, with sufficient ringfenced funding for apprentices and trainees. This will help grow the pipeline to environmental health and encourage the next generation of environmental health professionals. The new government should also prioritise additional funding to enhance the capacity of environmental health functions in local authorities. Tackling the funding and workforce challenges across environmental health is vital to ensure the UK’s health is safeguarded.
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