A Practical Guide to First Aid in the Workplace

As stated by the UK Government Health and Safety Executive (HSE):

• The Management of Health and Safety at Work Regulations 1999 place an obligation on employers to assess risks and, where necessary, take action to eliminate or control the risks
• The Health and Safety (First-Aid) Regulations 1981 require employers to provide adequate and appropriate equipment, facilities and personnel to ensure their employees receive immediate attention if they are injured or taken ill at work
• These regulations apply to all workplaces, including those with less than five employees and to the self-employed

It is the legal duty of employers to have arrangements in place for administering first-aid to staff who are injured or become ill at work. This applies irrespective of whether or not the situation was caused, directly or indirectly, by the work itself.

‘Adequate and appropriate’ will vary from workplace to workplace. That’s why it’s essential to carry out a comprehensive assessment of first-aid needs on your premises.

Employers are also legally obliged to inform all employees of the arrangements in place for the provision of first aid, including the location of relevant equipment, facilities and personnel.

While there is no legal requirement for employers to provide adequate first-aid responses for non-employees (including the public), HSE strongly recommends that all potential site visitors be included in your needs assessment and catered for accordingly.

In the event of injury or sudden illness at work, employers failing to provide appropriate first-aid can be prosecuted by HSE. Prosecutions are likely in cases where there is shown to be:

• Significant risk to employees that was not suitably mitigated
• Disregard for established standards
• Persistent poor compliance with the law

Those who work from home in a self-employed capacity also have a legal duty to ensure appropriate first-aid equipment and facilities are present, to be administered to themselves in the event of an accident:

• Low-hazard self-employment, such as desk-based paperwork at home, does not require the individual worker to provide anything beyond a basic first-aid kit suitable for general domestic use
• Higher-risk self-employment, such as long-distance driving, may require the individual to keep appropriate first-aid equipment on hand at all times

Self-employed workers in shared workspaces are responsible for their own first-aid requirements and duties. If an arrangement is made between a group, HSE advises that this be agreed upon in writing. More specific industrial first-aid legislation applies in a number of higher-risk sectors such as offshore work and diving, so make sure you’re familiar with the requirements for your industry.

All employers, self-employed people and people in control of work premises have duties under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR):

• They must report certain work-related injuries, cases of ill health and dangerous occurrences
• HSE will pass details to the relevant enforcing authority
• RIDDOR applies to all work activities but not all incidents are reportable

It is also advised that people have an accident report book in which they record all incidents. Any records made in reporting incidents must be stored in line with the Data Protection Act.

It’s vital that all employers undertake an assessment of first-aid needs in their work environment. The aim is to achieve a sound overview of the sorts of first-aid arrangements you might need in place on your premises.

HSE advice notes that:

• ‘You as an employer are best placed to understand the exact nature of your workplace, and decide what you need to provide’
• First-aid provision must be ‘adequate and appropriate in the circumstances’

Assessing first-aid needs in your business premises starts with careful consideration of the physical environment. What are the conditions like in the workspace? Are there any obvious hazards that are specific to that environment?

Think about all aspects of the workspace that could contribute to an incident requiring a first-aid response. Pay especially close attention to:

• Any active machinery
• Chemicals and other hazardous materials
• Uneven or elevated floors and walkways
• Confined spaces
• Areas exposed to harsh weather conditions
• Electrical hazards
• On-site traffic (e.g. warehousing or construction)
• Sharp or heavy implements
• Slipping or tripping hazards
• Any other potential sources of accident or injury

You should also include an assessment of the types of work done on-site, the size and nature of your workforce and its shift patterns, employee experience levels, and the likely impact of any holidays/absenteeism on the first-aid arrangements in place.

Think more expansively about any other potential factors outside of the immediate workplace environment, including:

• Travelling, remote or lone workers
• The proximity of your premises to emergency services and medical facilities
• The arrangements in place for any shared occupancy sites
• First-aid provision for site visitors, non-employees and the general public

For additional guidance, research your company’s accident history to help assess the sorts of measures you may need to have in place.

In workplaces with more obvious or potentially dangerous hazards, it’s likely you’ll need a trained first-aider on site at all times.

In standard offices, shops and other workplace environments free from any obvious hazards, it may be sufficient to provide access to a basic first-aid kit and assign a first-aid supervisor (an ‘appointed person’).

In either case, one or more specific individual(s), depending on the size of the workforce, should be assigned direct responsibility for:

• Keeping first-aid kits fully stocked and easily accessible
• Calling the emergency services if required
• Arranging first-aid supervision cover for themselves when not at work
• Informing employees of any temporary backup or cover arrangements

Appointing someone specific to take charge of first-aid arrangements at all times is a MINIMUM requirement in any workplace. In a relatively hazard-free environment, this person needn’t always necessarily have any specialist training.

Keeping a fully stocked (at all times) and accessible first-aid kit on site is the minimum requirement, even in less immediately hazardous work environments.

Larger sites may need more than one kit; injured employees or their colleagues should not have to move far from the accident location to access first-aid supplies.

It’s paramount that an employer informs his employees of existing arrangements with regard to first aid. Everyone on site must know:

• What and where the arrangements and facilities are in the event of an accident
• Who is responsible for overseeing basic first-aid procedures and equipment

There is no mandatory list of items that a properly stocked first-aid box must contain; it’s a case of common sense based on an appropriate assessment of the working environment. Stocked items should reflect the outcome of this assessment.

Suggested basics for a low-hazard environment kit include:

• A first-aid guidance leaflet
• Individually wrapped sterile plasters in various sizes appropriate to the nature of work
• Sterile eye pads
• Individually wrapped sterile triangular bandages
• Medium-sized sterile wound dressings
• Disposable gloves
• Safety pins

On larger, busier or more hazardous sites, your needs assessment may indicate it’s appropriate to provide a dedicated first-aid room. This should be centrally located, easily accessible to all, and supervised by a specific member of staff.

Dedicated first-aid rooms should be:

• In a convenient, easily accessible location for all employees
• Clearly signposted, to comply with regulation 4 of the Health and Safety (Safety Signs and Signals) Regulations 1996
• Open whenever people are at work
• Supervised at all times by a specific member of staff
• Large enough to fit in a medical couch and a chair, with space around it for examinations
• Clean, heated, well-lit and well-ventilated spaces with washable surfaces
• Plumbed with hot and cold running water
• Supplied with drinking water and cups
• Kept tidy, organised and free from obstacles
• Connected to a telephone, or have reliable mobile reception
• Located as close as possible to an access point for emergency services

If a dedicated room cannot be assigned exclusively on a permanent basis, other activities taking place in the room should be minimally disruptive, interruptible at short notice, and use only furniture arrangements that can quickly be reconfigured to a first-aid setup.

Only someone trained in first-aid is typically referred to as a ‘first-aider’. An untrained first-aid supervisor is usually called an ‘appointed person’.

Depending on the overall level of hazard you’ve assessed in your workplace, the first-aid supervisor may or may not need to be a trained first-aider.

As a minimum, an appointed person must be on-site at all times when people are working. This person is responsible for keeping the first-aid kit stocked and replenished.

If your supervisor is not trained in first-aid, their key duties in the event of an accident are:

• To take charge when somebody is injured or becomes unwell at work
• To be responsible for ensuring the injured or unwell party can access first-aid facilities and equipment
• To find a trained first-aider if one is available
• To contact the emergency services as necessary

Appointed persons should not attempt any first-aid treatment beyond their level of training or experience.

The findings of your first-aid needs assessment will dictate whether or not you need a qualified first-aider on site. If you do, appropriate training for the level you identify as necessary might include:

• First aid at work (FAW)
• Emergency first aid at work (EFAW)
• Other first-aid training appropriate to the nature of the work and site

EFAW training equips an individual to administer a general first-aid response in an emergency situation.

FAW training equips an individual to administer a general first-aid response in an emergency, as well as to provide other first-aid treatments for a range of more specific illnesses and injuries.

It’s always a good idea to send your trained first-aiders on annual refresher courses, to help keep them up to date with basic skills and aware of any recent changes to standard protocol.

It’s the employer’s responsibility to ensure they’re happy with the level of training their first-aiders will receive. As an employer screening a potential training provider, be prepared to ask:

• What the provider’s own qualifications are
• What specific course will be taught, and how it’s structured
• Which QA processes are in place for assessing and measuring the impact of training
• What qualifications, if any, trainees will receive
• What workplace duties the trainee should be able to undertake as a result

There are a great many training courses available for teaching first-aid in the workplace, ranging from nationally recognised and regulated qualifications in FAW and EFAW to courses provided by voluntary services (St. John’s Ambulance, British Red Cross), and courses designed by independent providers.

The number of appointed persons or trained first-aiders you need will be determined by your workplace hazard assessment, the nature of work on-site, and the number of employees.

As a very general rule of thumb:

• In low-hazard environments, at least one appointed person for workforces up to 25 people; at least one EFAW-trained first-aider per 50 people; at least one FAW-trained first-aider per 100 people
• In higher-hazard environments, at least one appointed person for workforces up to 5 people; at least one EFAW -trained first-aider per 25 people; at least one FAW-trained first-aider per 50 people

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